Sinus Tarsi Syndrome

The sinus tarsi is a canal in the ankle which extends out to the heel bone. Injury to this component can result in pain to the area and difficulty participating in regular sporting activities. It can also lead to other ankle injuries or occur simultaneously with another condition.

Symptoms

Pain will generally strike around the protrusion of bone on the outside of the ankle, but may also be present in other parts of the ankle. The areas of pain might also be tender to the touch, particularly at this protrusion where the sinus tarsi opens out of the ankle. The pain is often more pronounced when sprinting or walking on an uneven or sloped surface, and other activities may also be affected if they involve putting pressure on the outside (and sometimes the inside) of the ankle, such as jumping. The ankle may generally feel unstable, particularly when moving it against weight or pressure. Certain symptoms will only be noticeable to a doctor who has run relevant tests, such as an excess of fluid in the area.

Causes

Most often sinus tarsi syndrome is provoked by an ankle sprain in which the ankle rolls excessively outwards. Track athletes may be particularly prone to such sprains, though the injury is a potential risk for any sportspeople moving at speed on their feet. Another common cause is inward rolling of the ankle, leading to the sinus tarsi tissues becoming pinched. The injury is occasionally linked to overuse: exercising with weakened muscles or for an excessive amount of time. People with biomechanical errors in their feet, particularly overpronation (feet that naturally roll too far inwards), also frequently sustain the injury. In many cases the sinus tarsi syndrome is not present alone, and other conditions may have contributed to its occurrence.

Treatment

See a doctor in order to obtain an accurate diagnosis; this is particularly important because the injury may be associated with other conditions. Meanwhile take immediate rest from all sports and similar activities involving placing pressure on the ankle until the pain has subsided. Icing the injured area a few times per day can help to relieve pain and any swelling. Taking anti-inflammatory pain medication will also reduce symptoms, but always check with a doctor. As the pain decreases it is crucial to maintain steady movement in the joint; a physical therapist can help to recommend a suitable program of stretching and strengthening exercises.

If the injury is persistent then the doctor might suggest an ankle brace. In extreme instances surgical treatment is available, with some procedures focusing on removal of the sinus tarsi's contents.

Prevention

Biomechanical problems in the feet can be corrected using the appropriate shoe inserts or orthotics. A medical professional can advise you on the relevant orthotics, and this will help to reduce the risk of many injuries in the future. For those without biomechanical errors it is still important to wear suitable footwear which is shock absorbent and uses the correct grip for the surfaces that you play or train on. Always warm up sufficiently, and do not overexert yourself or train while tired.

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