What is Posterior Ankle Impingement?
Posterior ankle impingement is the result of structures at the back of the ankle getting caught between the heel bone (calcaneum) and the lower leg bone (tibia). This condition causes pain at the back of the ankle, just above the heel bone, in activities where the foot is pointed down. This condition is commonly seen in dancers, gymnasts, kicking sports and fast bowlers in cricket.
What causes Posterior Ankle Impingement?
The condition of impingement differs from person to person, it is often the causes are soft tissue structures at the back of the ankle and ligaments at the back of the ankle. In some people, the impingement may be due to a small extra bone in the back of the ankle called an ‘os trigonum’ in which 10% of adults deal with this situation. Other people have a slightly more prominent bony point at the back of their bone in the ankle joint (talus), which can cause impingement.
How do I know if I have Posterior Ankle Impingement?
Posterior Ankle Impingement may begin after a previous ankle sprain. This condition will not affect day to day activities in which pain will only be present when in loaded plantarflexion. Our physiotherapists will be able to diagnose this condition by asking you a range of questions about what activities you do and any previous foot or ankle injuries. it is vital for you to perform the activity that provokes your pain allowing the physiotherapist to decide what the issue is. Scans and imaging are not required unless you are not responsive to treatment.
How can physiotherapy help with Posterior Ankle Impingement?
Our physiotherapists will be able to help design a personal treatment plan to reduce and settle your pain. This will usually consist of a period of offloading from the aggravating activity. Medications may be advised to help settle any pain or associated inflammation if needed.
Strengthening exercises will be directed by your physiotherapist for the calf, as well as for any deficits identified further up the leg. It is important to initially avoid having the foot fully pointed during strengthening exercises.
What can I do at home?
It is important to avoid having your ankle in forced plantar flexion (toes pointed) to ensure the irritation and pain are reducing to allow a slow progression into your normal activities. Our physiotherapists will give you exercises depending upon your personal plan and the information you have provided.
How long will my recovery time be?
Your recovery time will depend on the activity you are completing. For a dancer rehabilitation may take up to 2-6 months whilst kicking sports may not take as long.
If you would like to find out more please call us or book an appointment here.
Reference: Australian Physiotherapy Association 2019, Your Body, viewed 19 November 2019, < https://australian.physio/>.