Anterior Ankle Impingement With Rehab Anterior ankle impingement is a condition that causes pain and swelling in the front of the ankle. CAUSES This condition may be caused by: Soft tissue getting caught between the shinbone (tibia) and the top ankle bone (talus). Extra bone (bone spur) on the tibia or talus. This condition can develop due to: Repeated and forceful movement of your foot upward toward your shin. Repeated hits to the front of your ankle, such as from a soccer ball. Damage to the tough bands of tissue that connect bones together (ligaments). RISK FACTORS
This condition is more likely to develop in: People who sprain their ankle often. Athletes who take part in certain sports, including: Soccer. Football. Gymnastics. Ballet. Running SYMPTOMS Symptoms of this condition include: Ankle pain that gets worse when you move your foot toward your shin and do certain activities, such as: Go up stairs or a ladder. Walk. Run uphill. Squat. Pain when pushing on the front of the ankle (tenderness). Ankle swelling. Ankle stiffness. A feeling of getting stuck when you try to move your foot toward your shin. DIAGNOSIS This condition may be diagnosed based on:
Your symptoms. Your medical history. A physical exam. During the exam, your health care provider will test for stiffness, tenderness, and pain. Imaging tests, such as: An X-ray. A CT scan. This may be done to check for bone damage. An MRI. This may be done to check for ligament damage. An ultrasound. This may be done to check for soft tissue damage. TREATMENT Treatment for this condition may involve: Not putting weight on your ankle for several days. Wearing a removable boot, brace, or splint for ankle support. Using ice to reduce swelling. Taking anti-inflammatory pain medicine.
Having medicines injected into your ankle joint to reduce pain and swelling Doing exercises when pain and swelling improve. Using a heel lift. Returning to full activity gradually. Having surgery. Surgery is needed if there is a large or loose bone spur or if other treatments do not help. The surgery may be done to: Remove bone spurs. Enlarge the joint space. Repair damaged ligaments. HOME CARE INSTRUCTIONS If You Have a Boot, Brace, or Splint: Wear it as told by your health care provider. Remove it only as told by your health care provider. Loosen it if your toes tingle, become numb, or turn cold and blue.
Keep it clean. If it is not waterproof: Do not let it get wet. Cover it with a watertight covering when you take a bath or a shower. Managing Pain, Stiffness, and Swelling If directed, apply ice to the injured area: Put ice in a plastic bag. Place a towel between your skin and the bag. Leave the ice on for 20 minutes, 2-3 times a day. Move your toes often to avoid stiffness and to lessen swelling. Raise (elevate) the injured area above the level of your heart while you are sitting or lying down. Activity Return to your normal activities as told by your health care provider.
Ask your health care provider what activities are safe for you. Do not do any activities that make pain or swelling worse. Do exercises as told you your health care provider. General Instructions Do not put your full weight on your ankle until your health care provider says you can. Take over-the-counter and prescription medicines only as told by your health care provider. Ask your health care provider when it is safe to drive if you have a boot, brace, or splint on your foot. PREVENTION Wear supportive footwear appropriate to your athletic activity. Avoid athletic activities that cause ankle pain or swelling.
See your health care provider if you have an ankle sprain that causes pain and swelling for more than 2-4 weeks. Do ankle range-of-motion and strengthening exercises as told by your health care provider before any athletic activity. Start any new athletic activity gradually to build up your strength and flexibility. SEEK MEDICAL CARE IF: You have ankle pain or swelling that is not getting better. You cannot put weight on your foot without feeling pain. EXERCISES Ask your health care provider which exercises are safe for you. Do exercises exactly as told by your health care provider and adjust them as directed.
It is normal to feel mild stretching, pulling, tightness, or discomfort as you do these exercises, but you should stop right away if you feel sudden pain or your pain gets worse. Do not begin these exercises until told by your health care provider. STRETCHING AND RANGE OF MOTION EXERCISES These exercises warm up your muscles and joints and improve the movement and flexibility of your ankle. These exercises also help to relieve pain and stiffness. Exercise A: Ankle Alphabet Sit with your left/right lower leg supported. Make sure your foot has room to move freely. Move your left / right foot to trace each letter of the alphabet in the air.
Keep your hip and knee still. Make the letters as large as you can without feeling discomfort. – _times. Complete this exercise times Repeat per day. STRENGTHENING EXERCISES These exercises build strength and endurance in your ankle. Endurance is the ability to use your muscles for a long time, even after they get tired. Exercise B: Plantar-flexors, Eccentric Stand on the edge of a step on the balls of your feet, and rest your hands on a rail for balance. If told by your health care provider, put on a backpack to add weight. Push up onto your toes. Slowly shift your weight to your left / right foot.
Pick up your other foot. Slowly lower your weight through your left / right foot so that your heel drops below the level of the step. Stop the motion early if this causes any pain at the front of your ankle. Put your other foot back on the step. times. Complete this exercise times Repeat per day. Exercise C: Everters Sit on the floor with your legs straight out in front of you. Loop a rubber exercise or band around the ball of your left / right foot and hold the band in your hands or secure it to a stable object. Slowly push your foot outward, away from your other leg. Hold this position for seconds.
Slowly return to the starting position. _times. Complete this exercise times Repeat per day. BALANCE EXERCISES These exercises improve or maintain your balance. Balance is important in improving ankle stability and preventing falls. Exercise D: Single-Leg Stand Without shoes, stand near a railing or in a doorframe you can hold on to if you need to. Stand on your right/ left foot. Keep your big toe down on the floor and try to keep your arch lifted. If this is too easy, you can stand with your eyes closed or on a pillow. Hold this position for ____ seconds. _times. Complete this exercise times Repeat per day.
Exercise E: Inversion/Eversion 1 You will need a balance board for this exercise. Ask your health care provider where you can get a balance board or how you can make one. Stand on a non-carpeted surface near a countertop or wall. Step onto the balance board so that your feet are hip-width apart. Using only your feet and ankles, tip the board from side to side as far as you can. If you are able to reach the ground, silently tap it. Do not let the board forcefully hit the ground. Keep your feet in place and your upper body and hips steady. Repeat _times, pausing from time to time to hold a steady position.
Complete this exercise __ _ times a day. Exercise F: Inversion/Eversion 2 You will need a balance board for this exercise. Ask your health care provider where you can get a balance board or how you can make one. Stand on a non-carpeted surface near a countertop or wall. Step onto the balance board so that your feet are hip-width apart. Using only your feet and ankles, tip the board from side to side so the board does not hit the ground. Keep your feet in place and your upper body and hips steady. Repeat times, pausing from time to time to hold a steady position. Complete this exercise _ _ times a day.
Exercise G: Plantar/Dorsi Flexion 1 You will need a balance board for this exercise. Ask your health care provider where you can get a balance board or how you can make one. Stand on a non-carpeted surface near a countertop or wall. Step onto the balance board so that your feet are hip-width apart. Using only your feet and ankles, tip the board forward and back so that the board silently taps the ground. Do not let the board forcefully hit the ground. Keep your feet in place and your upper body and hips steady. __ Repeat __times, pausing from time to time to hold a steady position.
Complete this exercise, times a day. Exercise H: Plantar/Dorsi Flexion 2 You will need a balance board for this exercise. Ask your health care provider where you can get a balance board or how you can make one. Stand on a non-carpeted surface near a countertop or wall. Step onto the balance board so that your feet are hip-width apart. Using only your feet and ankles, tip the board forward and back so that the board does not hit the ground. Keep your feet in place and your upper body and hips steady. Repeat times, pausing from time to time to hold a steady position. Complete this exercise __ _times a day.