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. If you are diagnosed with sinus tarsi syndrome there are options available for treatment.
What Are the Symptoms of Sinus Tarsi Syndrome?
- Persistent sinus tarsi pain located at the 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 for Sinus Tarsi include:
- 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
- Unstable footwear, or inappropriate footwear for the activity
What is the Treatment for Sinus Tarsi?
Sinus tarsi syndrome is primarily treated through conservative treatment options such as orthotics or shoes to support the sinus tarsi. 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 for sinus tarsi & orthotic insoles
- Balance and proprioceptive training
- Activity modifications
- Strengthening exercises
- Bracing and/ or taping
- Proper footwear
Healthcare providers that may help manage the symptoms of Sinus Tarsi Syndrome:
- Physiotherapists/ kinesiologists: can develop a balance/ proprioceptive training program, as well as provide muscle strengthening exercises to improve symptoms of Sinus Tarsi Syndrome.
How to Reduce Pain Caused by Sinus Tarsi Syndrome:
- Continue with treatment of ankle injuries
- Use custom orthotics for sinus tarsi syndrome
Staying active with Sinus Tarsi 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.
Don’t let Sinus Tarsi Syndrome get you down. Get back on your feet, today.
To feel better, read on!
How can SoleScience help you manage sinus tarsi syndrome?
Your SoleScience Pedorthist will create an individualized treatment plan that suits your specific needs, goals, and symptoms of sinus tarsi syndrome. 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 and help manage sinus tarsi foot pain.
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 by recommending the best shoes for sinus tarsi or offering custom orthotics solutions. 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 Orthotics to treat Sinus Tarsi Syndrome
Custom foot orthoses are made using a mold (cast) of your foot. This type of insole is made specifically for you and your needs and is designed to specifically help you manage sinus tarsi syndrome. 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.
(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.