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Tarsal Coalition? (Read 3106 times)


50 halfs by age 50

    I was diagnosed with this in Dec a month before my marathon and have been struggling with what to do with the info since. Basically, two of the bones in my left foot are tethered together (probably congenital). There's no joint space so no cushion. I've had problems since I played high school basketball, but just thought it was a bum ankle that turned into arthritis as I aged. I do okay running until the runs hit double digits in length. I can do up to 14 with mild stiffness and pain for about 24 hours after the run. Higher mileage resulted in me being unable to put much of any weight on the foot for about 24 hours after the run. What I'm looking for is longevity in running. This is my 4th year. I'll never be fast, but I'd like to last long enough to pick up some age group awards in my 70s, 80s Big grin The podiatrist was no help. He says I shouldn't be able to run at all and to wear a brace (which I can't stand to wear while running). I have a friend who's an ortho PA that says pain means I'm stressing the joint and could be causing long-term damage. A friend that's a PT says I'm building up scar tissue which could be bad or could actually help cushion the joint. I currently do a Gallowalking kinda thing, R4/W2 but trying to get back to R4/W1. I had wanted to try to eliminate walk breaks or increase running until I was at a R9/W1, but not sure if keeping the walk breaks helps the foot. I want to try to build up base mileage (though I've been derailed this month with bronchitis) to help strengthen the ankle but don't know if that's just making it worse. And I'm not sure I should ever do another full marathon. I would likely wait 4 or 5 years until I have time to train properly, but maybe it's a bad idea to even do another one at all. Anyway, I guess I'd like to know what you guys would do with this kind of info.

    *Mel* //  "A lot of people run a race to see who's the fastest. I run to see who has the most guts." - Steve Prefontaine


    A Dance with Monkeys

      Hey Chimera, do you know exactly which bones are fused?
      finney


      Resident pinniped

        Are they one fused bone, or are they connected by some sort of other soft tissue? If it's soft tissue, and it's giving you pain, I don't see why they couldn't do something to split the bones.


        50 halfs by age 50

          Hey Chimera, do you know exactly which bones are fused?
          Yep...talus and calcaneus. You can see the tethering plain as day on the Xray. Not a lot of joint space to look at Sad
          Are they one fused bone, or are they connected by some sort of other soft tissue? If it's soft tissue, and it's giving you pain, I don't see why they couldn't do something to split the bones.
          According to the podiatrist, they only do surgery as a last resort for folks who can't walk anymore. They release the tether then put some sort of soft tissue graft in the joint space for cushion. Apparently, I'm doing way more than I should be able to with the condition so surgery's not necessary at this point. The pod and the PT both independently said I may have just found the limit on what I can comfortably do.

          *Mel* //  "A lot of people run a race to see who's the fastest. I run to see who has the most guts." - Steve Prefontaine


          A Dance with Monkeys

            Yep...talus and calcaneus. You can see the tethering plain as day on the Xray. Not a lot of joint space to look at
            Goodness, that is your major weight bearing area. Are they completely fused or is there some motion?


            50 halfs by age 50

              Goodness, that is your major weight bearing area. Are they completely fused or is there some motion?
              Some ROM, but definitely decreased as compared to the other foot (where I have chronic PF...high arches and heel spurs).

              *Mel* //  "A lot of people run a race to see who's the fastest. I run to see who has the most guts." - Steve Prefontaine


              A Dance with Monkeys

                Some thoughts: 1. I am sorry, this is a tough and uncommon problem that likely few folks have much experience with 2. You should probably get a second opinion from an orthopedic surgeon who has a focus on feet and ankles, if possible. 3. I wonder if specific foot strengthening work such as barefoot running may help. Maybe 1-2 miles barefoot on grass, 1-3 times per week. 4. Another word for "coalition" is "chimera", which I find interesting given your name. 5. Why do you not like the brace? 6. DO you get any relief from postrun ice or antiinflammatories?


                50 halfs by age 50

                  Some thoughts: 1. I am sorry, this is a tough and uncommon problem that likely few folks have much experience with
                  Yikes, Doc...sounds serious Shocked I was really hoping you'd just say HTFU or Shut up and run or something less scary.
                  2. You should probably get a second opinion from an orthopedic surgeon who has a focus on feet and ankles, if possible.
                  Thanks, I'll look into it. My daughter sees an orthopod for her knees (soccer player)
                  3. I wonder if specific foot strengthening work such as barefoot running may help. Maybe 1-2 miles barefoot on grass, 1-3 times per week.
                  Would the beach work? Grass around here tends to be full of doggy bombs...people aren't always so good about picking up Dead
                  4. Another word for "coalition" is "chimera", which I find interesting given your name.
                  Fascinating! I missed that connection. I embraced the word back when I took undergrad immunology. Chimeric mice are cool!
                  5. Why do you not like the brace?
                  It's one of those elastic compression braces. I wear it when the ankle hurts...sometimes that's the only way I can walk. When the ankle doesn't hurt, the brace feels too tight and causes pain. It also chafes like crazy!
                  6. DO you get any relief from postrun ice or antiinflammatories?
                  yes...I ice after the LR when it bothers me. The antiinflammatories not so much...800 of vitamin i only took the edge off. Thanks for your help Trent!

