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Ankle impingement is a painful condition that prevents full movement of the ankle; it occurs when the soft tissues around the ankle become pinched.
Ankle impingement usually occurs when the ankle is fully bent, either up or down, causing pain at the front (anterior impingement) or the back (posterior impingement) of the ankle joint. Ankle impingement frequently occurs as a result of an ankle sprain, or it can be caused by arthritis.
Patients who have sprained their ankle and subsequently suffer ankle impingement usually experience pain and weakness in the joint for a long time after the original injury.
Ankle impingement is caused by a bony growth at the front or the back of the ankle bone. This bone spur can trap and squeeze soft tissues when the joint is moved fully up or down. This ‘impingement’ causes pain and can restrict movement in the joint.
Anterior ankle impingement is more common; it occurs at the front of the ankle and is frequently caused by a bad or a repeated ankle sprain. In this case, the ligaments get thicker and are pinched between the bottom of the shin bone and the bones of the foot. Subsequent healing can lead to the formation of too much scar tissue in the region, resulting in ankle impingement.
Posterior ankle impingement is less common; it occurs at the back of the ankle and is caused by a bony growth protruding at the back of the joint.
Ankle impingement (anterior ankle impingement or posterior ankle impingement) is usually successfully treated with rest or a steroid injection. More severe or recurring cases may sometimes require surgery.
For ankle impingement, resting the joint is usually recommended initially. If this fails to alleviate the condition, a steroid (corticosteroid or cortisone) injection may be required. If other, less-invasive treatments have been tried and failed, surgery may be required. The exact type of surgery you have will depend on the cause, location and severity of the ankle impingement.
Surgery involves removing the bone or soft tissue that’s causing the ankle impingement; this can usually be carried out arthroscopically (keyhole technique) or, if the bone spurs are large, by open surgery on the ankle joint.
The operation may be carried out under a general anaesthetic (so you’ll be asleep) or a local anaesthetic (so you’ll stay awake but won’t feel anything). The operation usually takes around an hour and you’ll usually go home on the same day.