Posterior Ankle Impingement - Symptoms, Diagnosis, Treatment & Recovery Time
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- เผยแพร่เมื่อ 27 มิ.ย. 2024
- Posterior ankle impingement is often mistaken for Achilles tendonitis, and sometimes both injuries can be present. So, getting the diagnosis right is important, because the approach to posterior ankle impingement treatment will depend on whether there are other injuries. In this video, Maryke explains what posterior ankle impingement is, how to tell it from other injuries such as Achilles tendonitis, and the various treatment options available.
👉 Maryke recommends using arch support orthotics in certain circumstances. Get some here:
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🌟Need more help with your injury? You’re welcome to consult one of the team at TMA online via video call for an assessment of your Achilles injury and a tailored treatment plan: www.treatmyachilles.com
📽️ Other videos you may find useful:
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▶️Exercises to Correct Over-Pronation in Runners • Exercises to Correct O...
▶️Achilles Tendonitis Causes, Symptoms, and Diagnosis - It All Hangs Together • Achilles Tendonitis Ca...
▶️Tingling Heel & Achilles - Causes & Treatment • Tingling Heel & Achill...
▶️How to Get Rid of Posterior Tibial Tendonitis • How to Get Rid of Post...
▶️Peroneal Tendinopathy or Tendonitis - Causes & Treatment • Peroneal Tendinopathy ...
▶️ Tarsal Tunnel Syndrome Treatment & Diagnosis • Tarsal Tunnel Syndrome...
📚Chapters in this video:
00:00:00 Introduction
00:01:04 What is posterior ankle impingement?
00:05:32 Diagnosis: Posterior ankle impingement or Achilles tendonitis or something else?
00:12:19 Treatment options for posterior ankle impingement
00:22:43 Posterior ankle impintement recovery times
00:24:54 How we can help
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References:
Baillie, P., et al. (2022). "Posterior Ankle Impingement Syndrome Clinical Features Are Not Associated With Imaging Findings in Elite Ballet Dancers and Athletes." Clinical Journal of Sport Medicine 32(6): 600-607.
Baillie, P., et al. (2022). "Associations between clinical and imaging findings in posterior ankle impingement syndrome: a systematic review." Acta Radiologica 63(5): 652-657.
Ciardi, G., et al. (2021). "Posterior Ankle Impingement Syndrome (PAIS) in Dancer: Systematic Review and Proposal of a Clinical Protocol." J Community Med Public Health 5(202): 2577-2228.100202.
El-Zawawi, M. S., et al. (2017). "Role of magnetic resonance imaging in the diagnosis of ankle impingement." Menoufia Medical Journal 30(1): 99-103.
Giannini, S., et al. (2013). "Posterior ankle impingement." Foot & Ankle International 34(3): 459-465.
Kudaş, S., et al. (2016). "Posterior ankle impingement syndrome in football players: Case series of 26 elite athletes." Acta Orthop Traumatol Turc 50(6): 649-654.
Mansingh, A. (2011). "Posterior ankle impingement in fast bowlers in cricket." West Indian Medical Journal 60(1).
Ribbans, W. J., et al. (2015). "The management of posterior ankle impingement syndrome in sport: a review." Foot and Ankle Surgery 21(1): 1-10.
Rietveld, A., et al. (2018). "Results of treatment of posterior ankle impingement syndrome and flexor hallucis longus tendinopathy in dancers: a systematic review." Journal of Dance Medicine & Science 22(1): 19-32.
Soler, T., et al. (2011). "The conservative treatment of posterior ankle impingement syndrome in professional ballet dancers: a literature review and experts consensus." European School of Physiotherapy: Amsterdam.
Yasui, Y., et al. (2016). "Posterior ankle impingement syndrome: a systematic four-stage approach." World Journal of Orthopedics 7(10): 657-663.
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👉 Maryke recommends using arch support orthotics in certain circumstances. Get some here:
✅ NASA Grade arch support insoles: geni.us/jngUm6e
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✅ Full length arch support insoles: geni.us/f1Lc
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Best video on this that I’ve found by the way. Thank you very much for the breakdown and sharing all the up to date information with things like avoiding anti inflammatory meds and ice and injection and actually letting the body heal.
Glad it was helpful! Good luck with your recovery.
Thank you so much for the video
I am a fast bowler and have pain while landing the front foot but I can do sprinting without any pain
Thank you for watching!
got this injury in sept 2022 after my heel slide through turf(wearing cleats) caused plantar flexion 3 times traumatically, just now is the pain finally gone. Spent over a year trying to fix it no luck, did physio(they gave me post tib tenonitis) did xray, ultrasound, mri and nothing showed up lmao. Most annoying inury ever man, gonna start soccer again soon
I have the same thing from soccer. How did u get rid of it?
Last year I aggravated what i felt was mt Achilles heel after wearing boots with a heel. With time of felt better but I just feel and sprained my ankle fairly badly.
PT began today for the sprain and i realize i still have pain from last yeat with a tight ball of tissue.
What would you recommend after my sprained ankle heals?
