The sinus tarsi is a tiny canal that traverses in to the ankle under the talus bone. The sinus tarsi syndrome occurs when there is damage to the sinus tarsi due to overuse, particularly in conjunct with bad foot bio-mechanics, and a large number of patients have had an ankle sprain in the past.
When there is undue movement of the sub-talar joint which triggers joint synovitis and infiltration of fibrotic tissue in to the sinus tarsi. Management for the syndrome focusses on improving the sub-talar joint stability as well as the functioning of the lower extremities.
Sinus tarsi syndrome is typified by constant ankle pain secondary to an injury to the ankle. It develops chiefly because of the instability of sub-talar joint which occurs as a result of ligamentous injuries consequently setting off synovitis and fibrotic tissue infiltration in to the sinus tarsi space.
Causes And Symptoms Of Sinus Tarsi Syndrome
The exact cause of the condition is yet unknown, but it has frequently been associated with ankle sprains. Sinus tarsi syndrome is supposed to occur after a traumatic event or a number of ankle sprains which cause considerable injury to the talo-crural interosseous and ligaments.
The injury causes instability of sub-talar joint occasioning excessive supination and pronation movements. The undue movement of sub-talar joint gives increased force on the synovium of subtalar joint and across sinus tarsi tissues. This in turn causes synovitis and infiltration of fibrotic tissues in sinus tarsi.
Symptoms of sinus tarsi syndrome are:
- Pain in the foot / ankle which may be rather difficult to localize.
- Some complain of discomfort and pain on the outside of the ankle.
- Tenderness is felt at the opening of the sinus tarsi on the outer aspect of the ankle.
- Difficulty running on a curve on the side of the painful ankle
- Difficulty in turning the ankle inwards.
Natural Treatment For Sinus Tarsi Syndrome
The following guidelines will help manage sinus tarsi syndrome effectively:
- Rest from all painful activities is the most vital aspect of the treatment regimen to promote quick healing.
- Apply ice for the first 12 hours to allay pain, tenderness, swelling and inflammation. Apply ice packs for 10 minutes every hour.
- In extreme cases, you may take NSAID’s or non-steroidal anti-inflammatory to manage the excruciating pain and swelling.
- Electrotherapy decreases inflammation successfully.
- After about a week of rest, you need to start physical therapy to enhance mobility. Fix up daily sessions with your physiotherapist.
- Also, for a period of 15 to 20 days, take herbal teas about 3 times per day. Recommended herbal teas are ginger and basil.
- Rectifying bio-mechanical problems such as over pronation is necessary. A podiatrist will prescribe orthotic insoles which go in to shoes to remedy bio-mechanical foot issues.
- Strengthening exercises for the ankle are very essential; particularly proprioceptive exercises such as the use of a wobble board. If you have been out of training on an injured ankle then the proprioception or co-ordination of the ankle will be disrupted. Balancing exercises and using a wobble board will help reinforce the proprioception and will also reduce the chances of re-injuring the ankle.
- Stretch the calf muscles at the back of the lower leg. Tight calf muscles adversely influence the bio-mechanics of the ankle. Perform simple stretches of the calves on a daily basis.