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Ankle Bone or Joint Injury

Sinus Tarsi Syndrome Advice

Minute Read


Posted 1 year ago


Last updated: 29/05/2023


by James McCormack

How do you fix Sinus Tarsi Syndrome?

Sinus Tarsi Syndrome is a clinical condition characterised by pain and tenderness over the outer aspect of the ankle joint. It results from trauma, such as an ankle sprain or repetitive stress that leads to subtalar joint instability.

Fixing Sinus Tarsi Syndrome required a multi-faceted approach:

  1. Offload the joint: Sinus Tarsi Syndrome is primarily an inflammatory condition resulting from an overload. Hence, reducing the time you spend on your feet is vital, especially focusing on reduced impact activity.

  2. Physical Therapy: A physical therapist can develop a structured rehabilitation program. This should include mobility and strengthening exercises to address imbalances that could overload the outer ankle. We have written a comprehensive article on the best exercises for Sinus Tarsi Syndrome.
  3. Orthotics and Supportive Footwear: As an overload of the outer ankle causes Sinus Tarsi Syndrome, custom insoles can help by altering the direction of force through the ankle when walking or standing. A simple medial wedge on an insole with mild arch support can open up the sinus tarsi region, quickly relieving pain and inflammation. A support shoe can have a similar effect to an insole in reducing pain and inflammation.
  4. Medication: Over-the-counter anti-inflammatory medications such as Ibuprofen can help reduce pain and inflammation. Always check with your healthcare provider before starting any new medication.
  5. Corticosteroid Injections: A cortisone injection may be considered if conservative treatments are unsuccessful. An experienced practitioner should provide a cortisone injection under ultrasound guidance to reduce inflammation in the sinus tarsi region. It normally takes 2-3 weeks for the injection to take full effect, and relief can last for 3-6 months.

Early diagnosis, individualised treatment, and consistent rehabilitation are key to effectively managing Sinus Tarsi Syndrome.

Can I run with Sinus Tarsi Syndrome?

In our experience, running with Sinus Tarsi Syndrome is not recommended, especially in the acute phase of the condition when symptoms are most severe. Here’s why:

  1. Risk of exacerbating symptoms: Running is a high-impact activity that places significant stress on the ankle joint. The high stress and impact can overload the sinus tarsi and increase inflammation and pain.
  2. Instability: Sinus Tarsi Syndrome is often caused by ankle instability. Running required high levels of ankle stability; therefore, if an individual has poor ankle stability, it can overload the sinus tarsi and worsen symptoms.

However, maintaining cardiovascular fitness is important, and there are many other low-impact exercises that you can do while you recover:

  1. Swimming and Water Aerobics: These provide a full-body workout without placing excessive stress on the feet and ankles.
  2. Cycling: This can also give a good cardiovascular workout with less impact on the lower limbs. We have spoken about this in greater detail below.
  3. Strength Training: Focusing on upper body and core exercises can help maintain overall fitness and stability. Using machine weights can reduce your risk of ankle irritation.
  4. Pilates and Yoga: Both of these are excellent options for increasing flexibility and strength, reducing the risk of future injuries.

A physical therapist can conduct a running gait analysis to assess for any signs of overloading the outer ankle and suggest modifications to your running form if necessary.  Advice on running shoes is an important part of the recovery process.

Can you walk with Sinus Tarsi Syndrome?

In our experience, you can continue to walk with Sinus Tarsi Syndrome, but there are some considerations.

Walking can irritate Sinus Tarsi Syndrome, so reducing your overall step count is recommended. However, it is not recommended to stop walking completely but consider short, frequent walking in supportive trainers for up to 30 minutes a few times a day rather than long walks.

Sinus Tarsi Syndrome is an inflammatory condition, so the more you walk or spend time on your feet, the more symptoms are likely to be irritated.

Can I cycle with Sinus Tarsi Syndrome?

Generally, non-impact exercises such as cycling are ok to do with Sinus Tarsi syndrome however, in highly irritable cases it may cause further pain.

As a general rule of thumb, if there is no pain during the exercise and there is no increased pain within 24 hours of exercise then it is okay to continue.

If possible wear cleats to reduce the amount of movement in the foot and ice the ankle afterwards.

How long does Sinus Tarsi Syndrome take to heal?

It takes 4-6 weeks for Sinus Tarsi Syndrome to heal using the correct footwear, insoles, and strengthening exercises. If the appropriate treatment is not provided then the pain may progressively worsen over time.

Will Sinus Tarsi Syndrome go away?

Sinus Tarsi Syndrome will improve and become pain-free with structured rehabilitation under the guidance of a Physical Therapist. It may not resolve at all with home treatment but progressively worsen if the appropriate measures aren’t taken to reduce symptoms levels and address the causes of pain.

Online Physiotherapy with James McCormack

This is not medical advice and we recommend a consultation with a medical professional such as James McCormack to achieve a diagnosis. He offers Online Physiotherapy Appointments for £45.

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