Thank you 💜
Here's a video about treatment for Achilles tendonitis: th-cam.com/video/H1nfgU1amvg/w-d-xo.html
But if you first want to make sure it is tendonitis - this video can help you diagnose and understand the condition better: th-cam.com/video/cNOxd3w37K0/w-d-xo.html
There are early degenerative changes with osteophyte at the medial border of the thallus.
Irregularity of the medial border of the thallus is seen ? previous fracture or degenerative changes.
The joint spaces and articular surfaces are normal.
No soft tissue abnormality seen.
CONCLUSION:
Early degenerative changes.
Hello,pls the above is the Xray result conducted on my left leg Ankle 🦵 pls what is the meaning and your advice will be appreciated thanks.
Hi there,
We cannot provide individual treatment advice without doing an in-depth assessment of your injury and your personal circumstances, as the advice might not be appropriate for you. You're welcome to book a video consultation with one of our physios if you would like an assessment and a personalised treatment plan: www.treatmyachilles.com/
Hi I’ve had ankle pain since July last year and my podiatrist diagnosed it as being caused by a posterior heel spur. Without any physical activity, just physical therapy, it seems to feel better, but as soon as I cycle for a short time like under 10 miles and minimal effort, the pain comes back and I’m back to zero. I got a second opinion from an orthopedist and based on a preliminary X-ray, I have a more than normal protrusion on the back of the talus. Will be getting an MRI in a couple of days. What’s your thoughts?
It's difficult to advise without having an in depth conversation because it can be one of many things:
1. It can be that you're going back to cycling too quickly
2. It can be the position on the bike
3. But cycling usually don't cause trouble for impingement so it might be that your diagnosis is not correct
4. There may be other things to consider that I am not aware of.
I think this is what I have as well. Injury occurred during high intensity plyometrics and sprint exercises in barefoot shoes. Sharp pain in the back of the heel / next to the Achilles but not Achilles. It’s been months now and I keep reaggrevating it by running and trying to get back to basketball and running I am ok most of the time and I can also do jump rope where I’m able to control the range of my foot plantar flexing but in basketball games when instincts kick in and I land hard on the heels at times or jump with full extension that’s when it hurts really bad. Very painful for about 30-60 seconds then sorta goes away. Very frustrating injury
Thanks for sharing!
Hello! I am a ballet dancer and I have been having pain since the end of November and I saw doctor early December. He thought it was achilles tendinitis and had me take it easy, stretch, and ice for a month. I was still in pain when I went back to dance in January and I got an MRI done and confirmed it was posterior ankle impingement. I got a cortisone shot and was in a boot for two weeks. I just went back to dance this week and took it pretty easy by not going fully on my toes. I tried to go fully only once and it was extremely painful. I still feel the same pain in the same spot. Is my last option surgery?
The rehab plans that have been reported in the research to be successful for ballet dancers usually involve 12 weeks (3 months) of rehab before going back to dance. It does not sound as if you've ticked that box - being and a boot and getting an injection does not count as rehab. So, I don't think surgery is an option at this point - what you most likely need is a progressive rehab plan to prepare your ankle for dance.
@@TreatMyAchilles Got it, thank you so much for your insight!
which ankle injury or condition (one side only) hurts after sitting for long periods?
If it is the outside, it can be Peroneal tendonitis: th-cam.com/video/MroDMgDAgJk/w-d-xo.html
If it is the inside, it might be Tib Post tendonitis: th-cam.com/video/qcc7G3aTmCg/w-d-xo.html
But there are a few other conditions as well.
If you wanted help with figuring this out and a rehab plan, this is something that our team of physios can assess and help you with via video call. You can read more about how the online consultations work here: www.sports-injury-physio.com/
I have posterior impingement do too an ankle sprain it's been 6 weeks and too be honest i've been irritating it a littel bit but i hade non-steroidal and other medican and it still not getting better i really can't take it anymore i just want to return to my sport. What should i do what would you recommend?
It is really difficult to provide any useful advice other than what I already shared in the video without doing a full assessment and understanding your situation properly. You'll get much better advice and see better progress by getting it assessed and getting a treatment plan that is actually designed around your specific needs. My colleagues Barry, Kevin and Dominic are very experienced in treating ankle impingement and they can help you with this via video call. You can read more about how the online consultations work here: www.treatmyachilles.com/treatment-packages
How are you now?
I don’t know which I have 😢 probably both with my luck. I’m 1 year post op from an achillies surgery.
