Tarsal Coalition...Pain in Feet

[Whazel]

Hi there.
I kind of doubt anyone will respond to this as a Tarsal Coalition is a pretty rare condition apparently.  But I have it.
Basically I have flat feet and a lot of pain around the top and inner areas of both feet.  My Ortho has had me in boot casts and real walking casts for the past 6, almost 7 months, along with getting orthotics made for my shoes and to help my arch.
He has said that surgery isn't a good idea as I'm 32 and most surgeries for this disorder/condition are done at a pediatric level.  The thing is is that I'm just not improving.  I'm a nature photographer and my feet are my livelihood.
The pain I get from just want on beach rocks is horrendous, top that with chronic back pain from three previous spinal fusions and I'm a walking ad for chronic pain.  
I'm just wondering if anyone knows about this, has it or knows anyone that has had surgery as an adult that has been successful.  The main surgery is a full fusion of two or three of the ankle/foot bones.  The other is an excision of some bone to allow for better movement which would result in less pain.
I'm just really frustrated...I see my doc on Monday and I need to go to him with some good information so he doesn't just stick me in another cast...I need to get back to work!
HELP!!

[DrNavneetMD]

Hello Dear,

Be patient and try to learn with the disease well and will to overcome the disease.
A tarsal coalition occurs when the bones of the feet fail to separate during fetal development. This leads to a problem in the foot that can be painful. It also may cause a stiff, flat foot. The condition is not common, but it is not rare. About one in a hundred people, 1% of the population, have a tarsal coalition.
Surgery for tarsal coalition falls into two categories: 1) surgery to remove or excise the bar and attempt to restore normal motion between the two bones or 2} surgery to fuse the affected joints together solidly.
As a general rule, excision is more likely to be successful in the younger child. In the older child or adolescent, a fusion may be required.
Fusion, also called an arthrodesis is a surgical procedure that is usually done when a joint becomes worn out and painful. The purpose of a fusion is to stop the motion between two or more bones. The procedure is done by removing the cartilage that covers the joint surfaces and allowing the bone surfaces to heal together or fuse as one bone.
[Reference- http://www.eorthopod.com/public/patient_education/6639/tarsal_coalition.html]

Best.
Take care

[Jakkie15]

I know this might not help a whole lot,
but I'm 17 and i have tarsal coalitions in both of my feet as well.
When I was 15, I had my first surgery for it on my right foot.
My doctor removed the extra cartilage and my the pain went away as soon as I could start moving again.
I would have to say it was one of the best dedcisions I've ever made and I could thankfully play sports and stay active after the procedure.
Tomorrow I actually get my left foot done.
My doctor said he would only preform the surgery if that foot ever became painful, and unfortunatly it has.
It was amazing what happened to my right foot after the surgery.
I use to have so much trouble with sprained ankles and always injuring it- but I haven't had an issue since.

[nanabee11]

I have many sugerys on both feet the last one was june of2009 the doctor used stem cell but i am still having alot of trouble and when i go on my feet to long i get in so much pain i dont know what the next step maybe  i will have to be in pain for the rest of my life i really do want to and i am only 45

[olsonkids4]

my son has had excersion surgery on both feet for tarsal coalition..he actually had the left done twice..finally we had both sub joints fused...best thing we ever did.  He is not completely pain free but a whole lot better.  He played football last fall and is now playing baseball.  First surgery was when he was 9 and the last of the surgeries he was 16.  We have been through it all so ask if you have any questions

[TCgirl05]

I am 31 and have the same thing. The pain has gotten more consistent and worse because I now have degenerative arthritis in my ankle. A guy has a blog about his surgery with entries/pictures and its pretty extensive. He was 35. I would say to get a 2nd opinion because it will get worse as you get older-thats why im having mine done. I was never athletic but I would like to enjoy things as simple as walking through the mall without having to take the next day off.

[SarahLove8]

hi,
i have tarsal coalition in my left foot and it is extremely painful for me to walk. the doctor has suggested i have the surgery but is it to risky?

[busybeekeeper]

My daughter is 12 and has just had excision op and recovering. Just wondered what the post op physio was like... how intensive? Also what is the feedback for excision a couple of years down the line? Can anyone help?

[horselover88]

Im 23 I have it too and I am really getting annoyed by the pain Im thinking about getting another cast but Idk if its worth it. The pain never goes away fully and I dont want to get surgery yet  Im afraid it wont work the first time :/ its just hard because its so rare and theres really not that much you can do for it. At least thats what Ive found!!

