What is it?
Posterior impingement syndrome is a condition causing pain at the back of the ankle due to soft tissue or bony compression. This impingement is usually secondary to excessive plantar-flexion (the movement in which the toes are pointed to the ground).
What are the symptoms?
Patients will often present with the following symptoms;
- Sharp pain at the back of the ankle
- Pain at the achilles tendon
- A feeling as if the ankle needs to be “cracked”
- Ache at rest or during activities that require pointing of toes e.g. jumping/ hopping, standing on toes, ballet, walking or running (especially downhill)
Why did I get it?
Whilst people of all ages and genders can suffer from posterior impingement syndrome, the most common people presenting with the condition are footballers, ballet dancers and gymnasts. Majority of patients have the following risk factors;
- Increased ankle range of motion
- Acute trauma (e.g. a tackle)
- Poor biomechanics
- Poor footwear
- Accessory bone in the ankle (known as os trigonum)
- Previous history of a severe ankle sprain
How is it diagnosed?
Typically the diagnosis of posterior ankle impingement is based upon the patient’s history and clinical examination findings. In some cases, you may be referred for an x-ray or Ultrasound to determine the cause of the impingement and to rule out further pathology.
How can I treat it?
- Rest, ice and compression
- Footwear advice
- Strengthening/ stretching program
- Padding/ strapping
- Activity modification
- Custom orthotics
- Cortisone injection/ surgery- reserved for non-responsive/ severe cases and are rarely indicated