                  *Mel* //  "A lot of people run a race to see who's the fastest. I run to see who has the most guts." - Steve Prefontaine


                  A Dance with Monkeys

                    Yes, beach running will be even better than grass! Glad you have access, I don't Undecided May be serious, maybe not. That is why I think you ought to see the orthopod. I wonder too if your brace is the wrong size or git. It is worth getting that checked out as well. Good luck!
                      Yes, beach running will be even better than grass! Glad you have access, I don't Undecided
                      Be careful that you don't get blisters. I was all pumped to run barefoot on the beach ALL WEEK during my summer vacation last year. Our first morning there, I made sure to wake up just before sunrise so that I could have a beautiful view of the Atlantic. After 3 miles I could feel some serous soreness, but I was manly and persevered past the pain. When I got back, I had the largest blisters on the balls of my feet. I tried to ignore them for the rest of the day as I enjoyed various water activities with the kids, but they ended up bursting and (I guess) getting infected in the water? From my knee on down, I had serious swelling for the ENTIRE WEEK! It really sucked. I mustered enough strength to run with my shoes on a few days later, but that was it!! Thank goodness we had plenty of cervesa.
                      TrailSurfer


                      Husband and father of 4

                        Be careful that you don't get blisters. I was all pumped to run barefoot on the beach ALL WEEK during my summer vacation last year. Our first morning there, I made sure to wake up just before sunrise so that I could have a beautiful view of the Atlantic. After 3 miles I could feel some serous soreness, but I was manly and persevered past the pain. When I got back, I had the largest blisters on the balls of my feet. I tried to ignore them for the rest of the day as I enjoyed various water activities with the kids, but they ended up bursting and (I guess) getting infected in the water? From my knee on down, I had serious swelling for the ENTIRE WEEK! It really sucked. I mustered enough strength to run with my shoes on a few days later, but that was it!! Thank goodness we had plenty of cervesa.
                        Ouch! Build up barefoot sand running slowly and not when the sand is hot. It is very doable that way. I hear there are some "like-barefoot" running shoes out there that allow more range of motion in the foot too. Assuming, chimera, you PF isn't agrivated. Ah, I here it is. It's the Nike Free. Here's the Nike site with it. http://www.nike.com/index.jhtml#l=nikestore,grid,_grid,s-nike%20free&re=US&co=US&la=EN I'm sure you can find reviews on it with pros and cons. Good luck.
                        Find the fun.


                        A Dance with Monkeys

                          It's the Nike Free.
                          Correct. $100. Or you can buy a pair of thin $5 water shoes. Smile
                          TrailSurfer


                          Husband and father of 4

                            Good point Roll eyes, water shoes do make more sense. I've never worn either.
                            Find the fun.
                            Ironmanlife


                              Chimera, I know this conversation is 2 years old but just found it and I am wondering what your outcome has been. I'm 44. I started running 3 decades ago and have been doing triathlons for nearly two decades. I'm a marathoner and multiple Ironman distance runner and back in my younger days I was a fairly good runner (~5:30/mile racer). Here's the catch. 10 years ago I was having foot problems while training for the Chicago Marathon and it was discovered that i had a double tarsal coalition in my right foot. The doctors said I shouldn't be able to run, but since I can, they said keep going. I've had calf and Achilles problems incessantly over the past 10 years. Every year it gets worse. I used to be out of commission for 2 months in a year, then 3 months the next year, etc. Last year I was able to do slow short base training for 2 months then couldn't run for another 10. This year I decided to start with strength building and stretching for 3 months. Then nearing the end of three months while doing very light, passive stretching, I tore my calf muscle. Am on crutches for 6 weeks. I've had PT, ART, MRIs, etc and nothing is wrong with my calf or achilles. I can only imagine it's due to my 2x tarsal coalition. I can't bear the thought of not running ever again but don't know what to do. What success have you had? Any advise or suggestions would be enormously appreciated.
                              HeidiGSR


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