Mid Tarsal Joint Pain

The human foot is an engineering masterpiece consisting of 26 bones, all intricately combined to carry body weight, absorb stress and permit motion. Yet even a minor foot injury can cause debilitating pain and cripple movement. One particular point of interest is the mid tarsal joint.

Facts

• Located in the middle of the foot, the mid tarsal joint consists of the talonavicular joint, which is between the talus and navicular bones, and the calcaneocuboid joint, which connects the calcaneus (heel) bone and the cuboid bone. The mid tarsal joint enables the foot to pivot inwards and outwards.

Symptoms

• An injury to the mid tarsal joint will cause pain in the outside middle of the foot. Pain and swelling can also be present along the top of the foot. The discomfort increases when attempting to bend or twist the foot.

Causes

• Mid tarsal injuries are relatively rare among the general population. They tend to strike mainly athletes who do a lot of running and jumping, like gymnasts and football players.

Types

• Mid tarsal injuries are often called foot sprains. They come in two types: medial and lateral. A medial sprain of the mid tarsal joint happens due to foot inversion, which means the sole of the foot turns, or opens, inward. The resulting stress can cause fractures in the bones. This is the same movement associated with the classic sprained ankle, and many mid tarsal injuries are misdiagnosed as such.

  In contrast, a lateral sprain is due to foot eversion, which is when the sole of the foot turns, or opens, outwards. This can result in a crushing of the cuboid bone or the calcaneus bone. The navicular bone may also suffer an avulsion fracture, meaning a piece of the bone is ripped away.

Identification

• Mid tarsal injuries should always be considered when evaluating any foot injury. They're often missed during an initial examination and written off as simple ankle sprains. X-rays or even an MRI scan may be needed to confirm diagnosis.

Treatments

• If no fractures are present, mid tarsal injuries can be supported by simply taping the foot or by using orthotic implants. Ibuprofen and other NSAIDs may be prescribed to control pain and inflammation. Cotricosteroid injections may be given if the pain persists.

  Mid tarsal injuries with bone fractures will often require a non-weight-bearing cast to be worn for six to eight weeks. Depending on the size and weight of the patient, it could take up to six months to properly heal. In severe cases, surgery may be needed to insert pins or wires in order to stabilize the joint before casting.