Posterior Ankle Impingement: When Your Ankle Feels Like It’s Caught in a Pinch

Posterior Ankle Impingement: When Your Ankle Feels Like It’s Caught in a Pinch

Ever had that nagging feeling in your ankle that makes you wonder if it’s been trapped in a vice? Well, you might be dealing with posterior ankle impingement syndrome (PAIS). It’s like your ankle’s way of saying, “Help, I’m stuck!”

What Is Posterior Ankle Impingement?

PAIS is like your ankle’s own personal game of Twister—except it’s not fun, and it often goes undiagnosed. The condition involves the pinching of bony or soft tissue structures at the back of your ankle, and guess what? It takes an average of 19 months for people to get a proper diagnosis. That’s right, almost two years of enduring mystery ankle pain!

Symptoms: What’s Your Ankle Trying to Tell You?

So, how do you know if PAIS is crashing your ankle party? Look out for these signs:

• Tenderness: Especially around the area between your Achilles tendon and the peroneal tendons (that’s the back part of your ankle).
• Pain: It’s often described as a mix of sharp, dull, and radiating pain that can be tricky to pinpoint. Think of it as a pain mystery novel—except it’s happening to you.
• Swelling: This usually kicks in about 3-4 weeks after an acute injury, often following an intense activity.
• Aggravated by Flexion: Pain often increases with activities involving plantar flexion (when you point your toes).

What Causes This Ankle Agony?

PAIS is primarily caused by the mechanical pinching of bony or soft tissue structures during the end range of plantar flexion (that’s when you point your toes downward). While it can strike suddenly, it’s more commonly the result of repetitive stress from activities that involve frequent plantar flexion.

Classic culprits include:

• Dance: Especially ballet—when you’re constantly on your toes, the risk goes up.
• Soccer: Lots of running and kicking can put a strain on the posterior ankle.
• Downhill Running: Gravity loves to add extra pressure.

Physiotherapy: The Road to Recovery

Here’s how to get your ankle back on track:

• Initial Treatment: Start with medications and ice to relieve pain. Gentle stretching and strengthening exercises are also key.
• Activity Modification: Rest and immobilize the ankle using a brace, boot, or cast to reduce inflammation.
• Conservative Management: This involves giving your ankle a break and avoiding activities that exacerbate the issue.

Self-Help Tips: DIY Ankle TLC

• Modify Activities: Steer clear of movements that stretch your ankle to its limits.
• Ice It: Apply ice to reduce pain and swelling.
• NSAIDs: Over-the-counter anti-inflammatories can help manage discomfort.

When to Seek Medical Attention

If your ankle’s been giving you grief despite trying the conservative route for three months, it might be time to consider arthroscopic surgery. This minimally invasive procedure can provide relief for those who haven’t found success with other treatments.

So, if your ankle’s feeling like it’s caught in a permanent pinch, don’t let it ruin your stride. Get it checked out, follow the right treatment plan, and you’ll be back to your usual self in no time!

References:

1. Smyth NA, Murawski CD, Levine DS, Kennedy JG. Hindfoot arthroscopic surgery for posterior ankle impingement: a systematic surgical approach and case series. Am J Sports Med. 2013;41:1869–1876
2. Russell JA, Kruse DW, Koutedakis Y, McEwan IM, Wyon MA. Pathoanatomy of posterior ankle impingement in ballet dancers. Clin Anat. 2010;23:613–621. doi: 10.1002/ca.20991
3. Carreira DS, Vora AM, Hearne KL, Kozy J. Outcome of Arthroscopic Treatment of Posterior Impingement of the Ankle. Foot Ankle Int. 2016;37:394–400. doi: 10.1177/1071100715620857