Peroneal Tendon Tear
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The sinus tarsi is a small articulation on the outside of the ankle bone between two bones, the talus and calcaneus bone. The articular spacing between these two bones facilitates a small tunnel for blood vessels, nerve endings, ligaments, and tendons to pass through. The structure of the sinus tarsi provides stability to the surrounding ankle joint. When this area is overloaded through repetitive motion or trauma it can lead to pain and inflammation in the area resulting in Sinus Tarsi Syndrome.
Due to the location of the sinus tarsi, injury to the area which is known as Sinus Tarsi Syndrome is often confused with a lateral ligament sprain.
Pain is located on the outside of the ankle joint. Low-level swelling is often seen in the location of pain and it may be associated with some tingling or burning in the area as the swelling compresses local nerves. It is usually tender when palpating the sinus tarsi and symptoms are worse when turning the foot outwards.
Symptoms are often exacerbated by walking on uneven surfaces, wearing unstable footwear, or running uphill. Standing for long periods of time can make the pain worse or compression of the area from tight shoes.
If you have the symptoms of Sinus Tarsi Syndrome we recommend that you see a Physical Therapist, Podiatrist, or Sports Doctor for a clinical assessment, following this they may refer you for imaging to confirm your diagnosis but this is not always necessary.
This involves the Therapist dorsiflexing and everting the foot while palpating the sinus tarsi. If this provokes the symptoms, then it is a positive test for Sinus Tarsi Syndrome.
An MRI is the most accurate form of imaging for Sinus Tarsi Syndrome. It can identify potential causes such as inflammation, osteophytes or degeneration of the joint.
This is another highly accurate form of diagnostics for Sinus Tarsi Syndrome and it is very cost effective.
Physical Therapy is the most effective form of treatment for Sinus Tarsi Syndrome. A Physical Therapist may use rigid taping or an ankle brace to help control movement at the subtalar joint to provide pain relief while KT Tape has minimal effectiveness as a form of treatment for this condition. Massage and ankle joint mobilisations may be used to reduce pain levels.
Strengthening and balance exercises alongside ankle stretches are extremely effective in addressing the biomechanical causes of Sinus Tarsi Syndrome. They can be used in addition to custom insoles or orthotics which space the sinus tarsi.
In very irritable cases, an ultrasound-guided corticosteroid injection may be carried out by a Radiographer or Sports Medicine Doctor to reduce inflammation in the Sinus Tarsi. This should be followed by a comprehensive rehabilitation protocol.
Surgery for Sinus Tarsi Syndrome is rarely required but in cases where conservative management fails, an osteotomy or arthroscopy may be recommended.
Your soleus muscle is part of your calf muscle group and plays a very important role in walking and running. The tighter your soleus is, the quicker you transition onto your big toe.
Your Gastrocneumius is the second major muscle in your calf muscle group. It can be helpful to stretch this as well.
The peroneal muscles are on the outer side of your ankle. It helps to turn your foot outwards and is a key stabiliser of the ankle.
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.