Ankle Pain and Ankle Impingement

ANTERIOR ANKLE PAIN AND IMPINGEMENT

• Ankle pain; commonly at the front of the ankle, particularly during weight bearing tasks such as lunging
• Pain may be felt either side of your ankle joint
• Symptoms may be acute in their onset
• Ankle pain and discomfort may  limit functional tasks such as running and jumping
• Symptoms may be experienced after exercise (an inflammatory reaction to micro-trauma)
• Reduced range of motion (particularly dorsiflexion); this may include a “blocking” sensation to your movement
• Swelling around the ankle is possible
• Likely tender on palpation

POSTERIOR ANKLE PAIN AND IMPINGEMENT

• Ankle pain; commonly experienced at the back of the ankle
• Ankle pain and discomfort that is often aggravated by end of range plantarflexion (i.e. pointing toes)
• More common in sports that require repetitive plantarflexion (i.e. running, dancing, soccer, volleyball)=
• May experience ankle instability
• May have swelling in the area
• Likely tender on palpation

SHORT TERM

ASSESSMENT AND DIAGNOSIS

Not all ankle pain is the result of impingement. Assessment of your presentation is necessary to try and determine the source of your symptoms. Diagnosis is a vital part of managing any injury. Not only is it important to determine which structures are responsible for your symptoms, but why they have become symptomatic. Addressing the ‘why’ will ensure adequate recovery and prevention of future injury.

LOAD MODIFICATION

Load often needs to be modified to reduce symptoms and allow contributing factors to be assessed and addressed. This doesn’t mean no running or no sport, but load should be reduced to a volume that provides an opportunity for tissues involved to rest and recover. 

DRY NEEDLING AND SOFT TISSUE TECHNIQUES

These techniques can help to improve the health of affected tissues. They may also help to address contributing factors such as joint range and calf strength.

FOOTWEAR CONSIDERATIONS

Footwear may be an important consideration in the management of your ankle pain. This includes not only runners, but casual and work footwear as well.

LONG TERM

STRENGTHENING (IF INDICATED)

Reduced strength and activation of the muscles that control your foot and ankle may have contributed to your symptoms. This can be accurately assessed by physiotherapists and strength coaches at The Injury Clinic and a plan put in place to not only assist in your recovery, but also reduce the likelihood of injury recurrence. 

MOTOR PATTERNING AND CO-ORDINATION

They way we move is often a contributor to injury, especially in sports that require change in direction. Strengthening alone is not necessarily enough to see the improvements we are after in biomechanics and movement patterns. Exercises that address and retrain how we move may be needed to reduce load through affected tissues.

REFERRAL

Sometimes referral to other specialists such as a sports physician is needed for either consideration of imaging or injection-based therapies.