Medically reviewed by Dr. Tom Biernacki, DPM
Board-certified podiatric surgeon | Balance Foot & Ankle, Howell & Bloomfield Hills, MI
Last reviewed: May 2026
Tarsal coalition near Auburn Hills is the most commonly missed cause of chronic “ankle sprains” in teenagers — and the window to remove it without developing permanent arthritis in the adjacent joints is shorter than most families realize. There’s a specific age range where surgical outcomes are dramatically better. Call (810) 206-1402 — tarsal coalition evaluations in Auburn Hills.
Medically Reviewed by: Dr. Tom Biernacki DPM · Board-Certified Podiatrist · Balance Foot & Ankle PLLC · Updated 2026
Tarsal Coalition Treatment Near Auburn Hills, MI
Tarsal coalition treatment near Auburn Hills, MI is available at Balance Foot & Ankle in Bloomfield Hills. Dr. Biernacki DPM diagnoses tarsal coalition — the congenital bony bridge causing rigid flatfoot and recurrent ankle pain in teens and adults — with CT scan, then manages with orthotics for fibrous types or surgical resection and arthrodesis for bony coalitions causing significant pain. Call (810) 206-1402.
Tarsal Coalition: When Foot Bones Fuse Together Abnormally
Tarsal coalition is a developmental condition where two or more of the hindfoot bones fail to properly separate during fetal development — remaining connected by a bony, cartilaginous, or fibrous bridge. The most common types are calcaneonavicular coalition (between the calcaneus and navicular, about 53% of cases) and talocalcaneal coalition (at the middle facet between the talus and calcaneus, about 37% of cases). These coalitions are present from birth but typically become symptomatic during adolescence — between ages 9–16 for calcaneonavicular and 12–16 for talocalcaneal — when the coalition ossifies and begins restricting normal subtalar motion. The result is a progressively rigid, painful flatfoot with limited inversion/eversion motion. The most distinctive clinical sign: the foot does not correct on tiptoe standing — unlike flexible flatfoot where the arch reforms. In our Auburn Hills-area patients, we diagnose tarsal coalition most commonly in teen athletes presenting with unexplained recurrent ankle pain, peroneal muscle spasm, or a flatfoot that hasn’t responded to orthotics after 3–6 months. CT scan is essential for surgical planning — it shows coalition type, extent, and presence of secondary degenerative changes that determine whether resection or arthrodesis is appropriate.
Key Takeaway: Teen with rigid flatfoot that won’t correct on tiptoe + recurrent ankle sprains = tarsal coalition. CT scan shows type and extent. Fibrous: orthotics + activity modification. Bony without arthritis: surgical resection + interposition graft. With arthritis: arthrodesis. Outcomes after resection in young patients without arthritis are excellent.
Treatment Options
Conservative management: For fibrous/cartilaginous coalitions or mild bony coalitions without secondary arthritis: custom orthotics providing arch support and limiting subtalar range of motion, activity modification, and boot immobilization during acute flares. Many patients manage through adolescence conservatively, and some fibrous coalitions become asymptomatic in adulthood. Surgical resection: Calcaneonavicular coalition: excision of the bony bar + extensor digitorum brevis or fat graft interposition. Excellent results in patients <16 with no arthritis — restores subtalar motion, relieves pain, allows return to sport. Talocalcaneal coalition resection: for coalitions <50% of the posterior facet, no arthritis, <16 years. More technically demanding. Arthrodesis: When secondary arthritis is present or coalition is too large to resect — isolated subtalar fusion provides reliable pain relief. Recovery after resection: NWB cast 3–4 weeks, then progressive WB and PT, return to sport 3–4 months.
⚠️ See a Podiatrist If:
- Teen with rigid flatfoot — arch doesn’t reform when standing on tiptoe
- Recurrent ankle sprains in an adolescent with limited foot inversion
- Peroneal muscle spasm holding the foot in a fixed valgus position
- Orthotics not helping flatfoot pain after 3+ months in a teenager
- Hindfoot stiffness with activity-related midfoot or ankle pain in a young adult
Pediatric Flat Feet Support Products
For children with symptomatic flat feet, these arch support options are appropriate for growing feet:
PowerStep Pinnacle Kids Adapt Insoles — Pediatric Arch Support
Designed specifically for growing feet — not an adult insole trimmed down. The Adapt’s adaptive arch support works with your child’s natural foot shape rather than forcing a fixed arch profile, and the low-profile design fits most children’s athletic shoes. For children with symptomatic flat feet (pain, fatigue, gait abnormalities), these are an excellent first-line option before custom orthotics. Trimmable to fit.
New Balance 860 Kids — Best Stability Shoe for Flat-Footed Children
The 860 series is one of the few stability running shoes designed and fitted for children — not just a scaled-down adult shoe. The medial post corrects the excess pronation associated with flat feet, the wide last accommodates pediatric foot width, and the durable construction holds up to the abuse children’s shoes take. For flat-footed kids who are active in sports or experience foot/knee fatigue, proper footwear is the highest-impact intervention available.
OrthoInfo – AAOS: Tarsal Coalition
Getting to Our Office From Auburn Hills
Our Bloomfield Hills office at 43494 Woodward Ave #208 is about 18 minutes from Auburn Hills via I-75 S to Woodward Ave. We accept most major insurance. Call (810) 206-1402 or book online.
Rigid Flatfoot in a Teen? Get a CT-Based Evaluation
Balance Foot & Ankle · Serving Auburn Hills & Michigan
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📋 Dr. Tom Biernacki, DPM, FACFAS answers:
Tarsal coalition near Auburn Hills is a condition where two or more tarsal bones are abnormally connected by bone, cartilage, or fibrous tissue. Our podiatrist serving Auburn Hills first attempts conservative management, which is effective for many patients. This includes immobilization with a walking boot or cast, custom orthotics to control abnormal motion, and physical therapy to reduce muscle spasm and improve function. Corticosteroid injections can relieve localized inflammation. When conservative care fails — typically after three to six months — surgical resection of the coalition is performed. The surgery removes the abnormal connection and interposes fat or muscle tissue to prevent re-fusion. Most patients near Auburn Hills experience significant pain relief and improved range of motion after resection. Early diagnosis is important because longstanding coalitions can lead to degenerative arthritis.
Dr. Tom Biernacki, DPM is a board-certified foot & ankle surgeon (ABFAS & ABPM) at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has made him one of the most-followed foot & ankle educators on YouTube.