A chronic pain on the outside of the ankle joint could be sinus tarsi syndrome. The sinus tarsi is a tunnel between the two bones in the rearfoot (the talus and calcaneus). It carries ligaments, blood vessels and nerves.
Sinus tarsi syndrome in runners can be caused by one of two things:
1. During an inversion ankle sprain, the structures in the sinus tarsi can get strained. Often this is not diagnosed until the initial acute ankle sprain has resolved
2. A foot that is maximally pronated
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