What Is Sinus Tarsi Syndrome? Symptoms, Diagnosis, and Treatment

Sinus Tarsi Syndrome,

Sinus tarsi syndrome (STS) may be a clinical condition characterized by ongoing pain within the anterior (front) lateral (side aspect) of the ankle—between the ankle and therefore the heel—which is typically a result of traumatic injuries. The foremost common explanation for sinus tarsi syndrome is assumed to be a result of chronic or long-term ankle sprains. 

According to Podiatry Today, “The sinus tarsi is an anatomical depression on the surface aspect of the foot that’s crammed with soft tissue structures: ligaments, muscle, nerves, blood vessels, and fat.”  The pain resulting from sinus tarsi syndrome could also be from injury to the ligaments, and instability of the joint, Podiatry Today goes on to elucidate.

The condition itself is taken into account a syndrome; a syndrome is defined as a gaggle of symptoms which occur together, or a condition that’s characterized by a gaggle of associated symptoms.


The condition was first diagnosed in 1957 by Denis O Connor, who also suggested a surgery called the O’Connor procedure as the primary treatment for STS. The surgery to correct STS involved removal of part or all the contents of the sinus tarsi—including the soft tissue structures.


Symptoms of sinus tarsi syndrome include:

  • Chronic (long-term) pain along the front and side aspect (also called anterolateral) of the ankle
  • Pain when the foot is turned in (inversion) or clothed  (eversion)
  • A feeling of instability of the foot or ankle (when bearing weight)
  • Difficulty walking on uneven surfaces (such as grass or gravel)
  • Swelling
  • Tenderness of the sinus tarsi area of the foot
  • Ecchymosis (bruising)

Possible Causes

Chronic ankle sprains are mostly thanks to a weak ligament within the ankle, called the talofibular ligament, consistent with Physiopedia.2  Other causes of sinus tarsi syndrome (other than chronic ankle sprains) may include:

  • Cysts
  • Degenerative changes (progressive and sometimes irreversible deterioration; loss of function within the tissues)
  • Injury to the extensor digitorum brevis muscle (a muscle located on the highest of the foot)
  • A severely pronated foot

Note that pronation of the foot may be a natural movement that happens when the foot lands during running or walking. However, when an individual over pronates the foot, it can cause pressure on the sinus tarsi. This will end in sinus tarsi syndrome. The treatment for overpronation involves orthotics (special shoes) which will help control the motion of the foot.3


Diagnosis of Sinus Tarsi Syndrome may involve:3

  • X-rays
  • A bone scan
  • A CT Scan
  • An MRI (reveals changes within the soft tissue of the sinus tarsi like connective tissue from previous injuries)
  • An injection with an area anesthetic (to help the healthcare provider locate the world of the problem)
  • An ankle arthroscopy (a narrow tube attached to a fiber-optic video camera, inserted through a really small incision [the size of a buttonhole], to look at and diagnose joint problems)
  • Ruling out other problems of the foot

According to Podiatry Today, an MRI is the best method of diagnosing sinus tarsi syndrome, due to its ability to effectively exhibit the soft tissue structure.


Conservative (non-invasive) treatment of sinus tarsi syndrome is taken into account “generally very effective,” consistent with the American Academy of Podiatric medicine (AAPSM). Conservative treatment modalities may include:4

  • Anti-inflammatory medications
  • Steroid injections
  • Physical therapy
  • Orthopedic shoes to stabilize the world
  • Immobilization of the foot
  • Bracing or taping (to stabilize the area)
  • Over the counter or custom orthoses (the correction of disorders of the limbs by the utilization of braces and other devices to supply support)

Surgical Treatment

On rare occasions, surgery could also be required when conservative treatment measures fail. The surgery may involve open surgery (via a surgical incision) or closed surgery (conducted using arthroscopy). 

Surgery should generally be chosen only as a final resort when all other non-invasive treatments have failed (such as immobilization, bracing, and more), says AAPSM.

A Word From Healthcare Solutions

Sinus tarsi syndrome (STS) may be a condition that’s common in those that have had an ankle sprain. It’s vital that an accurate diagnosis is formed foreSTS because the treatment is significantly different than that of other sorts of foot injuries. Although conservative treatment is usually successful, surgical intervention is required in some instances of STS. Surgery should only be considered because the previous resort for the treatment of sinus tarsi syndrome in any case non-invasive conservative treatment modalities are adequately pursued.

Read More: Broken ankle vs sprained ankle

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