If you have ankle pain, you know how frustrating it can be. Your ankle is key to the way you move, so pain can get in the way of walking, climbing stairs or staying active.
A sharp, pinching pain in the front or back of your ankle may be a sign of ankle impingement syndrome. It’s a condition you might face if you’re a runner or dancer or you’ve had repeated ankle sprains, but it can affect anyone.
Ahmed Attia, MD, an orthopedic foot and ankle surgeon with Banner - University Medicine, told us more about what causes ankle impingement and what you can do at home and with your health care provider to find relief.
What is ankle impingement syndrome?
“Ankle impingement syndrome is a condition that happens when structures in the front or back of your ankle get entrapped or pinched at the end range of motion,” Dr. Attia said.
The pinching causes swelling, irritation and pain, especially when you bend your ankle deeply.
Types of ankle impingement
“Ankle impingement is classified based on where the impinged or pinched structures are located,” Dr. Attia said.
- Anterior ankle impingement: Pain in the front of the ankle when you bend your foot upward or walk uphill.
- Posterior ankle impingement: Pain at the back of the ankle when you point your toes or do activities like dancing or running downhill.
Both types limit how comfortably you can move your ankle and both can get worse with activity.
Common causes of ankle impingement
- Repeated ankle sprains: Sprains can leave behind swelling and scar tissue and make your ankle joint less stable. These changes make it easier for tissues to get pinched when you move.
- Overuse or repetitive motion: Running, jumping, dancing and sports where you make quick direction changes can irritate your ankle over time.
- Poor biomechanics: Flat feet, high arches, stiff calves or tight Achilles tendons can change how your ankle moves and increase pressure in parts of the joint.
- Bone spurs or structural changes: Sometimes bony growths in the front or back of the ankle make the joint space narrower and increase friction.
- Trauma or incomplete healing: Old sprains, fractures or tendon injuries can leave your ankle weak and make impingement more likely later on.
Symptoms to watch for
“The most common symptoms are pain, swelling and less range of motion when you move your foot up or down,” Dr. Attia said.
You may have ankle impingement if you notice:
- Sharp or pinching pain in the front or back of the ankle in certain positions
- Swelling that gets worse with activity
- A catching or clicking feeling when you’re moving your foot
- Trouble bending your ankle up or down
- Pain climbing stairs, walking hills or playing sports
If these symptoms don’t get better or they keep coming back, it’s a good idea to get checked.
How ankle impingement is diagnosed
A health care provider will examine your ankle, check your range of motion and look for tenderness or swelling. They’ll also ask you about past injuries and activities that may be causing your symptoms.
It’s important to tell your provider:
- Where the pain is located
- How long you’ve had symptoms
- Whether you had an injury
- What you can and can’t do in your sports and workouts
- What you’ve tried to help ease the pain
In some cases, your provider may order imaging such as X-rays, ultrasound or MRI to look for bone spurs, inflammation or other structural changes.
Treatment options
Rest and activity modification
Taking a break from movements that trigger your pain may be the first step. Lower impact activities like cycling, swimming or gentle walking can help you stay fit without irritating the ankle joint.
Physical therapy
Physical therapy for ankle pain can help you:
- Strengthen your ankle and lower leg muscles
- Improve your mobility and balance
- Stretch tight calves or an irritated Achilles tendon
- Correct gait issues or running mechanics that place too much stress on your ankle
Anti-inflammatory methods
Ice, compression and NSAIDs (if approved by your provider) may help with pain and swelling.
Supportive devices
Bracing, taping or custom orthotics can support your ankle, keep it in better alignment and reduce strain on the joint when you’re active.
Injections
If you’re not able to reduce your symptoms with other techniques, your provider may recommend corticosteroid injections to help reduce inflammation and confirm the diagnosis.
Surgery (last resort)
In cases where bone spurs or thickened tissues cause significant pinching and conservative care doesn’t help, surgery may create more space in the joint.
“If other treatments don’t work, surgery can be extremely helpful. Surgery removes the tissue or bone spur,” Dr. Attia said. “Surgeries can be done through arthroscopy, where a camera is introduced through a keyhole incision. We can then use special tools to treat the condition successfully with a shorter recovery time, compared to a traditional open approach.”
Prevention and long-term recovery tips
To stay pain-free, it’s important to keep your ankle strong and flexible. It can help to:
- Strengthen your ankles, calves and hips
- Warm up before you exercise
- Stretch your calves and ankles regularly
- Rehab ankle sprains properly to prevent instability in the future
- Wear supportive shoes that are right for your activity
These habits can reduce the risk of impingement in the future and improve your ankle function.
When to see a provider
Make an appointment if:
- Pain lasts more than a few weeks
- Swelling doesn’t go down
- You have trouble bearing weight
Ongoing pain can lead to more stiffness or long-term mobility issues. Make an appointment with one of Banner Health’s orthopedic and sports medicine specialists. They can evaluate your ankle, give you a diagnosis and build a recovery plan that meets your needs.
Key takeaways
- Ankle impingement happens when tissues in the ankle joint get pinched during movement
- It often happens because of sprains, overuse or structural changes in the ankle
- Most people get better with rest, physical therapy and supportive care
