Ankle impingement occurs when either soft or bony tissues are compressed within the ankle joint at the extreme end of a motion.
Ankle impingement is a condition that causes a painful limitation of ankle range of motion due to a soft-tissue or bony abnormality. Ankle impingement can be divided into two types:
- Anterior ankle impingement – This involves pain on the front side of the ankle. It may eventually lead to development of bone spurs (bony overgrowths) in the ankle joint space.
- Posterior ankle impingement – This involves pain on the back side of the ankle. It is common in athletes who sustain forced plantarflexion (bending down at the ankle joint).
Causes of Ankle Impingement
Anterior ankle impingement occurs due to repetitive stresses at end-range positions of the ankle, such as when one jumps, squats or descends stairs. It is also common among participants in sports such as football, dance and gymnastics.
Posterior ankle impingement is caused by compression of soft or bony tissue between the shin bone (tibia) and the heel bone (calcaneus). It is common in athletes who sustain forced plantarflexion (bending down at the ankle joint), including ballet dancers, runners and soccer players.
Symptoms of Ankle Impingement
The symptoms of ankle impingement can vary depending on which type a person is experiencing. With anterior ankle impingement, symptoms can include:
- Pain on the front and/or outside of the ankle joint
- A feeling of ankle instability
- Decreased ankle range of motion when stretching the toes up
- Pain at the end-range of stretching the toes toward the shin
- Tenderness at the front of the ankle when touched
With posterior ankle impingement, someone may experience:
- Pain on the back of the ankle, especially during activities that involve pointing the toes down
- Decreased range of motion when pointing the toes
- Tenderness on the back of the ankle when touched
Diagnosis of Ankle Impingement
In most cases of ankle impingement, diagnosis will start with a physical examination of the ankle. A doctor will also most likely discuss the person’s symptoms and general health history. To provide a definitive diagnosis, the doctor may also order imaging tests such as X-rays or MRIs.
Treatment of Ankle Impingement
For mild cases of ankle impingement, doctors usually recommend conservative treatment options such as rest, ice and anti-inflammatory drugs. If these don’t prove effective, more targeted measures can be taken, including:
- Physical therapy
- Steroid injections
- Arthroscopic surgery