Ankle Impingement Treatment Plan

Do you have ankle pain at the front (anterior) or back (posterior) of your ankle when you straighten out or completely flex your foot? You might be experiencing an ankle impingement. Treatment for this syndrome involves decreasing the inflammation within the ankle. When that is not enough, surgery and other medical procedures may be considered. Keep scrolling for the best ways to manage ankle impingement syndrome pain.

Ankle Impingement Treatment Plan

Treating ankle impingement starts with conservative treatment to reduce inflammation and pain. When those treatments are not enough then your doctor may suggest additional treatments or surgery.

Treating Anterior vs. Posterior

There are two types of ankle impingement, anterior and posterior. Anterior ankle impingement is more common and involves pain at the front of the ankle. Also known as footballer’s ankle, the pain is brought on by repetitive dorsiflexion movements. This is when the foot is pointed up towards the shin. Posterior ankle impingement is when there is pain at the back of the ankle during plantarflexion (when you point your toes).

Regardless of the location, pain caused by bone spurs or something else taking up space in the ankle joint and treatment involves the same types of conservative remedies.

Ankle Impingement Injury Overview

Pain Management

Ankle impingement syndrome pain can be managed by reducing the swelling in the surrounding soft tissue. This can be done through several methods, which we have outlined for you below.

Massage

Massage uses pressure on the muscles and soft tissues to release tension and muscle knots. When used for ankle impingement you can release the tension built up and move the fluid back into your vessels that have developed from swelling. Be careful not to massage directly over the site of pain or over bony prominences.

Cold & Heat Therapy

Cold and heat work very differently but complement each other nicely for ankle impingement. Start off with an ankle ice pack to reduce swelling and pain. Use it for 20 minute intervals for the first few days after you begin feeling pain. When swelling has gone down you can introduce heat. Heating pads will soothe soreness and relax your muscles. Avoid using heat if you have bruising or swelling as it can make it worse.

Alternating Ice & Heat for Injuries

Taping & Bracing

One of the causes of ankle impingement is an ankle injury like an ankle sprain. The injury creates the feeling of ankle instability due to the loosening of the ligaments. Wearing an ankle brace can stabilize your ankle and protect your ankle from further injury. Taping your ankle will also give you ankle stability and reduce movement. This can be done with athletic or kinesiology tape; however it can be difficult to tape properly, so work with a physical therapist or another healthcare professional for guidance.

Finding the Right Ankle Brace

Reduced Activity Level

When you are used to being an active athlete or just a busy body, resting can be one of the hardest treatments. But with ankle impingement, it’s important to get off of your feet and let your ankle rest. Bone spurs coming off of the talus or ankle instability create swelling and pain that will not go away on its own. So don’t ignore it and let that ankle heal!

Anti-Inflammatory Medications

Anti-inflammatory medications like ibuprofen and naproxen are over-the-counter drugs that decrease inflammation and pain. They will not cure your ankle impingement but are a great addition to your treatment plan. Always talk to your doctor or pharmacist before you start a new medication to ensure that it is safe for you and there will be no unintended side effects.

Steroid Injections

Steroid injections are used to reduce swelling and pain in joints. Also called corticosteroid injections, this powerful medication along with a numbing medication is injected directly into the ankle joint. Patients generally experience relief quickly. You might be limited in the number of steroid injections you can get, so talk to your doctor to find out more information.

Proper Footwear

Wearing the right shoes can reduce the chronic ankle pain associated with ankle impingement. Shoes that stabilize your ankle will alleviate pain from ankle dorsiflexion. You can use orthotics or shoe inserts to correct under or overpronation. The cushioning from shoe inserts and properly fitting shoes will soften and support each step and alleviate pain.

Exercises

Strengthening exercises that increase your lower body strength can help reduce further injury to the ankle bone and reduce pain. Strong lower leg muscles will help maintain the ankle joint space to prevent compression and pain. Balance exercises are used to increase stability in your ankle. Lastly, don’t forget to stretch your lower body and ankle to maintain the range of motion and the flexibility of your joints.

Effective Ankle Impingement Exercises

Physical Therapy

Physical therapists are professionally trained to treat muscle and joint injuries, including ankle impingement. They will first evaluate your injury and determine the best treatment plan. This may include guided stretches, exercises, ice, or electrical stimulation. If you have developed scar tissue from repeated injuries your physical therapist can help work through that and loosen the tightness that has developed. Expect to be given a handout of stretches and exercises you can do at home.

Surgery for Ankle Impingement

Not everyone who has ankle impingement will need surgery. But those patients who have gone through other treatments and are not finding relief may require surgery. An orthopedic surgeon will review any diagnostic imaging like x-rays or magnetic resonance imaging (MRI) to get a better visualization of the injury. From there, the surgeon will determine which surgery is best.

Surgical treatment can involve a debridement, or removal, of the osteophytes (bone spurs) that have developed near the talus. This can be done through arthroscopic treatment, which uses small incisions and has a quick recovery time. If the osteophytes are large then open surgery may be necessary. Ask your surgeon if arthroscopy or open surgery is necessary for your injury.

Healing Your Ankle Impingement

Ankle impingement or athlete’s ankle is a condition often seen in ballet dancers, soccer players, and other athletes. It can also be caused by injuries such as ankle fractures or ankle sprains. Treatment can begin at home with options such as braces, ice, and medication. If home treatment does not bring relief then it’s time to consider medical intervention or surgery. Talk to your doctor before you begin treatment to help get you back on your feet quickly and safely.

Sources:

https://www.physio-pedia.com/Ankle_Impingement

https://www.choosept.com/symptomsconditionsdetail/physical-therapy-guide-to-ankle-impingment

https://stanfordhealthcare.org/medical-conditions/bones-joints-and-muscles/ankle-anterior-impingement.html