Posterior ankle impingement syndrome refers to a pathology that is characterised by pain and mechanical limitation in the posterior ankle joint caused as a result of repetitive plantarflexion. This explains its common occurrence in individuals involved in activities such as ballet dancing or playing football.
The etiology of the condition can be associated with both osseous and/or soft tissue lesions and anatomical variations. Compression of structures that are posterior to the tibiotalar and talocalcaneal articulations during terminal plantar flexion can also lead to posterior ankle impingement.
As described by Lavery et al., pathology associated with the lateral process of the posterior talus is the most common cause of posterior impingement. This can result from acute fracture, chronic injury due to repetitive microtrauma, or mechanical irritation of the surrounding soft tissues.
For instance, posterior capsuloligamentous injury due to repetitive or acute hyper-plantar-flexion can lead to inflammation, scarring and thickening of the capsule, posterior inferior tibiofibular ligament, and posterior fibers of the deltoid ligament. The flexor hallucis longus tendon is known to be commonly affected by tenosynovitis and tendinosis.
Other sources of impingement can also include anatomic soft tissue variants such as the posterior intermalleolar ligament and several anomalous muscles.
With a clinical presentation that is similar to Achilles or peroneal tendon pathology, a physical examination should be conducted to inspect abnormal alignment, joint effusion, or soft tissue edema. In addition, the bone and soft tissue structures need to be palpated to assess for localised tenderness.
Yasui et al. recommend a complete neurovascular examination as well as strength and range of motion assessment. According to the authors, if the patient is tender during passive or active range of motion, it may indicate pathology involving the flexor hallucis longus tendon.
While discussing the management of posterior ankle impingement syndrome in sports, Ribbans et al. outline conservative treatment options that are available for the condition as rest, cessation of activity, modification of technique, physical therapy, orthotics/footwear modification, non-steroidal anti-inflammatory drugs and injections.
Out of these, injections were found to be curative for soft-tissue pathologies and can be used to temporarily ameliorate symptoms during sporting schedules. Studies have shown that ultrasound-guided injections can help high-level athletes return to sports quicker.
Physical therapy should be implemented with a focus on improving ankle stability and optimising proprioception. The purpose of an orthotic inclusion in a comprehensive treatment programme for posterior ankle impingement syndrome would be for preventing dorsiflexion.
Postural stability is crucial to boost optimal articulation alignment which, in turn, facilitates optimal arthrokinematics of the foot and ankle.
An advantage of using MASS4D® customised orthotics is the enhancement of proprioceptive action through the foot and lower limbs, proximally to the central nervous system, throughout all types of movement.
These orthotics can also help in reducing any load on the soft tissue supportive structures around the ankle in order to improve ankle range of motion. There is also a marked reduction in compensation as the orthotics help to provide a stable base of support for resistance of body sway and improved ambulation.
Copyright 2018 MASS4D® All rights reserved.
Rehabilitation of Your Foot and Lower Back Conditions.
Long Lasting Wear
Strong Foot Support
Easy to use
Handmade MASS4D® Quality
Sign up for free recommended foot exercises, stretching, medical news and everything good for your feet
Please have a a look at our medical reviews and clinical articles on everything about lower biomechanics.
You should always seek the advice of a physician or other qualified healthcare provider with any questions regarding personal health or medical conditions.
The content, products and services offered herein, are here to educate consumers on healthcare and medical issues that may affect their daily lives. Nothing in the content, products or services should be considered, or used as a substitute for, medical advice, diagnosis or treatment. This site and its services do not constitute the practice of any medical, nursing or other professional healthcare advice, diagnosis or treatment.
The marks "MASS4D" and the MASS4D logo are trademarks. The content and design of MASS4D.com is protected by U.S. and international copyright laws. You may not copy, reproduce, republish, upload, post, display, transmit or frame any of these materials without prior written consent from MASS4D®.
The content, products or services on this site should not be considered or used as a substitute for medical advice, diagnosis or treatment and is not intended to provide individual medical advice. Included materials and conversations do not imply a personalised doctor-patient relationship.
Copyright and Intellectual property
MASS4D® is owned and operated by Scheibye General Trading LLC - Licence no: 853463
MASS4D® and Logo are registered trademarks of MASS4D Inc. All content, trademarks, artwork, and associated imagery are trademarks and/or copyright material of MASS4D® Inc.