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Sinus Tarsi Syndrome

Sinus Tarsi Syndrome

The sinus tarsi is a large opening on the outside aspect of the foot/ankle where blood vessels, nerves and soft tissue are housed.

Known as the ‘eye of the foot’ or ‘bullet hole’. Sinus tarsi syndrome is localised pain and swelling in the sinus tarsi region, often following an ankle injury. 


Signs & Symptoms of Sinus Tarsi Ankle Pain

  • Localised pain and swelling over sinus tarsi (antero-lateral aspect of ankle)
  • Feeling of instability
  • Pain worse with prolonged activity
  • Tend to be much worse with uneven ground
  • Pain with strong inversion (turning out) or eversion (turning in) of foot

Causes of Sinus Tarsi Syndrome

Sinus tarsi syndrome often occurs after a traumatic ankle injury. Residual swelling and possible scar tissue will take up space within the sinus tarsi causing pain and swelling. It can also occur as a result of a heavily pronated (flat foot) position – as the sinus tarsi space is narrowed and the soft tissues within the sinus tarsi get compressed/ impinged causing pain and swelling.

Sinus tarsi syndrome is often an end result of a sequelae of foot complaints, namely Posterior Tibialis tendon dysfunction (adult acquire flat foot) resulting in midfoot arthritis and compression of sinus tarsi.


Treatment for Sinus Tarsi Ankle Pain

Treatment depends on the severity of the problem and whether it is acute or chronic, however may involve:

  • Period of immobilisation
  • Improved footwear
  • Strapping &/or ankle brace
  • Custom foot orthoses if heavily pronated foot type
  • Steroid injections


Surgery is generally not required, however it is an option if conservative treatment fails. As with most injuries, the sooner sinus tarsi syndrome is addressed the likelihood of a quicker and better outcome is greatly increased.

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At Foundation Podiatry Townsville our Biomechanical Podiatrists both have over 16 years' experience each and are trained to diagnose and effectively treat Sinus Tarsi syndrome and other complex foot, ankle and lower limb complaints.

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