Flat feet can be a sign of a tarsal coalition. In particular, they cause a flat foot called a rigid flat foot – which is one where the position of the foot is stuck in that position. Tarsal coalition rigid flat feet can be very painful and sometimes can lead to a poor diagnosis and long term damage.

Tarsal coalition – By definition is an abnormal union between two bones within the tarsal region of the foot. At Sole Therapy we see a lot of flat feet but this case was very different.

Ankle PainPresentation:

A 13 year old female presented to Sole Therapy complaining of ankle pain, where her mother states that her daughter has ‘flat feet’. Pain is generally worse after participating in physical activity or standing for extended periods of time.
X-Ray confirmed the diagnosis of a calcaneonavicular tarsal coalition.


Assessment findings:

Flat foot pain

1.  A flat foot with pain on the outside and inside of the ankle.

2. Not being able to toe raise or circle her foot fluently (symptoms that indicate a tarsal coalition).

3. In addition to this her ankle range of motion was restricted at end point range of motion, as it is lacking a tarsal joint.


Abnormanl connection bone

A surgical opinion is often warranted after confirming the presence of a tarsal coalition, as full pain relief through the use of an orthotic is not always achieved at this stage as there is no tarsal joint to work with. Surgery often involves creating a joint space where the coalition is formed, thus offering the patient the best chance to restore normal ankle function.

Post-surgery it is advised that the patient does move into a pair of orthotics and supportive shoes to help maintain corrective structural alignment and optimise the functionality of the foot itself. Additionally ankle strengthening exercises are also recommended to ensure ankle stability is maintained.

Daniel TalevskiWords From Dr Daniel Talevski (Senior Podiatrist) “We LOVE seeing kids as we can fix their pain quickly, improve their posture long term and keep them active. We treat the cause of the problem and not just the symptoms. We are very lucky in that we see and help literally hundreds of kids every year!

If your child has flat feet don’t put off a biomechanics assessment. Make an appointment with us today. We can help improve your child’s posture and rule out any other hidden factors that may debilitate them for life”

Please call our helpful team on (02) 9583 1138 and our team will answer any questions and help with making times to see our Podiatrists.

Healthy regards,
Dr Daniel Talevski