Ankle Impingement Syndrome

What is Ankle Impingement Syndrome?

Ankle Impingement Syndrome is a medical condition where the bone spurs or soft tissue structures are compressed during activities that involve maximal ankle dorsiflexion motion, resulting in pain in the ankle region.

Types of Ankle Impingement Syndrome:

Ankle impingement can be divided into two types:

Anterior ankle impingement

This involves pain on the front side of the ankle. It may eventually lead to the development of bone spurs (bony overgrowths) in the ankle joint space.

Posterior ankle impingement

This involves pain on the back side of the ankle. It is common in athletes who sustain forced plantarflexion (bending down at the ankle joint).

Causes of Anterior and Posterior Ankle Impingement Syndrome:

A common cause of both anterior & posterior ankle impingement is a chronic repetitive strain on the ankle due to playing sports or excessive training. So, Activities that require repetitive bending of the foot upward (dorsiflexion) or downward (plantar flexion) can contribute to these conditions.

• Soccer
• Gymnastics
• Ballet/Dance
• Basketball
• Volleyball
• Football
• Running

Symptoms

• Ankle pain with specific motions (pointing the toe down in posterior impingement, bending the ankle up in anterior impingement)
• Limited ankle range of motion
• Ankle swelling

Diagnosis

Doctors diagnose ankle impingement with the help of physical exams and imaging studies.

They will examine the foot, lower leg, and knee to check for signs of pain, swelling, and tenderness in the foot.

X-rays may check for other injuries that may have contributed to the symptoms, such as fractures.

Doctors may also recommend CT scans or MRI to provide more information about any damage due to the injury.

MRIs will show irregularities in the structures surrounding and supporting the ankle joint, such as bones, cartilage, tendons, ligaments, and muscles. This helps determine the best course of treatment.

Treatments:

Non-Surgical Treatment

• Rest: Giving proper rest to the ankle is the first step toward recovery. The patient is recommended to stay away from sports or strenuous activity for up to 4 weeks.
• Icing the ankle: It is recommended to be done for 20 to 30 minutes at intervals of 3-4 hours for two to three days. This will help reduce the pain and swelling.
• Splint: Splint or plaster cast might be recommended by doctors to relieve the symptoms by providing support to the ankle.
• Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): like Ibuprofen etc., can help reduce pain and swelling.
• Physical Therapy: It is usually recommended with exercises for muscle strengthening and to reduce stiffness and increase flexibility.

Surgical Treatment

The doctors might recommend surgical options for treating this condition if the non-surgical treatment is not effective in relieving the symptoms. Surgery is also recommended when the removal of the prominent impinging bone spurs or soft tissue structures can help relieve the symptoms. The removal of bone spurs is usually surgically removed using the Ankle Arthroscopy technique.

Ankle Arthroscopy

This is a minimally invasive surgical procedure performed to diagnose and treat problems in the ankle joint.

The doctor will make a very small incision and insert the Arthroscope, a tiny camera, into your ankle enabling them to view the inside of the joint on the screen. The surgeons will then investigate the issue with the ankle and correct it, if necessary, using small instruments within the arthroscope.

Arthroscopic ankle surgery helps in diagnosing and treating several ankles with minimal risk. The recovery time and the prognosis will depend on the extent of the ankle injury and the complexity of the procedure.