The ankle joint is formed between the tibia (shin bone) and talus (bone in the foot). When we dorsiflex the ankle (toes and foot up to the ceiling) this compresses the front 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 compression of the joint capsule or synovium leading it to become inflamed, swollen and painful. Overtime bone spurs can also develop and each time the ankle moves into dorsiflexion the area becomes pinched.

Causes include poor rehabilitation following an ankle sprain, repeated ankle sprain, poor landing control i.e. in gymnasts or repeated heavy landing into dorsiflexion.  A detailed mechanical assessment is needed to highlight the potential causes and thus the areas to focus on to treat the problem.