Ankle Pain caused by Sinus Tarsi Syndrome

What is Sinus Tarsi Syndrome?

Sinus tarsi is an important space on the lateral foot and contains stabilizing ligaments of the subtalar joint, fat tissue, nerve endings of the peroneal nerve, and blood vessels. Sinus tarsi syndrome is commonly the result of a traumatic ankle injury or ankle sprains (1).

A traumatic ankle injury or history of ankle sprains may result in excessive movement at the subtalar joint, which in turn leads to chronic inflammation in the sinus tarsi space. The result is constant pain at the front and outside of the ankle.

What Are the Symptoms of Sinus Tarsi Syndrome?

Persistent pain at front and outside (lateral) ankle
Feeling of instability at the ankle
Symptoms worsened after walking on uneven ground or running
Previous traumatic ankle injury
Deep ankle pain, localized at the lateral ankle (sinus tarsi)

Risk Factors & How to Avoid Discomfort Caused by Sinus Tarsi

Risk factors for Sinus Tarsi include: (2)

History of serious ankle sprains
Single traumatic ankle injury
Rheumatoid arthritis (RA)
Gout
Ankylosing spondylitis
Pes planus foot structure: may be a factor if you have an excessively flexible flatfoot
Unstable footwear, or inappropriate footwear for the activity

How to Reduce Symptoms of Sinus Tarsi:

Continuing with treatment of ankle injuries

What is the Treatment for Sinus Tarsi?

Sinus tarsi syndrome is primarily treated through conservative treatment options, and surgery is only indicated in individuals who have persistent lateral ankle pain that has failed conservative treatment.

Conservative Sinus Tarsi Syndrome treatment options include:

Custom orthotics & orthotic insoles
Physiotherapy
Balance and proprioceptive training
Activity modifications
Strengthening exercises
Bracing and/ or taping
Proper footwear

Other healthcare providers that may help manage the symptoms of Sinus Tarsi Syndrome:

Physiotherapists/ kinesiologists: can develop a balance/ proprioceptive training program, as well as muscle strengthening exercises

Staying active with lateral ankle pain

It is important that you stay active while modifying your activities and drills or exercises that place excessive stress on the sinus tarsi. A physiotherapist or athletic trainer can help develop a program that will facilitate activity and transition back to sport following an injury.

References

(1) Helgeson K. (2009). Examination and intervention for sinus tarsi syndrome. North American Journal of Sports Physical Therapy, 4(1): 29-37.

(2) Choudhary S & McNally E. (2011). Review of common and unusual causes of lateral ankle pain. Musculoskeletal Radiology, 40: 1399-1413.

Don’t let Sinus Tarsi Syndrome get you down. Get back on your feet, today.

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How can SoleScience help you feel better?

Your SoleScience Pedorthist will create an individualized treatment plan that suits your specific needs, goals, and symptoms. We will work with you to determine not only what we need to do to address your current concerns, but also to prevent future problems.

Your pedorthist will complete a thorough and comprehensive foot examination at your initial appointment. A comprehensive follow-up exam will ensure that you are meeting your goals and allow your pedorthist to reassess your treatment plan (as necessary). During these appointments we will:

Assess joint and muscle function, including range of motion and gait assessment
Assess your footwear for both fit and function
Identify any risk factors that can be modified and make recommendations for change
Identify areas of risk with specialized tools such as pressure mapping (F-Scan or
Pedograph)
Discuss a treatment plan, which may include a change in footwear, activity modification, or custom foot orthoses and/or a complementary treatment referral (such as physiotherapy)

In addition to your individual treatment plan, your SoleScience Pedorthist will provide you with educational resources to help you best maintain your foot health.

Our take on the need for orthotics for lateral ankle pain

Sinus tarsi syndrome can plague athletes and individuals who suffer from recurrent ankle injuries and chronic ankle instability. As part of the treatment plan, SoleScience can help to limit instability at the subtalar and ankle joints, as well as provide pain relief. Custom orthotics and footwear have been shown to provide stability for these joints and allow you to get back on your feet.

Custom vs OTS Orthotics for Sinus Tarsi

Custom foot orthoses are made using a mold (cast) of your foot. This type of insole is made specifically for you and your needs. Your Pedorthist will not only take a cast of your foot in a specific position, but also choose the materials and constructions details tailored specifically to you. The evidence suggests that custom foot orthoses can be a viable part of your treatment plan to improve the stability at the subtalar joint and symptom reduction.

Off-the-shelf (OTS) devices are pre-fabricated for an “average” foot and are designed to slip into most footwear. This type of insole may be heat moldable, or modifiable for a degree of customization, but is not entirely custom made to your foot. There are dozens of insoles available in your local pharmacy or drugstore that may provide support and relief for various foot conditions.

Footwear recommendations for Sinus Tarsi

Your footwear choices are an integral part of your treatment plan and day-to-day comfort. Ensure that your footwear options include a stiff heel counter, to limit excessive movement at the rearfoot.(1) In addition, it is important that you are checking your shoes often for wear.

Your Pedorthist will recommend shoe choices for you, and will take into consideration the most appropriate shoes for work and activity requirements.

Make a confident choice in SoleScience, and we’ll do everything in our power to make you a raving fan!

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