Ankle Impingement

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INJURY TITLE

Ankle Impingement

 

INJURY OVERVIEW

Often thought to be responsible for the ongoing pain after an ankle sprain.  It can occur at the front of the ankle, the back and at the side.  Impingement is common in footballers and dancers due to the extremes of movement that their ankles move through.  This injury can follow a sprain and ankle sprains are very common amongst this population of athletes.

 

INJURY IN-DEPTH INFORMATION

Anterior (at the front):’footballers ankle’

Spurs (bony growths) can develop between the bones at the front of the ankle.  As they become larger they can impinge on other tissues causing pain.

 

Posterior (at the back):

A growth on the back of the ankle bone (talus) is a normal anatomical variant seen in approx. 10% of the population.  This can cause pain because it occupies space in the back of the ankle joint and when the pressure is increased in that area it will cause pain.

 

 

COMMON SIGNS & SYMPTOMS

Anterior

  • Pain with activity (especially running)
  • Pain when the ankle is bent upwards as far as it can go
  • Difficulty with lunges

Posterior

  • Pain at the back of the ankle
  • Pain on pointing the foot downwards

 

HOW IS IT ASSESSED

Anterior:

A maximal lunge forward with your heel remaining on the floor will reproduce your pain.

An X-Ray can help with the diagnostic process.

 

Posterior:

Found with a clinical test of passive placing the ankle in to a pointed position (show this).

If, following an injection of a small amount of steroid, this can be completed without pain – this is considered to be a positive test.

 

 

 

GENERAL TREATMENT

Anterior:

  • Mild cases respond to rest and anti inflammatories
  • Manual therapy to mobilise the ankle joints can also help
  • More severe cases may require injection therapy and/or a surgical opinion.

 

Posterior:

  • Relative rest
  • Manual mobilisation of the ankle joints
  • Possible use of acupuncture
  • Use of a corticosteroid injection for persistent cases.

 

Exercise Videos: i.e.

  • Rotator cuff strengthening
  • Pec stretch
  • etc

 

WHICH HEALTH PROFESSIONAL TO CONSULT

PHYSIO     X

MEDIC     X

PODIATRY     X

Put an ‘X’ next to each health professional that most commonly deals with this injury.

i.e. tennis elbow would be Physio and Medic as injections are common, whereas for muscular LBP it would be Physio and not Medic as they would just refer them to a Physio.

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