The sinus tarsi is an opening on the outside of the foot between the ankle and heel bone. It is often referred to as the “eye of the foot” because it opens towards the outside of foot. STS (sinus tarsi syndrome) was first described by Denis O’Connor in 1957 as a problem that can occur after an inversion ankle sprain or due to a “pinching” or impingement of the soft tissues in the sinus tarsi due to a very pronated (rolling in) foot.
Patients typically present with localized pain in the sinus tarsi region with a feeling of instability aggravated by weight bearing activity. Inverting the ankle or moving it into a position where it is turned inwards like it would go with an ankle sprain can cause severe pain. Patients may feel instability in ankle joint especially while walking on uneven surfaces and repetitive strain can aggravate the condition.
Medication and therapies that reduce swelling and inflammation are recommended as well as correction of any underlying biomechanical problems that contribute to the way the ankle bones move restricting the space in the sinus tarsi channel. Strengthening exercises for the ankle are suggested and helpful. When treated early, the outlook for recovery is good but without appropriate, early intervention the condition can lead to chronic pain.
Lift, shift, push, pull – construction work is a physically demanding job and most of the work is done on the move. So it’s understandable that those who work in construction come home with aching feet.
According to the Center to Protect Workers’ Rights, ankle and foot injuries are among the most commonly injured body parts for construction workers. Going up and down ladders, stairs and scaffolding and lifting heavy objects all day can create problems likes strains, sprains and bone bruising. Torn ligaments, overuse injuries, plantar fasciitis and broken bones account for loss time on the construction site. Maintaining balance and equilibrium to prevent falls and accidents are important as well as recognizing what can be done to minimize risk and prevent on the job injuries of the lower extremities. Here are a few best practices for proper care and prevention of foot and ankle injuries.
- Invest in well-made boots and if necessary prescription orthotics to compensate for any structurally abnormalities that can contribute to underlying foot problems.
- Treat minor problems before they become major problem. Yes, arch and heel pain is important, but don’t ignore your toes. Your big toe withstands 40 to 60% of your body’s weight so any injury or problem can have a big impact on your gait and ability to move effectively.
- Don’t ignore persistently swollen or numb feet, burning and tingling. These can be signs of a neuropathy, which diabetics are especially susceptible to.
- Infected or ingrown nails may develop into a cellulitis,a potentially serious bacterial skin infection that can rapidly spread to other parts of the body. Cellulitis appears as a swollen, red area of skin that feels hot and tender.
- Continued pain with activity. If your feet only hurt while you’re active, you could be suffering from a stress fracture. Without proper treatment, stress fractures can easily turn into broken bones.
Over the last several years clinical correlation studies have shown the below normal Vitamin D levels (hypovitaminosis D) may contribute to a variety of health problems. Cited sources have described Vitamin D deficiency as a “worldwide epidemic” with an estimated one billion people having inadequate levels of vitamin D in their blood, and deficiencies can be found in all ethnicities and age groups. Yet it is an often overlooked component in the treatment of foot and ankle injuries and chronic foot and ankle pain.
In the foot and ankle, stress fractures of the metatarsal bones and ankle may be seen in those with Vitamin D deficiency, as well as generalized foot pain. The prevalence of Vitamin D deficiency has been identified as one of the most common causes of fragility fractures and poor fracture healing. Healthy amounts of vitamin D are a critical factor in orthopedic healing and the healing of reconstructive surgery of the foot and ankle.
As specialists in the foot and ankle we see a variety of bone, joint, musculoskeletal and neurological problems of the lower extremity with systematic manifestations such as diabetes, arthritis and other metabolic disorders effected by low levels of Vitamin D. Patients with various –itis (inflammations) such as capsulitis and persistent and recurring tendonitis often test in the lower limits of normal for optimum levels of Vitamin D. Inadequate dietary intake, a lack of sunlight exposure, certain metabolic disorders and disorders that affect your body’s ability to absorb vitamin D can result in a deficiency. With an increasing knowledge of the health consequences of low levels of Vitamin D, doctors can benefit their patients by identifying those who are deficient and require therapeutic supplementation.