What is Ankle Impingement?
Ankle impingement is a condition where there is bony growth at either the front or back of the ankle bone where it joins the shin bone. Ankle Impingement are of two types, anterior ankle impingement, which occurs in the front region and posterior ankle impingement which occurs in the back region.
Symptoms of Ankle Impingement
Symptoms of ankle impingement depends on the type of impingement.
Symptoms of Anterior Ankle Impingement
- Pain due to anterior ankle impingement is present in the anterior side or the lateral side of the ankle. This anterior ankle impingement symptom of pain does not subside even after an ankle sprain has healed.
- Symptoms of weakness is felt in the ankle due to anterior ankle impingement.
- Pain is produced when the ankle is passively or actively dorsiflexed.
Symptoms of Posterior Ankle Impingement
- Pain in the posterior region of the ankle is a symptom of posterior ankle impingement.
- Tenderness is felt posteriorly at the bottom tip of the fibula.
- Worsening pain at the end of plantar flexion (foot pointing downwards).
- Pain upon standing on toes is also a symptom of posterior ankle impingement.
- X-ray shows if any bony spurs are present on the talus (heel bone) and at the end of the tibia (shin bone).
Causes of Ankle Impingement
When the ankle is fully bent either upwards or downwards, it traps the tissues present in the ankle joint between the bones in the ankle. This condition is known as ankle impingement. Posterior ankle impingement occurs in the back of the ankle. Posterior ankle impingement is commonly seen in ballet dancers.
Anterior ankle impingement occurs at the front of the ankle. Anterior ankle impingement occurs from an acute or recurrent ankle sprain causing the ligaments to thicken and get compressed between the bones i.e. the tibia and the talus bone. When these torn or ruptured ligaments heal, there is excessive scar tissue formation along the front and at the side of the ankle joint resulting in a meniscoid lesion.
Treatment of Ankle Impingement
- Rest should be taken for at least 4 weeks for ankle impingement to heal.
- A plaster cast or splint to treat ankle impingement may be applied to limit ankle movement.
- Cold therapy or ice application helps in reducing pain and inflammation associated with ankle impingement.
- NSAIDs such as ibuprofen and naproxen help in reducing pain and inflammation caused due to ankle impingement.
- Surgery for ankle impingement is required if the patient does not benefit from conservative treatment.
What is the Recovery Period for Ankle Impingement?
Surgical treatment for Ankle Impingement usually is the best way to treat this condition. Surgical treatment for ankle impingement facilitates speedy return of function and resuming normal activities with no pain. Recovery is generally very rapid if surgery for ankle impingement only involves removal of scar tissue from the outer aspect of the ankle. The patient may feel increased ankle pain for some six weeks before improvement is observed. Complete recovery from ankle impingement usually takes around seven to eight months. If there are other conditions in the ankle like peroneal tendonitis, ankle arthritis and the like which require additional correction then recovery may take a bit longer. The overall prognosis for ankle impingement due to these additional conditions may definitely be affected, but still complete recovery from ankle impingement is seen in majority of the cases.
What are the Exercises for Ankle Impingement?
Stretching Exercises for Ankle Impingement are as Follows:
Rehabilitation for Ankle Impingement usually begins with these forms of exercises. Most of the symptoms of ankle impingement may resolve after this therapy without further intervention from the physical therapist. While doing these exercises the patient should make sure that an effective stretch should be maintained for at least half a minute as long as it is pain free. Some of the exercises to achieve this are as follows:
Gastrocsoleus Stretching for Ankle Impingement:
To do this exercise, stand facing a wall and place the hands on the wall. Now extend the injured leg and place a cloth under the arch of the foot for support. Keep the front part of the knee slightly bent. Now, gently point the toes inward on the back foot. Keep the injured heel on the floor with the knee straight, shift the body weight towards the wall. You will feel a gentle stretch in the calf. Maintain this position for about half a minute. Come back to the normal position and repeat this exercise 5 times and do it about 10 times a day.
Range of Motion Exercises for Ankle Impingement Includes:
Ankle Plantar Flexion Exercise for Ankle Impingement:
To do this exercise, sit with the injured leg crossed over the opposite knee. Use the opposite hand to pull the top of the foot and toes towards the body. This should give a feeling of a gentle stretch on the top of the foot and ankle. Maintain this position for about half a minute and return to normal position. Repeat this exercise about 5 times and do it about 10 times a day.
Ankle Eversion Exercise for Ankle Impingement:
To do this exercise sit with the injured ankle crossed over the opposite knee. Grip the foot with the opposite hand, placing the thumb on the top of the foot and fingers across the bottom of the foot. Now, gently push the foot downwards with little rotation such that the toes rise up slightly. This should make you feel a gentle stretch on the inside of the ankle. Maintain this position for about half a minute and return to normal position. Repeat this exercise about 5 times and do it about 10 times a day.
Ankle Inversion Exercise:
To do this exercise, sit with the injured ankle crossed over the opposite knee. Grip the foot with the opposite hand placing the thumb on the bottom of the foot and fingers across the top of the foot. Gently pull the foot such that the toe comes towards the body and the thumb pushes the inside of the ball of foot away from the body. This should give a gentle stretch on the outside of the ankle. Maintain this position for about half a minute and then return to normal position. Repeat this exercise about 5 times and do it about 10 times a day.
Strengthening Exercises for Ankle Impingement
It should be noted that these exercises should be done under the guidance of a physical therapist. In the initial stages you may feel some soreness of the muscles but it will improve with time.
Dorsiflexor Strengthening Exercise for Ankle Impingement:
To do this exercise, you need to have a rubber tube to act as resistance which should be fixed to a stationary object such as a table or a pole. Loop the other end of the tube around the injured leg. Now, sit on the floor facing the object. There should be slight tension felt in the tube when the foot is relaxed. Now gently pull the foot backwards towards the body using the ankle and toes. Maintain this position for about half a minute and then return to normal position. Repeat this exercise about 5 times and do it about 10 times a day.
Ankle Eversion Strengthening Exercise for Ankle Impingement:
To do this exercise, take one end of the resistance tube while the other end is fixed to a stationary object. Take the other end of the tube and place it around the injured foot. Place your fists between the knees. Now draw the band across the opposite foot and slowly pull the little toe outwards and upwards. Make sure that there is gentle resistance offered by the rubber tubing. Maintain this position for about half a minute and return to normal position. Do this exercise about 10 times a day repeating it five times with each try.
Ankle Inversion Strengthening Exercise for Ankle Impingement:
To do this exercise, loop one of the tube over the injured foot and the other end attached to a fixed object. Now gently pull the big toe upwards and inwards ensuring that the rubber tube resists the entire motion. Maintain this position for about half a minute and maintaining the resistance by the tube come back to the starting position. Repeat this exercise about 5 times and do it about 10 times a day.
Balance Exercises that are Essential after Treatment of the Ankle Impingement
It is extremely vital to maintain caution when doing these exercises, as they are quite advanced and are done after almost complete healing of the condition. Make sure that you consult with the physical therapist before starting these exercises.
Inversion or Eversion Balance Exercises for Ankle Impingement:
Make a balance board of about 1.5 feet long and 1.5 inch wide. Use a stick or a rod which is placed underneath the board across it. Now, stand on a smooth surface and step on the board with the feet about a hip width apart at an equal distance from each side of the rod or the stick. Now, use your feet to balance the board and at the same time tipping it from side to side making sure that the board does not touch the ground. You can rest for a few moments before starting to balance the board again. Repeat this exercise about 5 times and do it about 4 times a day.