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Sinus Tarsi Syndrome: An Overview | Find Your Stride | Edinburgh Podiatrist

Recently, I have encountered several cases of sinus tarsi syndrome during my clinics, prompting this blog post on the condition. Below I aim to provide a brief overview of sinus tarsi syndrome, including its definition, causes, symptoms, and treatment options.

A painful ankle with inflammation
Sinus tarsi syndrome can cause non-specific pain around the ankle

What is Sinus Tarsi Syndrome?

Sinus tarsi syndrome is a relatively uncommon but impactful foot and ankle condition that can cause significant discomfort and impairment. It is characterised by pain and tenderness in the sinus tarsi, a small cavity located between the talus and calcaneus bones below the ankle joint. This condition typically occurs as a result of trauma, or structural abnormalities in the foot and ankle.

Why Does it Happen?

The exact cause of sinus tarsi syndrome is not fully understood, but it is often associated with an injury to the ligaments surrounding the sinus tarsi. Ankle sprains can result in stretching or tearing of these ligaments, and are therefore a common precipitating factor. Additionally, activities that involve repetitive stress on the foot and ankle, such as running or jumping, can contribute to the development of this condition. Furthermore, individuals with structural abnormalities in the foot, such as pes planus (flat foot) or a pes cavus (high-arched foot), may be more prone to developing sinus tarsi syndrome.

What Are the Symptoms?

Patients with sinus tarsi syndrome typically present with pain and tenderness in the lateral aspect of the ankle and hindfoot. This discomfort is often exacerbated by weight-bearing activities and may be accompanied by swelling or instability in the ankle joint. Additionally, individuals with this condition may experience difficulty walking or standing for prolonged periods. It is important to differentiate sinus tarsi syndrome from other ankle conditions, such as lateral ligament sprains or subtalar joint instability, as treatment approaches may differ.

What Are the Treatment Options?

The management of sinus tarsi syndrome involves a multidisciplinary approach, which may include conservative measures and, in some cases, surgical intervention. Initially, patients are advised to rest the affected foot/ankle to reduce inflammation and prevent further injury. Non-steroidal anti-inflammatory drugs (NSAIDs) may be prescribed to alleviate pain and swelling. Physical therapy is also crucial in rehabilitating the ankle and improving strength and flexibility in the surrounding muscles and ligaments.

Orthotic devices, such as custom-fitted shoe inserts or ankle braces, may be recommended to provide support and reduce excessive movement in the foot and ankle. In cases where conservative treatments fail to provide relief, corticosteroid injections into the sinus tarsi may be considered to alleviate pain and inflammation. However, it is important to note that the long-term use of corticosteroids should be approached with caution due to potential side effects.

In instances where the structural abnormalities of the foot and ankle contribute to the development of sinus tarsi syndrome, surgical intervention may be warranted. Procedures such as ligament repair or reconstruction, as well as addressing underlying anatomical issues, may be performed to alleviate pain and restore normal function to the affected joint.

In conclusion, sinus tarsi syndrome is a complex and often overlooked condition that can significantly impact an individual's quality of life.

Find Your Stride!

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