What should I do for anterior ankle impingement affecting my running?

Doctor's Answer

Photo of Dr Alan Cheung
Dr Alan Cheung

Orthopaedic Surgeon

Anterior Ankle Impingement is a condition where a patient has pain at the front of the ankle, due to compression of the bony or soft tissue structures during activities which involve deep ankle bending (maximal dorsiflexion).

Simple measures to reduce pain include avoiding walking or running on uneven ground, nonsteroidal anti-inflammatory drugs if tolerated, and ankle bracing.

I would strongly recommend that you see a good physiotherapist. They may use a physical therapy program that includes reducing inflammation, deep soft-tissue work on the gastrocnemius and soleus muscles, stretching of the Achilles tendon, work on improving proprioception and balance, strengthening of the peroneal tendon, and taping.

Although you may not have any bony cause for the pain in your ankle, soft tissue structures such as synovium, scar tissue or fibrocartilage may be being trapped causing pain. This problem may be addressed through keyhole surgery, if non-surgical management fails.

With regards to TCM, I am afraid that I know very little about this topic, as I grew up in England and am a Western trained doctor.

The good news is that 82% of patients with ankle impingement respond well to conservative treatment such as physiotherapy in the long term.

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