Ankle Impingement

Cause: Chronic irritation, previous fracture, sprain

Appearance: Pain with flexion or extension of the ankle (plantarflexion and dorsiflexion)

How to Diagnose: X-ray to determine if there is a bone impingement, clinical exam. MRI will show if the impingement is purely soft tissue (joint capsule)

Treatment:

- Contrast baths

o Cold/warm contrast for 10 min each, 3 times

- Physical therapy

- Cortisone injections (if able to have)

- In boney impingements the cause needs to be determined, if it is biomechanical in nature, orthotics/bracing help prevent recurrence

- Surgery

o In boney impingements, removal of fragment with arthroscopic technique should be attempted before open procedure unless open procedure is absolutely necessary

o For soft tissue impingement, arthroscopic debridement should be attempted prior to open, unless an open procedure is absolutely necessary

Long-term prognosis: Cortisone injections typically reduce symptoms enough to continue with play without much debilitation. In chronic cases, surgery has been shown to be successful at fully relieving symptoms as long as the impingement is completely debrided/removed

Who to call: Podiatrist, orthopedic surgeon (skilled in arthroscopy)