Posterior Ankle Impingement

Posterior Ankle Impingement is caused by repeated compression stress at the back of the ankle joint. It is usually triggered by forcefully pointing the foot downwards (plantar flexion) or push-off maneuvers. It is characterized by chronic pain at the back of the ankle that is exacerbated when the foot is pointed downwards (plantar flexion).

Sharp pain and clicking may be experienced during activities such as pointe work (dancing), downhill running, swimming, kicking a football, jumping, kneeling and activities on “tippy toes”. A throbbing pain, dull ache, tenderness to touch, puffiness or swelling may be present at the back of the ankle.  

Symptoms are a result of a squeezing or pinching of abnormally thickened soft tissues (tendons and/or ligaments) between the lower end of the leg bones (tibia and fibula) and the ankle bone (talus) as the foot is pointed downwards (plantar flexed), particularly in the presence of an extra bone called an os trigonum, which is often fractured in this condition, or an extra prominent ankle bone (talar trigonal process).

Excessive compression and irritation at the back of the ankle leads to the build-up of a mass of pain generating “scar” tissue, which can get trapped during movement.