Posterior ankle impingement

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What is posterior ankle impingement?

Footballers, ballet dancers, gymnasts and fast bowlers (due to the impact on their leading leg), are among those frequently affected by posterior ankle impingement. As the ‘plantar flexion’ movement occurs, the foot and ankle are angled away from the body to their greatest extent, with the ankle compressed.

If this extreme motion is repeated too many times or too forcefully, it can result in tissue damage and pain.

Pointe work when dancing, kicking a football, running or walking, especially downhill, hopping and jumping, are all examples of activities that may cause this problem.

How is posterior ankle impingement caused?

Pain felt to the rear of the ankle is the result of compression of the soft tissue or bone when ‘plantar flexion’ occurs, where the foot and ankle are angled away from the body. Impingement can be a consequence of ineffective rehabilitation following an injury and may also be due to bone spurs and arthritis.

What are the symptoms of posterior ankle impingement?

Searing pain to the rear of the ankle when involved in activities in which the foot is angled outwards is a common symptom, together with aching and swelling when at rest post-activity.

How is posterior ankle impingement diagnosed?

Having discussed your symptoms at an initial consultation, your consultant will advise you on the most appropriate treatment for you. X-rays and an MRI scan may also be organised to examine the affected area more closely and confirm the diagnosis.

How is posterior ankle impingement treated?

Normally, patients with posterior ankle impingement will not require surgery. The regular application of an ice pack, plenty of rest, the use of a compression bandage and lifting the ankle above your heart whenever you can should be enough to ease the swelling and pain.

In addition, your consultant may propose that you undergo a tailored rehabilitation plan of physiotherapy to improve your range of movement and rebuild muscle strength, to enable you to go back to playing sport sooner. Should surgery be required, this is likely to involve the removal of bone spurs in the ankle or any damaged soft tissue around the joint, carried out by arthroscopy (keyhole surgery).