What is Anterior Ankle Impingement?

Anterior Ankle Impingement causes painful compression in the front of your ankle during activities that require maximum ankle dorsiflexion. Also known as, Anterior Impingement Syndrome, or Footballer’s Ankle, this condition affects many people.

What Happens in Ankle Impingement?

In Ankle Impingement, compressive forces damage and inflame your ankle joint during weight-bearing activities. This compression leads to soft tissue inflammation, joint capsule pinching, and pain. Bone spurs or osteophytes may also form on the front edge of your tibia or talus, protecting the joint surface from repeated stress. Repeated ankle sprains can speed up this process, but arthritis doesn’t always accompany it.

Causes of Anterior Ankle Impingement

Factors like ankle sprains, repeated loaded ankle dorsiflexion, joint stiffness, swelling, and muscle tightness contribute to Anterior Ankle Impingement. Poor foot and lower limb biomechanics, inappropriate training, and poor core stability also play a role. A physiotherapist can identify and correct these factors, reducing your risk of developing impingement.

Symptoms

If you have Anterior Ankle Impingement, you’ll likely experience a dull ache that turns into a sharp pain during weight-bearing activities or excessive dorsiflexion. Activities like walking, running, deep squatting, lunging, and jumping can worsen your symptoms. You may also feel tenderness or a clicking sensation in the front of your ankle joint. Swelling may also occur.

Diagnosing Anterior Ankle Impingement

A physiotherapist diagnoses Ankle Impingement through a medical history assessment and a physical examination. They may also recommend X-rays or MRI scans to confirm the diagnosis and rule out other causes of ankle pain. These imaging tests show bone spurs or other abnormalities.

Treatment for Ankle Impingement

Treatment for Ankle Impingement involves several phases to ensure a complete recovery.

Phase 1: Pain Relief and Swelling Reduction
The first phase focuses on managing your pain and reducing swelling. Techniques like ice, compression, and elevation help. Your physiotherapist may also use electrotherapy, acupuncture, or massage.

Specific Interventions
Corticosteroid injections can help if you struggle with reducing inflammation and pain.

Phase 2: Restoring Full Range of Motion
As your symptoms improve, your physiotherapist will work on restoring your ankle’s full range of motion.

Phase 3: Strengthening Muscles
To prevent future episodes, you’ll need to regain muscle strength in your calf, ankle, and foot. Your physiotherapist will guide you through progressively challenging exercises.

Phase 4: Enhancing Balance and Proprioception
Your physiotherapist will help you develop balance and proprioception skills, especially important for high-speed activities.

Phase 5: Returning to Normal Function and Sport
Once you can perform daily activities without pain, your physiotherapist will tailor exercises to meet your specific needs, including sport-specific exercises if you’re an athlete.

Surgery

For high-level athletes with persistent symptoms, ankle impingement surgery may be beneficial. This surgery removes impinging bone spurs or soft tissues either arthroscopically or through a larger incision. However, surgery may not alleviate symptoms if significant ankle arthritis is the cause.

Feel free to consult your physiotherapist or ankle specialist for any concerns or questions about Ankle Impingement.

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