Tarsal Coalition...

Ever since I started working part time at the local bakery when I was almost 15 years old, I have had major issues with my ankles. I would do 3 or 4 hour shifts and then not be able to walk the next day as my ankles swelled to a state they couldn't move and were agony even to stand on. When I started working at Safeway during uni, the problem got worse as I worked longer shifts. When I was around 20 I went to a doctor to try and determine what the issue was. They did some x-rays to look for arthritis (negative) and eventually a specialist determined I had flat feet and orthodics would fix the pain. It didn't. I lived through the rest of my Safeway days in agony, and then things settled down once I begun full time work, however would dread days where I was on my feet non-stop for the day. Even a few hours at the shops could have bad effects. Things came to a head this past Summer when we went to Washington DC and I walked 8km seeing the sights, and then spent the night, the next day, and the day after that in such agony and inability to move that I decided enough was enough and my problem wasn't just something I would have to put up with. I went to the GP and he put me onto a specialist, thinking I might have this thing called tarsal coalition (where the bones in the ankles are grown together, limiting movement and causing pain and swelling the longer one stays on their feet), as my ankles have quite limited movement compared to a regular person. My problem didn't seem to be worsened by weight either, as I've had the issue whether I've weighed what I weigh now or weighed 20kg less.

Another x-ray determined I didn't have arthritis or tarsal coalition. The specialist sent me off for an MRI. The MRI determined I did actually have tarsal coalition (a type called talocalcaneal coalition which is harder to detect on an x-ray, which is why the specialist initially thought I didn't have tarsal coalition). This picture explains it pretty well:

Basically, it's a genetic condition which people are born with but symptoms don't come out until puberty as the bones are still growing and are softer before them. Because the talus and calcaneus bones are fused together, movement is limited and this causes the pain and swelling as other parts of the ankle/heel take over the workload.

I'm off to another specialist in a month's time (the first one's receptionist was the nastiest woman I had ever met, and they changed an appointment on me without bothering to tell me, so I took a day off work and showed up when they weren't expecting me because they didn't tell me they changed it) to see what is going to happen. From all accounts, they try non-surgical measures first, like orthodics or even keeping the ankle in a boot for several weeks (but this seems like something for younger people) before trying surgery which is where they chip away the excess bone, or alternatively completely fuse the two bones together so there is no pain anymore. I honestly don't think surgery is an option for me as I still need to work and I need to be on my feet and I also need to drive to work. If there are ways to manage this or minimise the pain/swelling that is good enough for me. However, I am a bit worried about how it will go when I ever get pregnant one day.

It is a relief to have a diagnosis after 13 years, as now people don't have to think I have been making it up! I would recommend though, that if you aren't happy with a diagnosis or the solution they give you doesn't help (like when I was given orthodics to supposedly eliminate the issue back in my early 20s) go to another doctor - waiting another 7 or so years before trying again to get a diagnosis is a bit silly when I look back on it.

Have you ever had to have significant time off work for an injury or other ailment? How did you ease yourself back into work? If you've stumbled upon this blog and you do have tarsal coalition, how do you cope with the pain and swelling associated with this condition, and have you had surgery?