|
|
Anterior Ankle ImpingementInjuries > Ankle > Anterior Ankle Impingement(Also known as Ankle Impingement, Anterior Impingement Syndrome, Anterior Impingement of the Ankle)What is anterior ankle impingement?The talus is a small bone of the ankle responsible for transferring weight bearing forces from the shin to the foot (figure 1). During the movement of ankle dorsiflexion (figure 2) i.e. when the foot and shin move towards each other, the bottom of the shin bone approaches the front of the talus. This places compressive forces on the structures at the front of the ankle joint. If these forces are excessive or beyond what the ankle can withstand, damage and inflammation of these structures may occur. This condition is known as anterior ankle impingement. Occasionally, bony spurs can also form at the front of the ankle joint which may contribute to the problem. Causes of anterior ankle impingementAnterior ankle impingement sometimes occurs following an ankle sprain or due to activities requiring repeated forced dorsiflexion (figure 2). Signs and symptoms of anterior ankle impingementPatients with this condition typically experience pain at the front of the ankle that increases with excessive dorsiflexion or weight bearing activities such as running. Treatment for anterior ankle impingementIt is recommended that patients with anterior ankle impingement undergo a physiotherapy program as the first line of treatment. One of the key components of this program is that the patient rests sufficiently from ANY activity that increases their pain until they are symptom free. This allows the body to begin the healing process in the absence of further tissue damage. Once this is achieved a gradual return to activity is indicated provided there is no increase in symptoms. Ignoring symptoms or adopting a 'no pain no gain' attitude is likely to aggravate the condition and may lead to the problem becoming chronic. Immediate appropriate treatment is essential to ensure a speedy recovery. Patients with this condition should follow the R.I.C.E. regime in the initial phase of injury. The R.I.C.E regime is beneficial in the first 72 hours following injury or when inflammatory signs are present (i.e. morning pain or pain with rest). The R.I.C.E. regime involves rest from aggravating activities (crutches may be required), regular icing, the use of a compression bandage and keeping the leg elevated. Anti-inflammatory medication may also significantly hasten the healing process by reducing the pain and swelling associated with inflammation. A graduated and pain-free flexibility, strength and return to activity program under direction from a physiotherapist is vital to ensure an optimal outcome. Alternative exercises placing minimal weight bearing forces through the ankle should be performed to maintain fitness such as swimming, cycling, and water running. Contributing factors to the development of anterior ankle impingementThere are several factors which can predispose patients to developing anterior ankle impingement. These need to be assessed and corrected with direction from a physiotherapist. Some of the factors which may contribute to the development of this condition include:
Physiotherapy for anterior ankle impingementPhysiotherapy treatment is vital to hasten the healing process and ensure an optimal outcome in all patients with this condition. Treatment may comprise:
Other intervention for anterior ankle impingementDespite appropriate physiotherapy management, some patients with this condition do not improve. When this occurs the treating physiotherapist can advise on the best course of management. This may include a corticosteroid injection, X-rays or other investigations, or for those patients with prominent bony spurs, surgical intervention may be indicated to remove the bony spur. Exercises for anterior ankle impingementThe following exercises are commonly prescribed to patients with anterior ankle impingement. You should discuss the suitability of these exercises with your physiotherapist prior to beginning them. Generally, they should be performed 1 - 3 times daily and only provided they do not cause or increase symptoms. Foot and Ankle Up and DownMove your foot and ankle up and down as far as possible and comfortable without pain (figure 3). Repeat 20 times.
Figure 3 - Foot and Ankle Up and Down
Foot and Ankle In and OutMove your foot and ankle in and out as far as possible and comfortable without pain (Figure 4). Repeat 20 times.
Figure 4 - Foot and Ankle In and Out
Foot and Ankle CirclesMove your foot and ankle in a circle as large as possible and comfortable without pain (figure 5). Repeat 20 times.
Figure 5 - Foot and Ankle Circles
Kneeling StretchBegin in four point kneeling (i.e. on your hands and knees) on a flat surface. Keep your knees and ankles together, toes pointed. Gently take your weight back onto your ankles until you feel a stretch at the front of your ankles or shins (figure 6). Hold for 15 seconds 4 times at a mild to moderate stretch pain-free. This exercise can be progressed by placing a rolled towel under your feet as demonstrated.
Figure 6 - Kneeling Stretch
Find a Physio for Anterior Ankle ImpingementFind a physiotherapist in your local area who can treat this condition.
Other ExercisesView more Ankle Flexibility Exercises. View more Ankle Strengthening Exercises. View Balance Exercises.
Physiotherapy products for Anterior Ankle ImpingementSome of the most commonly recommended products by physiotherapist for patients with this condition include:
To purchase physiotherapy products for Anterior Ankle Impingement click on one of the above links or visit the PhysioAdvisor Shop.
Return to the top of Anterior Ankle Impingement.
|
Figure 1 - The Talus
Figure 2 - Ankle dorsiflexion
|
.jpg)
.jpg)
.jpg)
.jpg)
.jpg)
.jpg)
.jpg)
.jpg)
.jpg)
.jpg)
.jpg)
.jpg)
.jpg)
.jpg)
.jpg)
.jpg)
