What is Sinus Tarsi Syndrome?
Jake Newby
| 4 min read
Medically reviewed by John Johnson, D.P.M., FACFAS
If you ever sprained your ankle and experienced lingering pain on the outer side of the ankle as a result, you may suffer from sinus tarsi syndrome.
Sinus tarsi syndrome is painful swelling and inflammation on the outside of the subtalar joint, which is located between your ankle bone and heel. The sinus tarsi is the medical name for the small space located within the subtalar joint, which is the next joint below the ankle that allows you to move your foot from side to side.
When something irritates the tissue in your sinus tarsi, it can swell and the extra pressure in your subtalar joint causes pain, according to the Cleveland Clinic. It can feel like a constant ache that becomes more pronounced the more you use your foot or ankle. The swelling caused by sinus tarsi syndrome can sometimes be physically noticeable and resemble a cyst.
Here are causes and risk factors for sinus tarsi syndrome, as well as treatment options.
What causes sinus tarsi syndrome?
Physical injury is the most common way to develop sinus tarsi syndrome. According to the American Academy of Podiatric Sports Medicine (AAPSM), ankle sprains cause sinus tarsi syndrome between 70% and 80% of the time.
Sinus tarsi syndrome can also be caused by a pinching or impingement of the soft tissues in the sinus tarsi following walking or running with an overpronated foot, which occurs when the foot rolls inward to an excessive degree. This can cause the arch to flatten and place strain on the muscles, tendons, and ligaments in the foot and ankle. While most people pronate to some degree and have no trouble, some people may experience pain and injury from overpronation.
Foot and ankle arthritis, diabetes, obesity and flat feet are other, less common causes of sinus tarsi syndrome.
What are risk factors for sinus tarsi syndrome?
Those who sprain their ankle multiple times are at a greater risk for sinus tarsi syndrome. Additionally, individuals who are very physically active can be prone to sinus tarsi syndrome. This can mean frequently engaging in vigorous exercise, playing a sport or having a physically demanding job that requires standing on hard surfaces all day.
Women who are pregnant also have an increased risk of overpronation, according to the Cleveland Clinic.
How to treat and manage sinus tarsi syndrome
Schedule an appointment with your primary care provider to have a look at the issue, at which point they will likely refer you to a specialist, who might recommend these treatment options:
Stretching and exercise: your doctor can introduce you to a series of stretching exercises designed to alleviate your symptoms. These can include calf stretches, pencil lifts, plantar stretches, ankle rotations and more. Be sure to take it slow when incorporating these exercises into your treatment plan and stop immediately if they cause pain.
Buying stable shoes/over-the-counter orthotics: supportive, stable shoes with good arch support and plenty of room for your toes can help alleviate pain caused by sinus tarsi syndrome. Your doctor may suggest buying orthotics, which are shoe inserts that can be bought at running shoe stores, online and at some pharmacies. Orthotics can also be custom made for your specific foot structure.
Taking over-the-counter nonsteroidal anti-inflammatory medications (NSAIDs): these include aspirin and ibuprofen. Advil is a leading name-brand NSAID. It’s important not to take these medications for more than 10 days in a row without your doctor’s approval as NSAIDs can cause stomach pain, acid reflux and other side effects.
Immobilizing your ankle: your doctor might recommend wearing an ankle brace or sleeve or walking boot that supports your ankle during the healing process. They may also recommend taping your ankle for added support.
If you still experience pain after trying these treatment methods, your doctor may recommend anti-inflammatory oral steroids, such as corticosteroids, or suggest direct cortisone shots to the subtalar joint. Physical therapy or seeing a podiatrist or foot and ankle orthopedist may be another option in resistant cases. Surgery is rarely recommended or needed to heal sinus tarsi syndrome and should be considered a last resort.
Photo credit: Getty Images
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