Understanding Sinus Tarsi Syndrome – Symptom & Treatment

Sinus tarsi syndrome is an inflammatory disorder characterized by group of symptoms & signs within sinus tarsi.

The most common cause for this disorder is ankle sprain or strain on foot from walking or running on flat foot.

It is characterized by the tenderness along with pain at the lateral part of ankle & is caused by inflammation.

Inflammation within sinus tarsi cavity tissues around them is the main reason of this disorder so it is also called as Sinus Tarsitis.

Early diagnosis & proper treatment leads to fast recovery otherwise it may progress in chronic foot pain.

What is sinus tarsi?

Sinus means cavity & the cavity between the calcaneus & talus is known as sinus tarsi.

It provide space to ligament, nerves and blood vessel to pass through.

It is also popularly known as “eye of the foot” because it opens towards the outside of foot and situated between the heel & ankle bone.



The common causes of sinus tarsitis is –

  • Ankle sprain
  • Repetitive strain on foot
  • Altered biomechanics of foot

Ankle sprain

Inversion ankle sprain is the most common cause.

In an inversion sprain, ankle rolls outside and may causes inflammation ligaments which also leads to sinus tarsitis.

Ankle sprain often cause instability of the subtalar joint of foot bones.

This instability can be a result of repetitive strain injuries caused running or walking on flat feet. Excessive movement caused by an instability in subtalar joint results into inflammation of joint known as synovitis.

Repetitive strain

Repetitive strain caused by running, walking, jumping or standing for long time on foot may gives rise to inflammation of ligaments of foot leading to sinus tarsitis.

Ballet dance or sitting for long time keeping foot underneath your body may trigger inflammation.

Altered foot biomechanics

People with flat feet or over pronated foot are more prone to get this disorder.

Altered biomechanics of foot increases pressure on the cavity and leads to inflammation.


Symptoms develops over the period of time after sprain or injury to ankle.

After discomfort caused by ankle sprain improves, you will still get get pain in lateral area of foot caused by irritation & inflammation of the tissues within sinus tarsi area.

Pain, tenderness, feeling of instability around ankle area are the most common symptoms of this condition.


Pain are localized around outer part of foot and increases with application of pressure or movement of foot.

Foot inversion or eversion movement leads to discomfort.

Feeling of instability

Patient may feel instability in ankle joint especially while walking on uneven surfaces.


Outside & front part of an ankle becomes tender and give rise to pain when pressure is applied.

Ankle joint may become stiff during morning hours and improve as day progress.


Patient may feel stiffness in ankle joint early in morning which fades away slowly as movement of feet increases.


First of all doctor will observe your foot and will do multiple clinical test to see the intensity of pain, tenderness and stability of the subtalar joint.

Usually athletes who face this problem may have flat feet, if this found to be happen with you then doctor will check for passive range of motion for ankle joint.

MRI is one of the most useful diagnostic testing that can help to identify pathology within sinus tarsi tunnel as well as  fibrosis & inflammation.

When all other test fails to help in diagnosing this disorder, some doctor prefer to inject corticosteroids & anaesthetic within the cavity and see if symptoms relieves or not.

If pain relieves, it confirms the diagnosis of sinus tarsi syndrome while persistent pain even after injection indicates some other pathology in foot.


Usually treatment is divided in three parts as follows

  • Conservative treatment
  • Corticosteroids pills & injections
  • Surgery

Conservative treatment

This involves some easy steps that helps to reduce inflammation of sinus tarsi area.

Giving rest to affected foot, applying ice compression and keeping leg elevated helps a lot to reduce inflammation and pain.

Once the pain start to reduce, your doctor will advice you to start some useful muscle-strengthening exercises as well as supportive shoes, best ankle brace and some anti-inflammatory pills.

Cortocosteroids pills & injections

If conservative line of treatment fails to deliver results and pain persist then doctor may start corticosteroids therapy.

Doctor may advice you to take oral corticosteroids as well as injections of corticosteroids in to the affected joint in view of reducing inflammation and to ease pain.


In some cases, conservative treatment & costicosteroids fails to relive pain, in such situations surgery is advised.

Surgery helps to reconstruct the subtalar joint and can be done either through arthroscope or by taking an incision.

References +

Kevin Helgeson
N Am J Sports Phys Ther. 2009 Feb; 4(1): 29–37.
PMCID: PMC2953318

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