Ankle/Talocrural impingement

Talocrural impingement, also known as 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 occurs during any movement that closed the space on the injured side of the joint.

This includes squatting down for anterior (front of ankle) pinching and pointing your toes for posterior (back of ankle) pinching.

Talocrural impingement causes a sharp pain, or pinch, with compression of the injury. this may be followed by a residual ache.

Stretching the injured side of the ankle causes a strong pain over the injury site.

Tips for managing Talocrural Impingement

There are two main types of Talocrural impingement:

1. Soft tissue impingement – occurring at the anterolateral (front outside corner) or posteromedial (back inside corner) aspect of the ankle.

2. Bony impingement – occurring at the anteromedial (front inside corner) or posterolateral (back outside corner) aspect of the ankle.

As the condition usually has an inflammatory component, it responds well to anti-inflammatory meds, either orally or topical (cream/gel).

Bracing or taping can prevent it from continuing to impinge and help the condition progress.

Exercises for the injury focus on bracing strength, such as a wall march exercise.

This builds muscular control to help avoid the end range movements that allow the joint to compress.

If progress is slow or you’re suffering from repeated flare ups, a cortisone injection will give rapid relief and resolve most impingement conditions (especially injuries without a bony cause or chronic inflammatory changes).

Before diving into a cortisone shot, getting a scan such as an MRI is helpful to confirm the diagnosis and look for other complicating factors, such as a tendon split, that can affect the ankle.

Myths about Talocrural Impingement

Pushing range and stretching the joint are both counterproductive and make the condition worse.

Over-stretching or compressing the joint will further exacerbate the reaction and make it angry as well as more prone to pinching.

You don’t have to wear “sensible” shoes!

For an anterior (front of ankle) impingement, wearing a pair of heels (or adding in-shoe heel wedges for males) will actually help by reducing the risk of ongoing pinching.

For posterior (back of ankle) impingement, flat shoes are best for reducing symptoms.

Stability exercises in the early phase of recovery, such as standing on a Bosu ball, 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.

If it doesn’t sound like any of those, check out our article on why an ankle might remain painful after an ankle sprain. It’s also got some great tips of fixing each of the issues that cause ongoing ankle soreness.