Ankle impingement is a condition where the bones and cartilage of the tibia repetitively contact the bones in the foot at the end ranges of motion. It can occur from a traumatic event, such as an ankle sprain, or sports that require extreme range of ankle motion, such as dancing

MECHANISM OF INJURY

Ankle impingement can occur after traumatic ankle sprains or even fractures. The capsule and synovial lining of the ankle joint can become inflamed and develop scar tissue in either the gutters between the ankle bones. This irritation of the tissue can cause pain with ankle dorsiflexion (bringing the foot toward the head) and subsequently symptoms with athletic activities.

Ankle impingement occurs when a bony growth at either the front or back of the ankle bone restricts the normal range of motion. This results in pain at the front, back, or even sides of the ankle

Symptoms of anterior impingement

  • Symptoms include pain felt at the front or side of the ankle.

  • Often it may follow a sprained ankle which may have healed but impingement pain remains

  • A giveaway sign of impingement is pain when forcing or passively moving the ankle into dorsiflexion (foot points upwards).

Symptoms of posterior Impingement

  • Pain at the back of the ankle

  • There will be tenderness behind the bottom tip of the fibula bone.

  • Pain at the end range of movement when the foot points down (plantarflexion).

  • Going up onto tiptoes may be painful.

  • An X-ray can show up any bony spurs on the talus (heel bone) and end of the tibia (shin bone).

What causes impingement syndrome?

Tissues in the ankle joint can become trapped between bones. It occurs either when the ankle bends fully up (dorsiflexed) or down (plantar flexed).Posterior impingement in the back of the ankle is more common in ballet dancers and can be due to a bony protrusion at the back of the ankle. Anterior impingement can follow a bad ankle sprain. This is because ligaments become thicker. As a result, the tibia and talus pinche them.

Impingement syndrome treatment

  • Rest for up to 4 weeks

  • A plaster or splint may be fitted to restrict movement of the ankle.

  • Ice can be applied to reduce pain and inflammation.

  • If conservative treatment does not work then surgery may be considered