If you want help with figuring it out and getting back to your normal activities, this is something that our team of physios can assess and help you with via video call. You can read more about how the online consultations work here: www.treatmyachilles.com/treatment-packages
Do you think it’s possible I have this? Because plantar flexion obviously occurs when driving. I do Uber for a job and often driving long hours. The pain happens at the base of my heel. And when it happens the pain feels like someone is taking a hot poker and stabbing me in the back of the heel. Often times when it occurs it takes everything in me to not scream or cry. The pain lasts usually about 30-60 seconds. Then it goes away. Usually during that 30-60 seconds I’m literally squirming. Doing anything and everything I can to alleviate the pain. Stretching it. Moving it. Trying to adjust my seating to get more comfortable again. etc. During the 30-60 seconds the first 10 seconds or so is the stabbing pain. Then the rest of the 30-60 seconds it like radiates to the whole back of my heel. The back of heel I’m talking about is if your are wearing ankle converse. And the back of the heel the ankle converse covers. I have tried wearing different shoes. From Jordan’s. To runners shoes. To timberlands work boots. Flip flops. Uggs. I have tried it all I get no success at stopping the pain from occurring.
Yes, it does sound as if your pain is being caused by something pinching and then once it gets moved out of the position it settles down.
I had a bad calcaneal fracture. I believe i had an impingement but i also thing i have peroneal tendonitis
This video about peroneal tendonitis may be of use: th-cam.com/video/MroDMgDAgJk/w-d-xo.html
I've had achilles tendonitis for 15 months so far. I would say I have seen a good progress considering how I was at the start but I feel like my progress has halted. I had trouble even walking 100M at the beginning but I can walk around 4km painfree or sometimes niggle level.
I can
1. isometric heel raise on injured leg (45 seconds)
2. Alfredson Protocol heel drop (with 15kg in backback) 15 reps 3 sets
3. 2 legged hopping 50 reps
4. injured legged hopping 15 reps
I can do these trouble free but here and than I do feel the niggle. I haven't been courageous enough to try running. I've tried shockwave therapy and HILT and it did help quite alot but I feel like my progress has halted. What are some options from here?
Do I need surgery.....?
You definitely do not need surgery. It is absolutely fine to feel a niggle every now and again - it doesn't mean that your tendon is still injured - it is often just the brain that is still on high alert and being over-protective. The fact that your tendon is strong (look at all the exercise it tolerates) + you mentioning not feeling courageous enough to run, makes me think that you will likely benefit from someone just taking a good look at everything you are doing and assessing you and talking through all the things that worry you and then helping you come up with a plan that makes you feel safe and eases you back into running. This is something our team can help you with via video call. You can find out more about the video call on our website: www.treatmyachilles.com/
@@TreatMyAchilles do you guys accept "zelle" as payment method?
Our payment platforms are PayPal and Square. I don't know whether Zelle can interact with any of those.
@@TreatMyAchilles December slots are not open for some therapists? Also, you wouldn't recommend doing single leg heel raise exercises everyday right? (especially with weights).
I think I have posterior ankle impingement. I play a lot of football and I’m not able to shoot the ball the way I used to. A lot of pain when pointing toes all the way down.
How are you now?
@@shotta287 I haven’t played in a long time, but every time I mimic kicking a ball, I can still feel like something is still wrong but no pain. I just know if I go back to playing, it will flair up and be painful again.
@@Teriquem same I haven’t played in over 2 months. Do you think you will play anytime soon or not for a long time yet?
Hello I am a fast bowler and need your help with posterior ankle impingement. Now after 3 years I feel like it's not even posterior ankle impingement. How could I contact you
You can contact us here: www.treatmyachilles.com/contact
- Minimal joint effusion in tibiotalar talocrural & talocalcaneal joint with T2W PDFS hyperintense signal within adjacent soft tissue in the region of talocalcaneal joint extending upto lateral aspect in the region of peroneus tendon, however no evidence of obvious capsular thickening in present scan.
Prominent steida process with subtle PDFS hyperintensity within ? posterior
Impingement.
Minimal tenosynovial fluid along peroneus longus & brevis tendon below lateral malleolus ?tenosynovitis.
Minimal T2W PDFS hyperintense signal within posterior talofibular ligament with intact fiber- likely grade I injury. This is my mri I m fast bowler ma'am could please help it's been 3 months what treatment should go steroid injection??
We can't comment on what the correct treatment options are for you because we've not assessed you. If you're not sure, get a second opinion from a doctor or physio who actually assesses you and understands your full circumstances and can make informed recommendations.
Hello! Is it common for this to come on not immediately after injury? I’m an LMT, and recently increased my workload 6 months post tri-malleolar fracture, and just recently started having discomfort in the lateral side of my ankle during plantar flexion, eversion and when pressing off when walking. I’m going back to my orthopedic soon to figure out what’s going on, but I wanted to try alleviate discomfort in the meantime
I don't know what LMT stands for but I am assuming it means you walk a lot? It sounds like you have likely irritated the outer joint - this can happen after fractures if:
- your foot is in a poor posture when you walk = helped by supportive shoes and sometimes insoles
- your foot strengthen was never properly restored after the fracture
- you simply increased your weightbearing (standing + walking) too quickly (6 months is not a long time for a joint) and now it is overworked and sore
@@TreatMyAchilles Thank you for your response, I greatly appreciate it! LMT is short for licensed massage therapist. I recently upped my work schedule to doing 2-3 hours back to back, so I’m thinking maybe that could be it? Thank you so much for taking the time to respond, it means a lot to me! ☺️