The cervical ligament of the ankle occupies the lateral portion of the tarsal sinus entrance, providing additional subtalar stability alongside the interosseous talocalcaneal ligament. It is a secondary restraint against excessive subtalar inversion. Cervical ligament tears in lateral ankle sprains contribute to the persistent subtalar instability that can develop after recurrent inversion injuries.
| Origin | Superior calcaneal surface at the entrance to the tarsal sinus (calcaneal sulcus) |
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| Insertion | Inferior talar neck |
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Binds the talus to the calcaneus in the sinus tarsi and limits inversion at the subtalar joint.
The cervical ligament is seen on MRI in the lateral, wider part of the sinus tarsi, lateral to the interosseous talocalcaneal ligament. Its disruption alongside the ATFL and CFL in severe lateral ankle sprains contributes to subtalar instability and to sinus tarsi syndrome, with diffuse anterolateral hindfoot pain and tenderness over the sinus tarsi opening in front of the fibular tip. MRI shows sinus tarsi fluid, scarring or ligament disruption. A local anaesthetic injection into the sinus tarsi confirms the diagnosis and can also relieve pain. Treatment ranges from rehabilitation targeting subtalar proprioception and orthotics to arthroscopic debridement for refractory cases.
Subtalar stabiliser disruption in severe lateral ankle sprains contributing to subtalar instability requiring targeted subtalar proprioceptive rehabilitation.
Persistent anterolateral hindfoot pain after sprain from injury and scarring of the cervical and interosseous ligaments, confirmed and treated with sinus tarsi injection.
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