What is it?
Anterior impingement syndrome is a condition that produces pain at the front of the ankle. The impingement is caused by the formation of bony spurs and/ or thickened soft tissues that impinge on one another when the ankle is dorsiflexed.
The pain that patients experience at the front of the ankle is made worse with activities that require excessive movement of the ankle joint such as lunging, running and kicking. Anterior impingement syndrome is commonly seen in all ages/ genders, however is most prevalent in ballet dancers, athletes and footballers due to the amount of ankle movement that is required.
What are the symptoms?
- Pain at the front of the ankle
- Pain increases when the ankle is dorsiflexed and when weight-bearing
- A bony lump or spur can sometimes be felt at the front of the ankle joint
Why did I get it?
The buildup of tissue at the front of the ankle joint that is a result of anterior impingement syndrome can occur due to:
- Repetitive flexion of the ankle joint e.g. in ballet
- Direct trauma causing the ankle to flex e.g. a car crash
- Secondary to a severe ankle sprain
- Systemic diseases (e.g. Rheumatoid arthritis) that are associated with multiple bone spurs
How is it diagnosed?
Anterior impingement syndrome is diagnosed based on a thorough history/ clinical examination. Whilst this is usually sufficient for the diagnosis, you may be referred for an x-ray or Ultrasound to determine the exact cause of the impingement and to rule out further pathology.
How can I treat it?
Mild cases of anterior impingement syndrome generally respond to the treatments listed below:
- Rest, ice and compression
- Footwear modifications e.g.adding a heel raise
- Anti-inflammatories
- Activity modification
- Footwear advice
- Mobilisation
- Custom orthotics
Surgery is rarely indicated and is reserved for severe cases and those that do not respond to prior treatment.
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