#287 3 causes of sinus tarsi syndrome in runners - DOC

#287 3 causes of sinus tarsi syndrome in runners

Today on the Doc On The Run podcast, we’re talking about three causes of sinus tarsi syndrome in runners.

If you are a runner and you have an aching pain, and not really even sure if it’s in your foot or your ankle you may have a condition called sinus tarsi syndrome. 

Sinus tarsi syndrome often affect runners and can be confused with ankle pain, but when you get it, the problem is really not even in your ankle. 

Technically, the actual anatomic part of your foot and ankle doctors actually call the “Sinus Tarsi”  is a tunnel that runs between the bones in your foot, and just in front of them beneath your ankle. 

The word “Sinus” means tunnel. 

The word “Tarsi” refers to the “tarsal bones.”

The tarsal bones are the large bones in your rear-foot underneath your ankle, specifically the two bones called the talus and calcaneus.  

The joint between the talus and calcaneus bones is called the subtalar joint. It the subtalar joint gets the name simply because the talus bone is sitting on top of that joint.  

Pretty much every runner understands or at least has heard the terms pronation and supination. Pronation and supination are motions that happen where your foot and your heel bone basically tilt from side to side to accommodate for uneven sloping surfaces beneath you as you walk or run. All of that motion happens in the subtalar joint.

Pronation and supination are not bad things. You have to have them in order to absorb force, keep your balance and prepare your foot to become rigid so you can push off when you run.  

When a doctor tells you that you developed a case of sinus tarsi syndrome that just means that you have irritated and inflamed the lining of the subtalar joint.

So of course as a runner suffering from this condition and trying to figure out what to do, so you don’t get it again, it may be helpful if you can understand the three common causes of sinus tarsi syndrome in runners. 

Running in unstable shoes  

If your shoes are worn out or if you’re running in shoes that are too flexible and too unstable for your particular foot type, your foot may pronate and supinate excessively when you run. All of that swinging at the subtalar joint to the end ranges of motion can stretch the lining of the joint capsule and irritate the tissue that lines the inside of the joint. When that happens, you start getting pain because a tissue on the inside the joint is swollen (and it can’t swell outward, so it swells inward) and it starts getting pinched between the bones when they move. That is what happens when you’re suffering from a case of sinus tarsi syndrome.

All that really happened is that you have put yourself in a situation where the shoes beneath you are wobbling just enough that is causing too much pronation and supination. Again all of that motion is leading to irritation of the lining of the subtalar joint. When that tissue swells it starts to hurt. 

Hitting an obstacle  

If runner along and your foot steps on a reflector on the road, and irregularity at a crosswalk, or a run a root or a rock on a trail. The forcible pronation from landing on an obstacle under the outside of the foot actually compresses the subtalar joint and can pinch the synovial tissue that lines the joint and leads to the swelling of that tissue that you then experience is constant pain. 

Once that happens when tissue swells that tissue gets pinched in the joint, over and over as you pronate. That continual pinching of the inflamed tissue that causes that pain and irritation is the essence of sinus tarsi syndrome. 

Running on the wrong side of the road.

If the slope of the road, or the slope of the sidewalk underneath you compresses the subtalar joint foot when your foot is in a pronated position. Basically you’re squeezing those bones together. Because the lining of the joint and the tissue that lines that joint gets compressed, and puts more stress in the sinus tarsi, you can start getting inflammation and irritation that we call sinus tarsi syndrome. 

The solution in the thing you need to do is make sure you understand how to avoid these really simple causes of sinus tarsi syndrome. 

If you haven’t seen it already, watch this short video I made for you on how runners with heel pain can run on the right side of the road to supinate the foot. You need to think about where you run and whether or not you’re making any of these same mistakes that are leading to you developing ankle and foot pain that we as doctors call sinus tarsi syndrome.  Just go to www.docontherun.com, click on the Podcast tab, go the podcast section and go to this episode where you’ll find the show notes. At the bottom of that page you can get access to the video. It’s free. Go check it out so you can quit making one of the most common mistakes runners which can lead to sinus tarsi syndrome. 

If you want to run after an injury, the side of the road will either increase or decrease the stress on the recovering foot.

Here is a video on how to choose the right side for you…


If you have a question that you would like answered as a future addition of the Doc On The Run Podcast, send it to me PodcastQuestion@docontherun.com. And then make sure you join me for the next edition of the Doc On The Run Podcast!