Anterior ankle impingement is a painful condition caused by soft tissue or bony impingement at the front of the ankle. Pain is often felt on walking, going up and down stairs and any movement that pulls the foot upwards from the floor. Injury is thought to be caused by forceful traction, trauma, recurrent microtrauma, ankle instability and other mechanical influences. Football players and dancers appear to be mostly affected due to the repetitive ankle movement into dorsiflexion.
X-ray and MRI can be useful in diagnosing anterior ankle impingement, and also whether pain is caused by soft tissue, bony spurs, or osteochondral lesions. Ultrasound is less specific due to the inability to diagnose intra-articular problems.
First-line treatment is usually conservative, consisting of rest, avoiding certain exercises, physical therapy, and non-steroidal anti-inflammatory drugs. A conservative approach is advised for 3-6 months, and should this fail, a surgical approach may be considered.