Sinus tarsi syndrome can be a tricky problem. It usually presents with pain on the outside of the ankle joint. Sinus tarsi syndrome can be due to two quite distinct causes. It can follow a lateral ankle sprain in which the structures in the sinus tarsi are damaged as part of the ankle sprain.  This usually presents as a chronic problem following the ankle sprain. The other cause of an sinus tarsi syndrome is a chronic pronated subtalar joint in which the joint functions at its end range of motion. If the forces driving the joint into its pronated position are great enough, sinus tarsi syndrome can result. Treatment of the post-ankle sprain sinus tarsi syndrome is best managed with physical therapy and mobilisation. The chronic sinus tarsi syndrome from a pronated foot is best managed with a foot orthotics. In either case, if they are resistant to treatment, they can be helped with a sinus tarsi injection.

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