Monday, May 11, 2009

Ankle Impingement



Tissues in the ankle joint can become trapped between bones in the ankle. This is known as impingement and occurs when the ankle is bent fully up or down. Posterior impingement (as it is known) in the back of the ankle is more common in ballet dancers and can be due to a bony protrusion at the back of the ankle.
Anterior impingement (at the front of the ankle) can occur from a bad or repeated ankle sprain as the ligaments thicken and get pinched between the bones (tibia and talus bone). As the torn or ruptured ligament heals, the body forms too much scar tissue along the front and round the side of the ankle joint creating a meniscoid lesion.
Symptoms of anterior ankle impingement
-Pain at the front or side of the ankle which does not go after an ankle sprain heals.
-Weakness in the ankle.
-Pain when the ankle is forced or passively moved into dorsi flexion (toes and foot pointing upwards).

Symptoms of posterior impingement
-Pain at the back of the ankle.
-Tenderness behind the bottom tip of the fibulabone
-Pain which is worse at the end of the movement when the foot is pointed down into plantarflexion (foot pointing downwards).
-Pain when going up onto the toes.
-An X-ray can show up any bony spurs on the talus (heel bone) and end of the tibia (shin bone).
Treatment
-Rest for up to 4 weeks.
-A plaster cast or splint may be fitted to restrict movement of the ankle.
-Cold therapy or ice to reduce pain and inflammation.
-A doctor may prescribe NSAID's (non stroidal anti inflammatory medication).
-If conservative treatment does not work then surgery may be considered.

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