What is anterior ankle impingement?
Anterior ankle impingement is a condition in which soft tissue gets trapped between the bones of the ankle joint as the foot is forced upwards leading to pain. This pain is either at the front on the inner (anteromedial) or outer (anterolateral) side.
Why does it develop?
Anteromedial impingement usually occurs due to spurs on the front of the tibia and/ or talus (see figure 1 below) trapping of the soft tissue, which becomes inflamed and thickened and thus a vicious circle develops. The spurs develop due to repetitive minor trauma and are common in footballers and dancers, however not all of them lead to this trapping of the soft tissue.
Anterolateral impingement is usually caused by inflamed or scarred soft tissue, which is thickened and therefore can become trapped, usually without the presence of bony spurs (see figure 2 below)
What symptoms does they cause?
Pain: at the front of the ankle when the foot is forced upwards i.e. when walking up or down hills or stairs or when running. As with other causes of pain in the ankle they can lead to a sensation of instability or insecurity.
Stiffness: the pain and/ or spurs may lead to restriction in ankle movement.
What options are there for treatment?
a. Pain relieving medication
Simple pain killers may be sufficient to reduce the symptoms to an acceptable level.
These might be thought to be appropriate in some cases to attempt to decrease the inflammation.
The soft tissue thickening and/ or the bony spurs can be removed using key hole techniques (see: Arthroscopic Surgery)