Sinus Tarsi Syndrome: What You Need to Know

What is Sinus Tarsi Syndrome?

Sinus Tarsi Syndrome is ongoing foot pain after suffering a lateral ankle sprain. The resulting inflammation and lateral ankle instability following the sprain causes pain deep inside the joint that makes it difficult to bear weight on the affected foot. The symptoms get worse with activity, especially ankle twisting, and get better with rest. 

How do lateral ankle sprain occur?

A lateral ankle sprain occurs when the ligaments on the outside of the ankle are stretched or torn. This can happen when the foot turns inward, causing the ankle to roll outward, typically during a sports injury that involves jumping, running, or a sudden change in direction such as in basketball, soccer, or tennis. 

inversion ankle sprain infographic

What are the treatment options for a lateral ankle sprain?

The treatment goals are to reduce pain and swelling, promote healing of the ligament, and restore function of the ankle. Because walking with a sprained ankle can be painful, you may require crutches until the pain subsides. Your doctor may recommend an elastic bandage, sports tape or an ankle support brace to stabilize the ankle; or for a severe sprain, a cast or walking boot may be necessary to immobilize the ankle while it heals.

Can I treat it on my own?

R.I.C.E. method for injuries infographic

To prevent lasting injury you should see a medical professional. Self-treatment for the sprain typically involves rest, ice, compression, and elevation (R.I.C.E.), as well as physical therapy exercises to strengthen the ankle and prevent further injury. Ice packs should be applied immediTately for 15 to 20 minutes every two to three hours. To help stop swelling, the ankle should be compressed with an elastic bandage until swelling stops with the wrapping being not too tight as to hinder circulation; and the wrapping should start at the area furthest from the heart. Elevating the foot and resting it will help to reduce swelling by draining excess fluid from the site. Usually, over-the-counter pain relievers are enough to manage the pain.

Should I see a medical professional?

Better safe than sorry. For severe injuries, such as when the injury doesn’t heal in a reasonable length of time, or the ankle remains unstable, or for persistent or latent pain, such as occurs in Sinus Tarsi Syndrome, you may be referred to a specialist in musculoskeletal injuries: an orthopedic surgeon or a physician specializing in physical medicine and rehabilitation.

A physician may administer an injection of anesthetic and corticosteroid as an initial or diagnostic treatment and order one or more imaging scans to rule out a broken bone and/or to evaluate in more detail the extent of ligament damage: X-ray, MRI, CT Scan, or Ultrasound. Surgery may be performed to repair a ligament that won't heal or to reconstruct a ligament with tissue from a nearby ligament or tendon.

How is Sinus Tarsi Syndrome diagnosed?

To diagnose Sinus Tarsi Syndrome, routine and stress radiographs are taken to rule out ankle and subtalar instability as well as an MRI to rule out contiguous arthrosis and ganglion cyst formation. Occasionally, sinus tarsi exploration and debridement surgery is performed either by open method or arthroscopically.

When indicated, open debridement begins with an incision over the sinus tarsi. The capsule of the subtalar joint is incised, the joint is inspected and injuries are addressed as needed. The wound is closed and the patient is placed in a splint postoperatively. After 10 days, the patient is placed into a weight-bearing short-leg cast for 4 more weeks. A comprehensive rehabilitation program follows, with an emphasis placed on reducing swelling and improving range of motion, strength, and proprioception.

Short Leg Cast

What dress shoes are good for Sinus Tarsi Syndrome?

When choosing a dress shoe for Sinus Tarsi Syndrome, it is important to look for shoes with good arch support, cushioned soles, and a wide toe box to reduce pressure on the forefoot. Additionally, shoes with adjustable laces or straps can provide a customized fit, and lightweight materials can reduce overall foot strain.

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