"Footballer's ankle"- anterior impingement syndrome
Here at The Physio Nook we deal with a large number of footballers every season, with many and varied injuries. One that some may not hear so much about is anterior impingement of the ankle, or “footballer’s ankle”
What is it?
As the name suggests, this is condition characterized by pain at the front of the ankle. It is believed to be due in a large part to the repetitive trauma to the connective tissues at the front of the talocrural joint caused by kicking a football. It tends to be more prevalent on the player’s dominant foot for this reason.
The joint capsule anteriorly is repeatedly stretched, as well as being compressed against the bones at the front of the ankle. This then leads to an inflammatory response, followed by thickening of the capsule itself, and possibly the formation of osteophytes (extra bone) in the area. These together cause a nipping or pinching of the capsule at the front of the talocrural joint, which is an impingement syndrome.
Symptoms of Footballer’s Ankle
Predominantly, quite localized pain at the front of the ankle near the talocrural joint line. Often end range of both dorsiflexion and plantarflexion cause an increase in this pain, as the capsule is either pinched (dorsi) or stretched (plantar). Clicking, weakness and instability or a lack of confidence in the ankle are also common.
How do we treat it?
Early intervention follows the classic RICE protocol with rest from sport and regular icing being crucial. Local ultrasound and electrotherapy modalities often accelerate the healing process and settle the joint capsule down, as well as either oral or topical anti-inflammatories.
Manual therapy commences following the initial short settling down period, involving specific ankle joint mobilizations, capsular stretching and local soft tissue therapy. Stretching, strengthening and proprioceptive exercises are prescribed according to each individual’s presentation, as well as taping methods. If the condition doesn’t progress as expected, investigations and a surgical opinion may be required to assess and manage excessive thickening of the capsule and/or osteophytes.
If all goes according to plan however, more functional weight-bearing exercises are introduced and a gradual return to running and directional running, stop-start and other more sport specific drills will lead to the ultimate goal- a return to the football field.
I hope this summary will help you or someone you know. As always, we are here at The Physio Nook to help out with any musculoskeletal disorders you may have, ankle or otherwise! Feel free to call us, email, or drop in for a great service.
Paul Woodward
Principal Physiotherapist
The Physio Nook.
As the name suggests, this is condition characterized by pain at the front of the ankle. It is believed to be due in a large part to the repetitive trauma to the connective tissues at the front of the talocrural joint caused by kicking a football. It tends to be more prevalent on the player’s dominant foot for this reason.
The joint capsule anteriorly is repeatedly stretched, as well as being compressed against the bones at the front of the ankle. This then leads to an inflammatory response, followed by thickening of the capsule itself, and possibly the formation of osteophytes (extra bone) in the area. These together cause a nipping or pinching of the capsule at the front of the talocrural joint, which is an impingement syndrome.
Symptoms of Footballer’s Ankle
Predominantly, quite localized pain at the front of the ankle near the talocrural joint line. Often end range of both dorsiflexion and plantarflexion cause an increase in this pain, as the capsule is either pinched (dorsi) or stretched (plantar). Clicking, weakness and instability or a lack of confidence in the ankle are also common.
How do we treat it?
Early intervention follows the classic RICE protocol with rest from sport and regular icing being crucial. Local ultrasound and electrotherapy modalities often accelerate the healing process and settle the joint capsule down, as well as either oral or topical anti-inflammatories.
Manual therapy commences following the initial short settling down period, involving specific ankle joint mobilizations, capsular stretching and local soft tissue therapy. Stretching, strengthening and proprioceptive exercises are prescribed according to each individual’s presentation, as well as taping methods. If the condition doesn’t progress as expected, investigations and a surgical opinion may be required to assess and manage excessive thickening of the capsule and/or osteophytes.
If all goes according to plan however, more functional weight-bearing exercises are introduced and a gradual return to running and directional running, stop-start and other more sport specific drills will lead to the ultimate goal- a return to the football field.
I hope this summary will help you or someone you know. As always, we are here at The Physio Nook to help out with any musculoskeletal disorders you may have, ankle or otherwise! Feel free to call us, email, or drop in for a great service.
Paul Woodward
Principal Physiotherapist
The Physio Nook.
