Sinus Tarsi Syndrome

What is Sinus Tarsi Syndrome?
The sinus tarsi is a small osseous canal which runs into the ankle under the talus bone. Damage to the sinus tarsi can be caused from overuse in conjunction with over pronation or poor foot biomechanics, however the majority of patients have suffered an inversion ankle sprain at some point in the past. The sinus tarsi has a lot of synovial fluid/tissue which becomes inflamed. It may also occur with inflammatory conditions such as gout or osteoarthritis.

Symptoms of sinus tarsi syndrome
-Poorly localised pain just in front of the lateral malleolus (bony bit on the outside of the ankle).
-Tenderness at the opening of the sinus tarsi on the outside of the ankle.
-Pain or difficulty running on a curve on the side of the painful ankle for example running round a left hand bend while running track, if the left foot is painful.
-Passive inversion of the subtalar joint (joint under the talus).
-An anesthetic injection into the painful sinus tarsi will confirm the diagnosis by relieving pain and allowing normal function.
-An MRI scan my indicate excessive fluid in the sinus tarsi.

Treatment of sinus tarsi
-Rest from painful activities.
-Apply ice or cold therapy to reduce pain and inflammation.
-A doctor may prescribe NSAID's or non steroidal anti inflammatory drugs such as ibuprofen.
-Electrotherapy such as ultrasound may help reduce inflammation.
-Mobilization of the subtalar joint is an important part of treatment and rehabilitation.
-Correction of any biomechanical problems such as over pronation.
-Strengthening exercises for the ankle especially proprioceptive exercises such as use of a wobble board.