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)
- Ankylosing spondylitis
- Pes planus foot structure: may be a factor if you have an excessively flexible flatfoot
How to Reduce Symptoms of Sinus Tarsi:
- Unstable footwear, or inappropriate footwear for the activity
- 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 pain that has failed conservative treatment.
Conservative treatment options include:
- Custom foot orthotics
- 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 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.
(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.