Ankle Impingement

Ankle Impingement is defined as pain in the ankle due to impingement in one of two areas: anterior (anterolateral and anteromedial) and posterior (posteromedial).

The condition is common in athletes, especially soccer players, distance runners and ballet dancers.

Types of Impingement :-

1. Anterior Impingement (AI) :-

• Anteromedial Impingement
• Anterolateral Impingement

2. Posterior Impingement (PI) :-

• Posteromedial impingement
• Posterolateral impingement

Clinical features :-

1. Anterior ankle pain.

• Anterolateral
• Anteromedial

2. Posterior ankle pain

• Posterolateral
• Posteromedial

Athletes affected by posterior impingement may attempt to compensate for the loss of plantar flexion by assuming an inverted foot position this may predispose to.

1. Frequent Ankle Sprains.
2. Calf Sprain.
3. Contractures.
4. Planter Foot Pain.
5. Toe Curling

Diagnosed :-

• CT- Scan.
• Isotope bone scanning (rarely used).
• MRI scan.

Examination :-

The physical examination should include inspection of the ankle for swelling, erythema, and alignment, joint effusion, or soft tissue edema.

Medical Management :-

Diagnosis :-

• Standard radiographs.
• MRI for soft tissue swelling and extent of injury.
• Diagnostic injection is a local anesthetic administered into joint capsule and soft tissue, if injection relieved the symptoms it is a positive test.

Physiotherapist Treatment :-

• Gastrocnemius Stretch - Single Leg. Stand facing a wall, with your hands resting on the wall.
• Heel Rises - Sitting. Sit upright on a chair, with your feet flat on the floor.
• Active Inversion - Sitting.
• Active Eversion - Sitting.
• Calf Raises - Two Legs.