Anterior Ankle Impingement

Anterior Ankle Impingement

Article by J.Miller, Z.Russell

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.


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

anterior ankle impingement
Anterior 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.


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.

Foot, Ankle & Heel Pain Products & FAQs

Common Ankle Injuries

Welcome to an exploration of common ankle injuries. The ever-present sprained ankle is at the forefront, accompanied by various sources contributing to ankle pain. Fractures, stress fractures, and tendinopathies are part of this landscape, each with implications. Ankle impingement and foot posture issues emerge, and biomechanical issues take centre stage, affecting alignment and eventually fast-tracking ankle arthritis. Even the younger population experiences heel concerns, with Severs disease impacting many young athletes' seasons. This article serves as a concise guide to understanding the complexities of ankle problems.

Sprained Ankles

The most common ankle injury is a sprained ankle, but ankle pain can have numerous sources.

Ankle Fractures

An ankle fracture occurs when there is a break in one or more of the bones. The most common ankle fractures are avulsion fractures of your distal fibula, which can be a side effect of an ankle sprain. All suspected fractures require medical investigation and professional management by your health professional to avoid long-term foot and ankle issues. If your healthcare professional suspects an ankle fracture, you will be referred for at least an X-ray and potentially an Orthopaedic Surgeon.

Ankle Tendinopathies

While muscle strains are more common in your legs, there are essential muscles that converge into tendons that wrap around your ankle to stabilise your ankle and foot to protect them from sprains and allow you to walk and run. These muscles and their tendon vitally provide a normal foot arch and avoid flat feet. Your muscles or tendons can become injured or inflamed due to overuse or trauma. The inflammation is called tendonitis. They can also tear, completely rupture, or sublux out of place. Medically tendon injuries are known as tendinopathies, and at the ankle may include:

Ankle Arthritis

Your ankle pain and dysfunction can lead to degenerative conditions such as ankle osteoarthritis. While arthritis usually is a chronic deterioration of your ankle joint, it is crucial to slow ankle arthritis progression. Would you please seek the professional advice of your ankle and foot health practitioner, e.g. physiotherapist or podiatrist?

Biomechanical Conditions

Biomechanical disorders may result in foot deformation, painful weight-bearing and potentially nerve compression. In simple terms, this is where your foot and ankle do not have normal bone alignment and motion control. Here are a few possible conditions related to poor ankle biomechanics.

Muscle Injuries

Nerve-Related Ankle Pain

Children & Youth Conditions

Systemic Conditions That May Cause Ankle Pain

Soft Tissue Inflammation

Other Useful Information

Foot, Ankle & Heel Pain FAQs

Welcome to our comprehensive FAQ guide on Foot, Ankle & Heel Pain. In this guide, we aim to address common questions and concerns related to foot, ankle, and heel pain. We will cover various topics, including ankle injuries, heel pain, Achilles pain, foot pain, shin pain, youth injuries, and balance and proprioception. Whether you're experiencing discomfort or seeking preventive measures, this guide will provide valuable insights and advice to help you understand and manage these conditions effectively.

Ankle Injuries

Heel Pain

Achilles Pain

Foot Pain

Shin Pain

Youth Injuries

Balance & Proprioception

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