Anterior Ankle Impingement Treatment in Dallas

Footballer's Ankle, Athlete's Ankle & Anterior Ankle

Pain in Front of Ankle When Walking

Anterior ankle impingement, more commonly known as footballer’s ankle, is a form of chronic ankle pain caused by bone spurs, inflammation, or scar tissue on the front of the ankle bone. 

These bone spurs typically are the result of long-term sporting activities that involve kicking, such as soccer (or, to give the sport its European name, football). This is because repeated kicking motions will move the ankle to its extremes.

If you’re experiencing pain in the front of your ankle when walking, or ankle pain after running, call one of our Dallas orthopedic surgeons.

The ankle joint consists of two bones: the tibia in the leg and the talus in the foot. These two bones glide over one another with the help of some articular cartilage that cushions the impact of the tibia on the talus.

During any extreme movement of the ankle, but especially during dorsiflexion (when your knees are bending, putting your shin at a smaller-than-right-angle to your foot), this places compression on the structures at the front of the ankle joint. Doing this repeatedly or beyond what the ankle can withstand may result in damage and inflammation, creating anterior ankle impingement. 

Most often, this repeated compression will result in osteophytes, or bone spurs, which are most likely the cumulative result of repetitive contact between the two bones. 

The most common symptom of footballer's ankle is a pain in the front of the ankle, and diminished movement of the ankle joint. In some cases, there is also swelling. The swelling is usually worse after the patient has engaged in sports or exercise. 

Some of the more common symptoms of anterior ankle impingement include:

  • Front of ankle pain, usually described as a dull ache during rest and sharp pain with exercise or weight-bearing
  • Increased symptoms following certain activities, like squatting, walking, or running
  • Tenderness on palpation of the front of the ankle joint
  • A clicking sensation during certain ankle movements
  • Puffiness or swelling of the ankle joint

This condition mostly occurs as a result of:

  • Ankle sprain
  • Recurrent ankle sprains 
  • Activities that require repeated dorsiflexion of the ankle, such as landing and deep squatting 

There are also several factors that may predispose you to develop anterior ankle impingement. Some of these factors are:

  • Inadequate rehabilitation following a previous ankle injury 
  • Joint stiffness or swelling
  • Muscle tightness
  • Bony anomalies
  • Poor foot biomechanics (flat feet or high arches)
  • Inappropriate training (including technique, footwear, or training surfaces)
  • Excessive training
  • Inadequate recovery periods from training and games
  • Inadequate warm up 
  • Poor core stability 
  • Poor proprioception or balance

For many of these factors, a physical therapist can help you correct the issue to prevent further instances of impingement or footballer's ankle. 

Typically, a doctor will be able to diagnose anterior ankle impingement based on your symptoms and a physical evaluation. Your doctor may have you flex your ankle during a physical examination. 

In some cases, diagnostic imaging tests may be necessary. This can include X-rays of all sides of the ankle, or potentially an MRI. An MRI can be helpful for ruling out other possible causes of your front of ankle pain and can also help confirm the diagnosis of anterior ankle impingement if your doctor spots swelling or inflammation on the front of the ankle. 

As with many joint injuries, the vast majority of cases of athlete's ankle can be resolved nonsurgically. However, in some severe cases, surgery can be necessary.

Nonsurgical Treatment for Footballer's Ankle

There are several stages of nonsurgical treatment for footballer's ankle, but the main components are managing your pain and restoring a full range of motion in your ankle. 

For managing painful symptoms, the RICE method is the most effective: Rest, Ice, Compression, and Elevation.

Resting will involve avoiding any activities that trigger your front of ankle pain. Ice is a very simple method for reducing any pain and swelling in the ankle. You can apply ice for 20-30 minutes every 2 to 4 hours, or if you notice the site of your injury admitting a lot of heat. 

Applying a compression bandage on your ankle will help to support the injured soft tissue and also reduce swelling. 

Elevating your injured ankle above your heart will allow gravity to aid in the reduction of swelling in the ankle joint.

Anti-inflammatory medication and natural creams such as arnica can also be helpful in reducing front of ankle pain as well as swelling. 

The second objective of nonsurgical treatment for anterior ankle impingement is restoring a full range of motion. This could involve physical therapy, or simple exercises suggested by your doctor. Exercising the muscles around the ankle joint lends support to the injured area and allows it to heal faster, and also reduces the chance that the injury will occur a second time.

This is typically considered a last resort for patients with an anterior ankle impingement diagnosis, reserved for persistent cases of anterior ankle impingement, or possibly in the case of a high-level athlete. 

During the surgical procedure, a surgeon will remove any prominent impinging bone spurs or soft tissue structures to relieve front of ankle pain. This can be done arthroscopically or with open surgery. Typically, open surgery will only be an option if the bone spurs are very large.

Surgery is really only an option when the front of ankle pain can be directly attributed to anterior ankle impingement and not to ankle arthritis. In fact, if a patient has significant arthritis, removing bone spurs could actually increase painful symptoms, as it will allow the ankle to move more. In very rare cases, providers may consider ankle replacement.

anterior ankle impingement treatment in dallas

Front of Ankle Pain Treatment in Dallas

Depending on the specific condition and its severity, these treatment options may include physical therapy, over-the-counter anti-inflammatory medication, slings, and supports, cortisone shots, or surgery. 

If you have an acute or chronic foot or ankle injury, such as pain in the front of your ankle when walking, call SPORT at (469) 200-2832 to arrange a consultation or you can request one online. Hurt today? We can arrange a same-day urgent care visit to ensure you get fast, effective relief.