Extensor Tendonitis: Foot
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The tarsal bones are the bones that make up the back of your foot; these are the Calcaneus, Talus, Cuboid, Navicular and Cuneiform bones. These bones are not fully formed when you are born and develop throughout childhood. However, in some cases, rather than developing independently, two or more bones can become interconnected through fibrous tissue, bone or cartilage. When this occurs, it is known as a Tarsal Coalition.
The symptoms of a Tarsal Coalition include pain and stiffness in the hindfoot when walking or doing impact activities such as running or jumping. Symptoms begin to become prevalent from the ages of 9-16, although it is not uncommon to develop Tarsal Coalition symptoms as an adult.
In children, it is common to see them limping, and often, the pain discourages them from participating in sports.
A significant genetic element to developing a Tarsal Coalition is that the bones develop improperly during fetal development.
Tarsal Coalition in adults is usually a consequence of arthritis, trauma or infection.
Tarsal Coalition can be identified as a possible cause of pain by a Physical Therapist or a Sports Doctor following a Physical examination, but an x-ray usually confirms the diagnosis.
In some cases, a CT scan may be requested for greater clarity on the coalition.
A Physical Therapist provides treatment for a Tarsal Coalition following an assessment of the mobility and strength of the foot and ankle. A gait analysis can identify the need for insoles to provide extra support or the correct type of footwear for the patient.
A rehabilitation protocol consisting of various balance, strength and stability exercises is highly effective.
A period of modified rest from impact activity can be beneficial while non-impact activities such as swimming and cycling can be a temporary replacement for impact exercise, to allow inflammation levels in the hindfoot to subside.
In some cases, a steroid injection is required to reduce inflammation levels, but this is generally avoided unless necessary in most paediatric cases.
Surgery is the last resort for this condition which can be in the form of joint resection or a joint fusion. There are risks involved with all forms of surgery, and this should be discussed in detail with your Orthopaedic Consultant.
This is not medical advice and we recommend a consultation with a medical professional such as James McCormack before trying any of these exercises. James offers Online Physiotherapy Appointments for £45.
Related Article: Midfoot Arthritis