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 Hartland 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 Hartland.
Medically Reviewed by: Dr. Tom Biernacki DPM · Board-Certified Podiatrist · Balance Foot & Ankle PLLC · Updated 2026
Tarsal Coalition Treatment Near Hartland, MI
Tarsal coalition treatment near Hartland, MI is available at Balance Foot & Ankle in Howell. Dr. Biernacki DPM evaluates and treats tarsal coalition — an abnormal bony or fibrous bridge between hindfoot bones causing rigid flatfoot and recurrent ankle pain — with CT-guided diagnosis, custom orthotics for partial coalitions, and surgical resection or arthrodesis for symptomatic bony bars. Call (810) 206-1402.
The Rigid Flatfoot That Won’t Respond to Orthotics
A tarsal coalition is an abnormal bridge — bony (synostosis), cartilaginous (synchondrosis), or fibrous (syndesmosis) — connecting two normally separate hindfoot bones, most commonly the calcaneonavicular (between the calcaneus and navicular) or talocalcaneal (between the talus and calcaneus at the middle facet) joints. It is congenital in origin, present from birth, but typically becomes symptomatic in adolescence when the coalition ossifies and limits subtalar motion. The clinical presentation: a teenager or young adult with a rigid, painful flatfoot that doesn’t correct on tiptoe standing, recurrent ankle sprains, or classic peroneal spastic flatfoot — involuntary spasm of the peroneal muscles producing a fixed valgus deformity that resists passive correction. In our Hartland-area patients, tarsal coalition is frequently discovered during evaluation for “recurrent ankle sprains that won’t get better” in teens — the coalition restricts subtalar motion, loading the lateral ankle ligaments abnormally with every step. CT scan is the definitive diagnostic test: it shows the extent of the coalition, the joint surfaces involved, and whether secondary arthritis has developed — which determines surgical planning.
Key Takeaway: Rigid flatfoot in a teen that doesn’t correct on tiptoe = tarsal coalition. Peroneal spastic flatfoot = talocalcaneal coalition until proven otherwise. CT scan diagnoses type and extent. Fibrous/cartilaginous coalition: conservative treatment with orthotics. Bony coalition without arthritis: surgical resection + fat graft interposition. With arthritis: subtalar arthrodesis.
Treatment
Conservative (fibrous/cartilaginous or mild bony coalition): Custom orthotics with medial arch support limit painful subtalar motion. Activity modification during flares. Immobilization in CAM boot for acute pain episodes. Many fibrous coalitions are managed conservatively through adolescence without surgery. Surgical resection (bony coalition, no secondary arthritis): Calcaneonavicular coalition resection with fat graft or extensor digitorum brevis interposition — prevents re-bridging and excellent outcomes in properly selected patients (typically <age 16, no arthritis). Talocalcaneal coalition resection: technically more demanding, best for coalitions <50% of the posterior facet without arthritis. Arthrodesis (with secondary arthritis): Isolated subtalar arthrodesis for talocalcaneal coalition with joint destruction. Occasionally combined procedures for complex deformity correction. Recovery from resection: boot NWB 3–4 weeks → progressive WB → return to sport 3–4 months.
⚠️ See a Podiatrist If:
- Teen or young adult with rigid flatfoot that doesn’t correct on tiptoe
- Recurrent ankle sprains that won’t fully resolve despite good rehabilitation
- Foot that locks in valgus position (turns outward) involuntarily — peroneal spasm
- Hindfoot or midfoot stiffness with pain in a teen athlete that’s limiting sport
- Flatfoot that orthotics haven’t helped after 3+ months — may be coalition-driven
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 Hartland
Our Howell office at 4330 E Grand River Ave, Howell, MI 48843 is about 10 minutes from Hartland via US-23 or M-59. We accept most major insurance. Call (810) 206-1402 or book online.
Rigid Flatfoot or Recurrent Ankle Sprains? Get Evaluated
Balance Foot & Ankle · Serving Hartland & Michigan
Book Your Appointment →Ready to Get Relief?
Same-day appointments available in Howell & Bloomfield Hills, MI
4.9★ | 1,123 Reviews | 3,000+ Surgeries
Or call: (810) 206-1402
📋 Dr. Tom Biernacki, DPM, FACFAS answers:
Tarsal coalition near Hartland is a condition where two or more tarsal bones are abnormally connected by bone, cartilage, or fibrous tissue. Our podiatrist serving Hartland 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 Hartland 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.