Talocrural (ankle) impingement

Ankle impingement
  • Talocrural (ankle) impingement is a pinching-type injury that occurs around the ankle joint
  • It is most commonly seen after ankle sprain but can occur in isolation as well
  • Compressing the injured site causes a sharp pain, or pinch, with a residual ache, while stretching the injury causes an intense localised pain

TIPS

  • As the condition has an inflammatory component, it responds well to anti inflammatory meds, either orally or topical (cream/gel)
  • There are two main types of Talocrural impingement
    • Soft tissue impingement – occurring at the anterolateral (front outside corner) or posteromedial (back inside corner) aspect of the ankle
    • Bony impingement – occurring at the anteromedial (front inside corner) or posterolateral (back outside corner) aspect of the ankle
  • Once confirmed, a cortisone injection will give rapid relief and resolve most impingement conditions (especially injuries without a bony cause or chronic inflammatory changes)

MYTHS

  • Pushing range and stretching the joint are both counterproductive and make the condition worse
  • You don’t have to wear “sensible” shoes! In fact, for an anterior impingement, wearing a pair of heels will actually help by reducing the risk of ongoing pinching. For posterior impingement, flat shoes are best for reducing symptoms
  • Stability exercises in the early phase of recovery can often aggravate the condition and make the reaction worse

WHAT ELSE COULD IT BE?

  • If there’s a deep ache and swelling but no sharp pain, it could be a Talar dome lesion
  • If there’s a constant ache and you have difficulty walking, it could be a Fibula fracture
  • If it persists despite anti inflammatory meds, it could be a Bone bruise/oedema

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