Ace Physiotherapy and Sports in Singapore
What is Sinus Tarsi Syndrome?
The sinus tarsi is a small bony groove located between the heel bone (calcaneus) and the talus bone in the ankle. This space contains several important ligaments that help stabilize the ankle joint. Sinus tarsi syndrome occurs when these ligaments become injured or inflamed, often leading to persistent pain, tenderness, and instability around the outside of the ankle. Physiotherapy is one of the most effective treatments to restore movement, reduce pain, and prevent recurrence.
How does Sinus Tarsi Syndrome happen?
Sinus tarsi syndrome may be caused by a single traumatic incident or by repetitive stress on the ankle. In many cases, it develops following an acute ankle injury such as a forcible inward twist of the foot, which not only damages the ligaments inside the sinus tarsi but also injures the surrounding lateral ligaments. In other cases, the condition may arise from overuse combined with biomechanical factors such as flat feet or excessive pronation, which place continuous strain on the ligaments and lead to inflammation and chronic discomfort.
What are the symptoms of sinus tarsi syndrome?
Sinus tarsi injuries often occur alongside damage to the lateral ligaments of the ankle, which is why they are sometimes mistaken for a typical sprained ankle. In many cases, people initially notice improvement as the lateral ligaments begin to heal, but if sinus tarsi syndrome is present, ankle pain can persist for several weeks after the injury. The discomfort is usually felt towards the front and outer side of the ankle, with the pain being most severe in the morning before gradually easing throughout the day. In addition to persistent pain, symptoms may also include a reduced range of ankle movement, episodes of weakness or muscle spasm, and problems with balance or stability, all of which can make daily activities and walking more difficult.
What should I do if I have sinus tarsi syndrome?
If you suspect sinus tarsi syndrome following an ankle injury, early care is important to control pain and swelling. You can begin your recovery by following the RICE regime—Rest, Ice, Compression, and Elevation—during the first 24 to 48 hours. While swelling is a natural part of healing, excessive swelling can delay recovery, so the RICE approach helps limit fluid build-up around the injured ligaments. Rest means reducing weight-bearing on the affected ankle, and in some cases, crutches may be necessary if walking is painful. Ice should be applied for 15 to 20 minutes every one to two hours using a wrapped ice pack or bag of frozen peas to avoid direct skin contact. Compression with an elastic bandage can provide support and reduce swelling, but it should be snug without being overly tight. Elevating the ankle on pillows or a chair so that it rests above heart level further assists in reducing swelling and discomfort. While these initial measures are helpful, it is essential to see a physiotherapist as soon as possible—ideally within the first 48 hours—for a full assessment and tailored treatment plan to restore ankle strength, mobility, and stability.
What shouldn’t I do if I have sinus tarsi syndrome?
If you suspect that you have sinus tarsi syndrome, you should not ignore your problem and continue to exercise, as this may worsen the injury and delay your recovery.
Physiotherapy treatment for sinus tarsi syndrome
Physiotherapy is an important part of treating ankle injuries. Initially, your physiotherapist will provide a diagnosis, explain the extent of the damage, and give you an estimated timeframe for recovery. Treatment focuses on reducing pain, promoting healing, and restoring ankle function. This involves restoring full range of motion, strengthening the muscles around the ankle, improving balance with specific proprioceptive exercises, and gradually returning to full activity. Preventive strategies such as ankle taping or supports may also be advised when returning to regular activity.
Other possible treatments include:
Could there be any long-term effects from sinus tarsi syndrome?
With proper treatment, sinus tarsi syndrome usually improves within a few weeks and rarely causes long-term complications.
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