Posterior ankle impingement

What is posterior ankle impingement?

The ankle joint is formed between the tibia (shin bone) and talus (bone in the foot). When we plantarflex the ankle (toes and foot down towards the floor) this compresses the back of the ankle. Usually a balance in muscle strength and good proprioceptive (balance) control will ensure that there is a balance in forces across this joint space but in some cases it becomes subjected to much higher loads. This causes increased sensitivity of the structures at the back of the ankle (opposite to anterior impingement).

How does it present?

It is common in footballers, dancers and sprinters and tends to cause problems, (sharp pain) in terminal plantar flexion i.e. when the foot is pointed (e.g. when kicking a ball). Similar to anterior impingement the causes can be multi- factorial so a detailed assessment is required. Swelling and focal tenderness can occur around the back of the ankle.

How is it treated?

Treatment will include soft tissue release and joint mobilisations. Taping techniques and home exercises addressing ankle stability and strength are also paramount. Lastly footwear and technique may need to be assessed to prevent re-occurrence.

What You Need To Know
  • Will cause a sharp pain when the toes and foot point down.
  • Common in footballers, sprinters and ballet dancers.
  • Swelling, heat and redness can develop around the back of the ankle.
  • Working on ankle strength and balance can be effective in managing this condition.