

About the condition
Posterior Ankle Impingement (and Os Trigonum)
What is Posterior Ankle Impingement? Posterior ankle impingement is a condition that causes pain at the back of the ankle. It occurs when the soft tissues at the back of the ankle become compressed between the bones, often due to repetitive stress or overuse.
Symptoms
• Pain at the back of the ankle, especially during activities that involve pointing the toes downward.
• Swelling and tenderness in the affected area.
• Stiffness and reduced range of motion in the ankle.
• Pain that worsens with activity.
Causes
• Overuse or repetitive stress on the ankle.
• Activities that involve frequent pointing of the toes, such as ballet or soccer.
• Previous injuries to the ankle, such as fractures or sprains.
• Anatomical variations, such as an extra bone (os trigonum) or a prominent Stieda process at the back of the ankle.
Diagnosis A podiatrist will diagnose posterior ankle impingement based on your medical history and a physical examination of your ankle. Imaging tests such as X-rays, MRI, or CT scans may be used to assess the severity of the condition and rule out other causes of ankle pain.
Treatment
Treatment
• Relative Rest: Avoid activities that put stress on the ankle.
• Symptom management: Apply ice, using analgesics and/or ibuprofen, massage, stretches can help manage short term symptoms.
• Footwear: Wearing footwear without a heel stack shoes may help, HOKAs may also be useful.
• Orthotics: Use custom orthotic devices to support your feet and reduce pressure on the ankle.
• Physical Therapy: A physiotherapist can provide exercises and treatments to help alleviate pain and improve ankle function.
• Injections: Corticosteroid injections may be used to reduce inflammation.
• Surgery: In severe cases, surgery may be necessary to remove the impinging tissue or bone.
Prevention
• Maintain a healthy weight.
• Wear supportive footwear.
• Avoid activities that put excessive stress on the ankle.
• Stretch and strengthen the muscles around the ankle.
• Gradually increase the intensity of your physical activities.
• Avoid high heels