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Sinus tarsi syndrome is characterised by pain over the entrance of the tunnel at the anterolateral aspect (outside) of the ankle. It is capable of causing considerable pain and ankle instability (weakness) due to the significant number of nerve endings located within the space. The sinus tarsi is surrounded by a thin membrane, used to reduce friction, generated during ankle and foot movements. This membrane is called the synovial membrane and is filled with a lubricating fluid called synovial fluid. Sinus tarsi syndrome occurs when the synovial membrane becomes inflamed and swollen, resulting in synovitis. The pain is often aggravated by prolonged walking and standing and running. The true cause of sinus tarsi syndrome is not fully understood. However, there are multiple risk factors associated with the onset of this condition. These risk factors include: A significant single traumatic event/injury – research has shown high incident rates (43%) of ankle ligament tears associated with the onset of sinus tarsi syndrome (Lee et al, 2008). Multiple/repetitive ankle sprains – ligaments have poor blood supply and when repetitively injured can become thickened and compromised. A chronically thickened ligament can cause impingement (pinching) within the sinus tarsi (Lee et al, 2008) Pronated foot arch (flat feet) – due to excessive compression at the sinus tarsi Hypermobility syndrome – general joint laxity can predispose you to sinus tarsi syndrome How do you know if you have sinus tarsi syndrome? Sinus tarsi syndrome symptoms typically present gradually over a period of time and are often associated with an old ankle injury which never completely settled. Common symptoms of sinus tarsi syndrome include: Deep burning or shooting pain located on the outer aspect of the foot Tenderness to touch the area on the outside of the ankle just in front of the ankle bone Pain that increases with activities including walking, prolonged standing and running. This video should not serve as a replacement for professional health or medical advice. Always consult a health professional before starting a new exercise or fitness programme. Please stop and consult a physiotherapist if these exercises cause you pain.