Anterior ankle impingement: Causes and treatments

Your ankles are more than just joints that can help you walk. They’re complex structures made up of bones, ligaments, tendons and muscles to provide you with stability and move your feet up and down. Cartilage acts as a smooth cushion between the bones to help allow for pain-free movement. Your ankle makes a hinge joint where your shinbone meets your foot bone. Sometimes things can go awry, and one common problem is anterior ankle impingement. Anterior ankle impingement is a common cause of ankle pain, especially for athletes or those who do repetitive activities that involve the ankles. This condition happens when the tissue at the front of the ankle joint gets pinched or compressed. Symptoms of anterior ankle impingement can include:

  • Dull ache.
  • Sharp pain.
  • Tenderness.
  • Swelling.
  • Stiffness.
  • Catching sensation.
  • Popping sensation. 
  • Reduced flexibility.
  • Difficulty bearing weight.

If you are experiencing symptoms and suspect you may be dealing with anterior ankle impingement, it’s important to consult a health care professional, such as a physical therapist or doctor, to determine the most appropriate treatment approach based on your specific needs, symptoms and underlying causes. Early interventions and comprehensive management are key to helping you achieve optimal outcomes and preventing long-term complications. 

Causes of anterior ankle impingement

Anterior ankle impingement can be caused by several factors, including:

  • Overuse or repetitive stress.
  • Previous injuries causing scar tissue formation.
  • Tight calf muscles.
  • Bone spurs or excessive bone growth. 
  • Poor biomechanics.
  • Rheumatoid arthritis.
  • Osteoarthritis.

Treatments to help get your ankle back on track

Anterior ankle impingement is usually treatable with conservative approaches, such as:

  • Rest.
  • Cold therapy.
  • Over-the-counter pain relievers.
  • Physical therapy.
  • Custom orthotics.
  • Activity modification. 
  • Steroid injections.
  • Surgery (in severe cases). 

Physical therapy for anterior ankle impingement

Ankle pain from anterior ankle impingement can sideline you from the activities you love. Physical therapy is a powerful tool to help get you back on your feet. PT techniques that can help tackle this issue include:

  • Electrical stimulation Electrical stimulation uses low-level electrical currents that target muscles and nerves around the affected ankle through electrodes placed on your skin. These controlled currents can help dial down pain by blocking pain signals traveling to your brain. If tight muscles are contributing to your pain and limited movement, currents can help ease muscle spasms and get your muscles moving how they’re supposed to. Currents can also help reeducate and activate weakened muscles, which can improve muscle function and support your ankle joint. 
  • Joint mobilization — Joint mobilization is a type of manual therapy. Your physical therapist can use their hands to stretch your tight ankle ligaments by guiding your ankle through gentle stretches. These stretches can help loosen the ligaments and joint capsule and in turn restore the ligaments’ normal length, improve ankle mobility, allow smoother movement and reduce pain. 
  • Soft tissue manipulation — Soft tissue manipulation is another type of manual therapy. This technique focuses on the ankle muscles, tendons and fascia by applying gentle and sustained pressure on these targets. Your physical therapist will use their fingers to knead out tension, break up knots and restore flexibility to tight spots. This can help release tension, improve flexibility and interrupt pain signals to your brain. 
  • Therapeutic exercises — These exercises can be the key to helping you reclaim ankle mobility and function. Your physical therapist can design a custom treatment plan using different types of exercises, such as:
  • Range of motion — Gentle range-of-motion stretches can help target tight muscles and the joint capsule. They can help increase joint mobility and take pressure off your anterior ankle structures. These exercises could include slowly tracing circles with your foot or gently pulling your toes toward you. Range-of-motion exercises can help ease impingement symptoms. 
  • Strengthening exercises — Building strength and endurance in your ankle and lower leg muscles helps improve your stability and support. These strengthening exercises can target your calves, the muscle on the front of your shin and the intrinsic foot muscles. Exercises to improve strength can use resistance bands, body weight exercises or specific weight machines. By strengthening these muscles, you can help reduce the risk of excessive movement that can cause impingement. 
  • Balance and proprioception exercises — These exercises help improve your body’s ability to maintain balance and proper alignment during movement. You can think of it like you’re standing on one leg on an unstable surface like a wobble board. By improving your joint awareness, or proprioception, and overall balance, these exercises can help prevent future injuries. They can also help improve your overall function when doing activities like walking, running or jumping. 
  • Functional training — Functional training uses activities that mimic real-life movements and activities. They help you tackle everyday tasks and sports without missing a beat. These exercises start slow and gradually progress in difficulty as your ankle strengthens and pain subsides. Your personalized program may include specific movements such as:
  • Walking on uneven surfaces.
  • Stair climbing.
  • Jumping drills.
  • Balance and agility drills.
  • Sports-specific movements.

Lattimore PT can get you on the road to recovery from anterior ankle impingement

At Lattimore PT, we understand the frustration of being sidelined by ankle pain. Our team of skilled physical therapists includes 30 therapists with their Certification in Orthopedic Manual Physical Therapy (COMT). This certification distinguishes them as having advanced skills in manual therapy techniques so that they can provide more comprehensive and targeted treatment for your anterior ankle impingement pain. In addition to manual therapy, your treatment plan will also incorporate a variety of modalities and techniques specifically tailored to meet your needs. Every member of our physical therapy team at our clinics can help empower you to return to your desired activities with confidence. Take the first step toward a stronger, healthier you and experience the Lattimore way. 

Contact our team today for more information or to schedule an initial appointment.

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