Anterior Ankle Impingement (Footballer's Ankle)

Anterior Ankle Impingement (Footballer's Ankle)

Anterior ankle impingement can be due to scar tissue and inflammation or bone spurs that form in the anterior (front) of the ankle joint and limit range of motion and can cause pain. The classic form of impingement is referred to as "footballer's ankle." Despite the name, this can happen in many different types of sports including soccer, football, basketball, and in dancers.

This process is felt to develop as a result of repeated strain on the anterior capsule (front of the joint) with repeated plantar flexion that leads to calcific deposits, or from repetitive dorsiflexion that leads to subchondral injury (damage to the bone) to the talus (ankle bone) which leads to bone spur formation. This can also be found in the chronically unstable ankles. The end result is a decrease in motion (primarily dorsiflexion) due to these changes.

The presenting symptoms are typically a decrease in overall ankle range of motion, mostly affecting dorsiflexion. This can also be associated with pain and inflammation. The diagnosis is made from a careful physical examination and xrays of the ankle. Occasionally an MRI is also utilized to evaluate other structures of the ankle.

The treatment for anterior impingement in the ankle can include physical therapy to help improve the range of motion and break down scar tissue, anti-inflammatory medications to relieve pain and swelling, and ultimately surgery to remove the tissue or bone that is causing the blockage. This can be done with ankle arthroscopy (see section on ankle arthroscopy). This typically has a very rapid return to sports and activity after surgery.