When you have an anterior ankle impingement, it means that the joint capsule at the front of the ankle is being pinched, compressed or wedged when you move your foot up on your ankle (toes towards the sky). This produces pain, swelling, restricted movement or a locking sensation, and even weakness around the foot and ankle.
Why have I developed an anterior ankle impingement?
To best understand an anterior ankle impingement, picture your foot moving upwards on your ankle. The two bones in your lower leg, the tibia (shin bone) and fibula lie over a bone called the talus that sits directly beneath them and acts like a hinge as you point your toes up.
When your foot is pointed downwards, the gap between the tibia and the talus is at its largest and most open. When the toes are pointed upwards, the front of the talus gets nearer to the end of the tibia, closing the gap between them. This can compress the structures at the front of the ankle and irritate the joint capsule – though there are often other factors at play, too. These include:
- An irregular bone shape at the front of the talus
- The biomechanics of our feet
- A bone spur at the front of the ankle
- Calcification at the front of the ankle following an injury, like an ankle sprain
- Swelling at the front of the ankle that narrows the joint space
- A cyst or other growth at the front of the ankle
Most often, it is the way we move our feet during sports and physical activity, as well as the injuries we sustain during physical activity, that leads to an anterior ankle impingement because of the pressure they place on the ankle joint. These include:
- Soccer, rugby and other ball sports
- Uphill running
- Tripping and falling while the foot is still firmly planted on the ground
- Any activity which sprains the ankle
- Jumping sports
Treating an ankle impingement
While you’re at home and experiencing painful symptoms, start by stopping any activities that trigger the pain. These are usually those that involve bending your foot up on your ankle, or squatting down so that the shin bone moves closer to the foot. If you have swelling, you can elevate your foot, and ice your ankle to help with this, which should help relieve some of your pain, too. If the pain is bad, non-steroidal anti-inflammatories like Ibuprofen can help.
The next step is to book an appointment with your podiatrist. We’ll work to help repair any damage that has occurred, address the cause of the compression, and restore the movement and strength in your ankle. Our goal is not to just relieve your current symptoms, but to reduce the likelihood of the pain returning in the future.
You’ll start with a biomechanical assessment to understand exactly what’s causing and aggravating the problem, so we know the best course of treatment for you. This may include custom foot orthotics to correct any contributing structural and functional foot problems, and promote a large space at the front of the ankle that will allow the damaged structures to heal.
We’ll make sure your footwear is optimising your recovery and not worsening your symptoms. When you’re ready, we may start you on a stretching, strengthening or gait retraining programme if muscle weakness, tightness or gait abnormalities have contributed to the problem.
If the cause of your impingement is a bone spur or calcification, this will be assessed with medical imaging and the right treatment, whether that’s surgical removal or something else, will be indicated.