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Sinus Tarsi Syndrome

 

Sinus tarsi syndrome is a cause of pain on the outside of the ankle. Specifically, the pain is located in a space called the sinus tarsi, located between a bone called the talus that forms part of your ankle, and the heel bone. You can see the location of the sinus tarsi in the image.

 

The sinus tarsi has a number of nerves, ligaments and blood vessels that run through it. When these structures are damaged, which is often a result of traumatic injuries like ankle sprains that swell and compress this space, residual scar tissue that takes up space after an ankle injury, or problems with the biomechanics or posture of the feet such as having flat feet, pain at the sinus tarsi can start. Symptoms can include:

 

  • Pain at the outside the ankle, or a pinching sensation
  • Swelling in the area of the sinus tarsi
  • Ankle instability or weakness when walking 
  • Pain worsened when turning the foot out
  • Pain and difficulty walking on uneven surfaces, like over rocks
  • Burning, numbness or tingling radiating from the area if nerves are being compressed within the sinus tarsi
  • Symptoms that are exacerbated by activity, including standing and walking, and eased with rest

 

 

Treating Sinus Tarsi Ankle Pain

Treating sinus tarsi syndrome starts by reducing the painful symptoms and reducing the swelling, as swelling is one of the causes of sinus tarsi pain. You can start at home by icing the area and avoiding movements that produce pain. We start with strapping the feet for many of our patients, who often find instant relief by keeping the sinus tarsi in a naturally more opened position and giving the damaged structures inside some room.

 

Next, we’ll look at what is causing the pain and address this. This is very important in preventing this pain from recurring in the future. Your exact treatment will depend on your cause, but may include:

 

  • The EXO-L brace for those with a history of ankle sprains or ankle instability
  • Custom foot orthotics if a flat foot posture or other biomechanical abnormalities contributed to the pain, as well as to help improve the stability of the ankle
  • Stretching and strengthening program to help any muscle imbalances around the foot and ankle, particularly around the calf muscle which when tight, affects how the foot moves through gait and can contribute to pain
  • Footwear assessment to help with ankle stability and good foot and ankle support

 

Surgery is generally not required for sinus tarsi syndrome as the condition usually responds well to the non-surgical treatment methods we’ve outlined, plus any surgery carries significant risks. Cortisone injections, however, can be useful in helping to temporarily alleviate the pain and inflammation, which can allow you to comfortably focus on your rehabilitation for long-term management and prevention. 

 

If you’re unsure what’s causing your ankle pain, book in with our podiatrists for an assessment to uncover what is causing your pain, why, and how to treat it.