Anterior Ankle Impingement

Anterior Ankle Impingement

Posted on by My Central Fitness under Foot & Ankle Injuries

Anterior ankle impingement (anterior tibio-talar impingement) is a condition where soft tissue or bony tissue is trapped between the tibia (shin bone) and talus bone during dorsiflexion at the ankle (pointing foot up). Anterior impingement is seen in a lot of footballers as well as dancers and basketballers. It is highly common following an ankle sprain.

In some cases, a bony spur can develop (known as osteophyte). This is something than can be seen on an x-ray.

Symptoms

  • Pain in the front of the ankle, which usually starts off as a vague discomfort
  • Pain worsens with activity such as running and jumping, as well as deep squats and deep lunges that require high amounts of ankle dorsiflexion
  • Pain on landing from a jump during testing
  • Pain progressively sharpens around the front of the foot
  • Ankle may feel stiff
  • Puffiness of ankle joint (especially in front)
  • Tenderness along front of ankle on palpation
  • Reduced range of dorsiflexion at ankle

Additional Information

Home treatments

  • Range of motion exercises to maximise dorsiflexion at the ankle joint
  • Anti-inflammatory medication (consult GP) if appropriate to cause of impingement if inflammation present
  • Ice to manage swelling associated and pain
  • Compression
  • Relative rest depending on extent of injury

Professional Medical Treatment

  • Mobilisation of the ankle joint
  • Soft tissue management
  • Providing heel lifts or orthoses to reduce dorsiflexion range needed during activity
  • Taping / bracing
  • Cortico-steriod injection if persistent symptoms and no response to exercises and manual mobilisation
  • Extreme cases may require arthroscopic surgery to remove bony or soft tissue abnormality

Physical Therapy Exercises

  • Stability exercises to ensure optimal ankle biomechanics
  • Strengthening exercises to aid in stability exercises
  • Physiotherapy can teach you how to traction your ankle to relieve symptoms of impingement and manage range
  • Optimisation of gait and lower limb mechanics

Prevention Exercises

  • Ensuring adequate ankle stability
  • Ensuring proper rehabilitation after ankle sprain rather than rushing back into sport and ignoring signs of instability
  • Ensuring correct foot mechanics (wearing orthotics if necessary)
  • Managing ankle stiffness if prone