[amers81]

Hi,
I normally never comment on forums, but i was online trying to research more about coallitions in children.  My son who is 10 just got back from the doctors and we are pretty sure he has the same thing that i did.  I was diagnosed with a tarsal coallition when i was 27.  Growing up i remember always having on and off pain in my ankle, but since i played basketball my mom just thought it was sports related.  One day i came home from work and my foot was killing me, I looked at it and it was all bruised and swollen.  I went to the first doctor who told me that i just had arthritis and to take some motrin and come back if it got worse! Really?!  I was only 27 and couldn't even walk on my foot. I decided to get a second opinion and went to a specialist.  he took an Xray and thought he knew what it might be but ordered an Mri just to be sure.  When i went back he told me i had a tarsal coallition, and because it was left untreated for so long, i ended up tearing one of my tendonds on the side of my foot, which was causing all the swelling.  He told me we had to do surgery and that it was going to be complicated, they had to unfuse my coallition, fix the torn tendon, and because i was never able to bend my ankle correctley growing up my achillis (sp) tendon had become tight so they werer going to lengthen my achillis tendon.  I had the surgery 4 years ago, the recovery process wasn't the easiest but after a couple months of physical therapy i was back to work and feeling great!  Since my surgery i have had no pain at all in that foot!  It has been amazing and if your doctor says your too old to have the surgery, go to a different doctor.  yes, the surgery is much easier to do in children,but that doesn't meant that we have to suffer as adults.  Having the surgery was the best thing i did.  Hope this helped some of you.  The best part is that i am aware of it and when my son started complaining about his ankle i knew that we needed to get him in.  Good luck to you guys and I hope you find the answers you are looking for

[janejane13]

Hello,
My 10 year old is having tarsal coalition repair of one foot. How bad is the post op pain the first few days? We are very worried.
Thank you!

[ri626]

Hi,
I also have tarsal coalition in my left ankle and the specialists all say I should get the fusion surgery since I'm 20, and that I'm too old for the corrective/excersion surgery.
But playing AFL is a big part of my life and since the fusion surgery inhibits all lateral movement, I'm not sure if I should choose that surgery. I really want the corrective surgery but have heard from the specialists that it's really risky and unpredictable. I would love any feedback on anyone who's had either of surgeries and how they went with sport when it was all healed.
Also, after fusion surgery, how is the foot when walking on uneven ground (due to no lateral movement)?
I'm extremely scared I'll lose all lateral movement and don't want to not be able to run around with future kids etc.

[Irving63]

Yea I'm 22 and I just found out that I have it. .I use to play football but the foot caused me to stop playing ever day is a day full of pain...is surgery the only way to stop the pain?

[Cate_M]

Hello,
I have this too, to be exact I have a Subtalar Tarsal Coalition. Unlike some of the other people who have above stated their stories, I never had issues with spraining my ankle, or rolling it. My foot's movement was restricted by an additional 25-30% in comparison to the average coalition patient according to the orthopaedic specialist I went to see. So I had no ability to roll my ankle, because it was impossible. I had the coalition only in One of my feet.

But like most tarsal coalition patients, I did experience pain. Some days, I couldn't walk. My pain got severely worse if I had exercised and then rested. For example, I would play a soccer game, drive home, and would't be able to walk to my front door. And I'm not a wuss when it comes to pain, I once broke three bones at once and was convinced it was just bruised. ( which may speak more to my stubborn personality than anything else)

Before I go further into things, I should probably let you know that I DID have the surgery recommended. The surgeon was the Top Orthopaedic surgeon in my country.

It is now two years after the surgery, and the pain is Worse than it was before I had the surgery. The movement in my foot was improved by an estimated 2-3%. Which is nothing. About a centimetre. In the first two months after the surgery, my doctors thought the pain I was feeling was simply due to the trauma my foot had undergone, and perhaps some prolonged pain for some reason. They kept me on regular doses of a variety of pain medications, which knocked the edge off but little else. Two and a half years later, My doctor is asking me why I don't want to accept his prescription for either vicodin, oxycodon or Tylenol 3's (which consists mainly of codeine, all of which are class 3 painkillers).  He is a good doctor, very ethical, very by-the-book. ( In my opinion). The surgeon I had was fabulous, with a great success rate. I did all of the rehab I was supposed to do. My diet is healthy.

But I walk with a permanent limp. I live in constant, nearly unbearable, pain. I am an athlete, who can no longer play sports. I am a girl that cannot dress her favourite outfit with a nice pair of shoes. I can't go for a run with my dog, hike with my friends, or walk to the store if its further than 15 minutes away. I can't get out of bed right away, or I will fall onto my face. I've had doctors suggest that I amputate the foot to relieve the pain. They truly believe its a better option than what I currently live with.

I'm not trying to turn anybody off of the surgery, --I'm not. But I think that EVERYBODY should be Fully Aware that this surgery, -however good the success rates, the surgeon, the rehab, the everything else that should matter-it still has a % that is not successful. Usually that means that nothing changes. But in a rare amount of cases, you will end up like I did. In more pain. And this time, its going to get to be emotionally painful too, because it's like loosing the rest of your limb. If you are not prepared for the surgery to do harm, do not hope that the surgery will do good.

For those of you that choose the surgery route, I wish you all the very best. I hope, I very much hope, that this surgery will be a complete success for all of you.

Signed,
A 16-year-old girl

[MelG622]

Wow  I can totally relate !!  I'm 35 and just had surgery  to remove my Coalition two days ago. I had surgery 20 years ago however that Dr. Just fused the bones which really left the collision untreated which  affected my tendon ,  and it has caused horrible pain  throughout the years.  I am looking forward to being  able to walk and ride my bike without pain.  The recovery process is rough but I know it will be worth it.