Anterior ankle impingement, more commonly known as a “jammed ankle” is what athletes say they are experiencing when they flex their foot towards their shin and feel a sharp pain at the front of their ankle.
This pain is due to compression of the bones and/or soft tissue when the ankle is forcefully flexed under load, such as a squat or landing from a jump. This condition is variously referred to as anterior impingement of the ankle, ankle impingement, anterior impingement syndrome, or footballer’s ankle.
Structures Involved
Per the diagram above, in the ankle the tibia glides on the talus, with both bones being separated by a layer of cartilage.
As the foot and shin move toward each other the ankle is forcefully flexed and the tibia (shin bone) and talus (foot bone) butt against each other, causing pain. Forcefully repeating this action under load can lead to the joint capsule and synovium becoming pinched leading to pain at the front of the ankle. In some but not all cases, this can also lead to bone spurs forming on the edge of the tibia or talus.
What Causes Anterior Ankle Impingement?
The primary causes are ankle sprains (especially repeated sprains) and ankle dorsiflexion under load which typically happens when landing after jumping and deep squatting.
Factors that can contribute to this condition include improper warm up technique, tightness in the calf muscles and connective tissue holding the tibia and fibula together, overtraining, carryover from improper rehabilitation of a previous ankle injury, and joint swelling and/or stiffness and poor form during training.
Symptoms
The primary symptom is sharp pain at the front of the ankle when bending the ankle and dull pain in the ankle at rest. If severe, range of motion may be limited and you may notice swelling over the joint. The front of the ankle will also be tender to the touch.
You may notice an increase in symptoms after activities that involve ankle dorsiflexion under load. These include walking or running on uneven surfaces, deep squats or lunges where the knee moves forward over the toes, landing after jumping, heavy lifting, and calf stretches performed with the knee bent.
Prognosis
It’s important to properly diagnose and fully rehabilitate anterior ankle impingement, but with rest, activity modification and mobilization the prognosis for this type of injury is fairly good. If there is range of motion restriction physiotherapy and chiropractic care can help to restore normal range of motion.
How Apex Can Help
The health professionals at the Apex Centre are highly skilled in physical assessments and have advanced training in manual therapy techniques to restore the normal mechanics of the joints. Our therapists look at the whole picture, not just the area of pain, to provide a comprehensive approach to treatment.
Resources
- https://eorthopod.com/ankle-impingement/
- http://www.sportsmd.com/sports-injuries/foot-ankle-injuries/anterior-ankle-impingement/
