Close look on anterior ankle impingement

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Anterior ankle impingement results to pain in the front part of the ankle due to the compression or crushing of the bone or soft tissue structures. This compression generally occurs during activities that involve maximal dorsiflexion of the ankle.

Repetitive compression at the front part of the ankle joint results to the pinching of the joint capsule and synovium which is responsible for triggering pain among individuals with anterior ankle impingement.

In some instances, the repetitive crushing of the anterior ankle joint can result to the formation of bone spurs on the front edge of the tibia or talus. It is believed that these spurs form to protect the surface from repetitive pulling of the joint capsule on the anterior lip of the tibia or cumulative repetition of bone contact.

anterior-ankle-impingement
Dull ankle pain at the front region while at rest which becomes sharp during excessive dorsiflexion or weight bearing.

What are the causes?

It is important to note that anterior ankle impingement is generally due to the following:

  • Repeated ankle sprains
  • Ankle sprain
  • Activities that necessitates repetitive dorsiflexion of the ankle such as deep squatting and landing

Various factors put one at risk for developing the condition. Some of the factors that contributes to the development of the impingement include:

  • Muscle tightness
  • Poor rehabilitation after an ankle injury
  • Bony irregularities
  • Joint stiffness or swelling
  • Poor lower limb and foot biomechanics
  • Poor core stability and proprioception
  • Extensive or strenuous training
  • Poor training especially with technique, surfaces or footwear
  • Inadequate warm up
  • Limited recovery periods from training

Indications

  • Dull ankle pain at the front region while at rest which becomes sharp during excessive dorsiflexion or weight bearing
  • Intensified symptoms after excessive walking or running, deep squatting, landing from a jump or heavy lifting
  • Tenderness or soreness upon palpation of the front part of the ankle joint
  • Clicking sensation during some ankle movements
  • Swelling or puffiness of the joint

Management of anterior ankle impingement

The treatment for anterior ankle impingement aims on managing the pain.

  • Rest – avoid activities or movements that triggers the ankle pain
  • Ice – an ice pack should be applied for 20-30 minutes every 2-4 hours during the initial stage to reduce the swelling and pain
  • Compression – a compression bandage or stocking can help provide support to the damage soft tissue as well as minimize excessive swelling
  • Elevation – raising the injured ankle above the level of the heart can help minimize the swelling around the ankle

In severe cases, a period of rest from the aggravating activity is instructed. Additionally, anti-inflammatory medications and creams such as arnica can be used to minimize the swelling and pain.

More Information / Disclaimer

The information posted on this page on anterior ankle impingement is for learning purposes only. Learn to recognize and manage this ankle condition by taking a standard first aid course with Toronto First Aid.

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