Ankle Anterior Impingement

Ankle impingement is an uncommon problem that occurs secondary to more common injuries of ankle, such as sprain or fracture. If your child has been experiencing pain or a limitation in sports because of the ankle injury for longer than three months, there is a chance that ankle impingement is the cause.

Impingement means to collide, impact, smash or strike, and can be related to pinching, especially in this context. There are two locations and three types of ankle impingement.  This problem can occur in the front of the ankle or in the back of the ankle. The more common type is in the front. The types of ankle impingement are related to the cause of pinching. It can be scar tissue (the most common cause in kids), an extra amount of ligament or a bone spur (the most common cause in adults). All three causes can occur in children.

Symptoms

Symptoms of anterior ankle impingement include:

  • Pain with activity, not at rest.
  • Pain in the soft spot in the front-outside portion of the ankle.
  • Pain when the ankle is bent up (especially with running and jumping).

Diagnosis

The diagnosis is based on history of pain and the physical exam. An X-ray and MRI can be done to rule out other sources of pain, but are often normal.

Treatment

If ankle impingement is diagnosed, the best treatment is surgery to clean out the scar tissue or the other impinging tissue. If the diagnosis is still unclear, then an attempt at physical therapy can be done to see if strengthening exercises can restore normal function to the ankle.