Summers in New York City exhibit beautiful weather that engages everyone to enjoy outdoor sports. The sunshine encourages "weekend warrior" athletes to increase play time. With an increase in these physical activities, there is always a possibility of pain in the foot.
The sinus tarsi is also known as "the eye of the foot". It refers to a canal on the outside of the foot between the ankle and heel bone. Sinus tarsi syndrome is characterized by localized pain on palpation at this opening. Patients not only complain of pain, but also may complain of instability and aggravation upon weightbearing activities. Pain is worse when weightbearing on uneven surfaces. Pain may also be aggravated on foot inversion (turning in) or foot eversion (turning out).
Sinus tarsi syndrome may be caused by an inversion ankle sprain. It can also be due to impingment of soft tissue in the canal or an overpronated (rolling in) foot.
An injection with local anesthetic to the sinus tarsi will confirm diagnosis by relieving pain. An MRI showing increased fluid in the sinus tarsi canal will also confirm diagnosis.
After confirming diagnosis, conservative treatment is established. The athlete must rest from painful activities. Treatment may include anti-inflammatories, ankle sleeves, immobilization, orthoses, cold therapy, steroid injections, or physical therapy. Surgery, such as arthroscopy, should be considered as last resort after all conservative treatment have been exhausted.
When sinus tarsi pain has subsided, the weekend warrior athlete must perform strengthening exercises. Balancing exercises with use of a wobble board will increase and strengthen proprioception of the ankle. Stretching exercises for the calf muscle are also very important. Tight calf muscles affect the biomechanics of the ankle and can cause injury. Sinus tarsi syndrome is a problem that must be properly diagnosed. Proper diagnosis will set the tone for appropriate treatment so that the athlete can return and continue to enjoy the sunshine for the rest of the summer.
If you have any questions, please feel free to contact our office.