A sprained ankle is a common injury that is treated by Dr. Rajnish Manohar at his Podiatry clinics in both Zephyrhills and Brandon Florida. The Gentle Foot Care Clinic is a place to get some relief from both foot-related injuries and foot-related medical conditions alike. One of the common developments after a sprained ankle is a condition known as Sinus Tarsi Syndrome. Another name for it is Sinus Tarsitis Ankle.
Dr. Manohar would like you to know what the sinus tarsi is, exactly what triggers sinus tarsi syndrome, the signs of the condition, how it is detected and the very best treatment alternatives.
What is Sinus Tarsi Syndrome?
The sinus tarsi is a little cylindrical cavity found on the outside part of the hind foot. It sits between the talus and calcaneus (heel bone), a location called the subtalar joint. See the diagram shown for the locations of these two areas of the foot.
A number of ligaments, blood vessels and nerves travel through the sinus tarsi. It plays an essential role in balance and proprioception. Swelling around the Sinus Tarsi region or injury of any of the surrounding ligaments lead to Sinus Tarsi Syndrome.
What are the Symptoms of Sinus Tarsi Syndrome?
Symptoms of sinus tarsi syndrome tend to come on slowly in time. If you have hurt the ankle, the signs and symptoms of the initial injury have the tendency to never ever totally settle, so despite the fact that the hurt ligament heals correctly, you are left with discomfort due to the resultant irritation of the sinus tarsi area. The most common sinus tarsi signs are:
- Pain when still: has the tendency to be localized to the sinus tarsi area and feels deep inside. Gets worse with extended activities such as walking or running and eases with rest
- Pain when you move your ankle: specifically inversion (turning the sole of the foot inwards) and plantarflexion (pointing the foot down).
- Instability while walking: particularly when exercising on irregular ground or slopes, when jumping or swiftly changing direction
- Stiffness: the ankle might feel stiff first thing in the morning and after that improve as you get moving around and loosen up
- Tenderness to Touch: around the outdoors and front of the ankle.
Sinus tarsi syndrome commonly affects people between the ages of 10 and 30 years old.
What Causes Sinus Tarsi Syndrome?
Sinus tarsi syndrome is typically caused by instability of the subtalar joint. The two most typical causes of this are sprained ankles and altered foot biomechanics:
- Sprained Ankles: Instability of the subtalar joint is a typical issue following an ankle sprain. It might establish after a single strain or after repeated injuries. This instability triggers extreme activity at the subtalar joint which can cause inflammation (known as synovitis) and the formation of scar tissue in the sinus tarsi canal.
- Irregular Foot Biomechanics: People with over-pronated or flat feet are more likely to struggle with sinus tarsi syndrome. This is because the altered foot position enhances the pressure on the sinus tarsi area.
Some other activities that can trigger sinus tarsi syndrome from recurring actions consist of:
- Sitting with your feet tucked beneath you
- Dance, especially Ballet: due to foot positions
- Baseball and Softball Pitchers: due to the position of the tracking foot
How do I know if I have Sinus Tarsi Syndrome?
An MRI scan is the very best way to see exactly what is going on in the sinus tarsi structures. It will reveal any swelling and fibrosis in the location. Dr. Manohar will surely suggest an MRI when you visit one of his offices in either Brandon or Zephyrhills Florida.
Another typical diagnostic tool is to inject the sinus tarsi area with local anaesthetic and corticosteroids. Cessation of signs suggests a positive medical diagnosis of sinus tarsi syndrome. The impacts of the injection are usually short lived and further treatment will be required. If signs fail to settle after an injection, the issue is unlikely to be sinus tarsitis.
How can I treat Sinus Tarsi Syndrome?
When detected early, a full recovery can be made in just a few weeks. However, if the problem is not resolved in the early stages, or if a physical therapy regimen is not consistent, sinus tarsi discomfort can become a chronic issue taking months to settle. Treatment usually consists of the following:.
- Combination of Ice and Rest
This is necessary. Any activities which activates the sinus tarsi pain has to be prevented to enable time for the tissues to heal. This might need using crutches and or an ankle brace in the short-term. The most typical reason for extended discomfort from sinus tarsi syndrome is failure to rest for aggravating activities. Applying ice frequently assists to decrease discomfort and swelling. Ice massage is particularly useful right here as it closely targets the sinus tarsi area.
- Anti-inflammatory Medicines
Dr. Manohar might prescribe non-steroidal anti-inflammatories which assist to reduce pain and swelling. Be sure to talk to your primary care physician before taking any medication.
- Regular physical therapy
This helps to address the cause of sinus tarsitis, be it hypermobility of the subtalar joint or altered foot biomechanics which in turn reduces the signs and symptoms. It might include: mobilization of the ankle joint, ultrasound, ankle taping, and rehabilitative workouts to enhance and stretch the location.
- Different Shoes/Shoe Modifications
Encouraging shoes to limit extreme rear foot activity as opposed to open backed shoes can be practical. If you have abnormal foot biomechanics such as flat feet, you may also be suggested to try orthotics such as shoe inserts to correct this.
These need to just be begun as soon as the discomfort has subsided. It is ok to work out the other muscles of the leg, but ankle workouts ought to be prevented up until your pain is at a minimum. As soon as the signs and symptoms have lessened a little, you can start stretching exercises, particularly focusing on calf stretches and enhancing workouts for the calf, ankle and foot muscles.
- Stability Training.
To make a complete recuperation, balance and proprioception training is vital to prevent any instability around the subtalar joint.
- Return to Normal Activity only when ready
When signs and symptoms have actually decreased, you can slowly go back to your usual activities. It is very important to pace yourself and not try to do too much prematurely, or you might flare the condition up once more.
- Surgical Intervention
This is not a common treatment, but if the signs and symptoms of sinus tarsi syndrome fail to get better using the other methods listed above, surgery could be required. This might be to get rid of any persistent synovitis (inflammation) and scar tissue, reconstruction of the ligaments or arthrodesis– combination of the subtalar joint.
If you’ve sprained your ankle and think you may have some of the symptoms of Sinus Tarsi Syndrome, please contact Dr. Rajnish Manohar at his Brandon office (813) 502-5904 or in Zephyrhills (813) 782-3233. Alternately, you can submit a request by clicking the button below to schedule an appointment.