Anterior ankle impingement causes pain in the front of the ankle. Several factors, including overuse and trauma, can trigger the condition.

With anterior ankle impingement, a person may experience worsening pain during exercise and after sitting for a long time. It can also result in swelling and stiffness of the joint.

Many treatments are available for ankle impingement, including physical therapy, corticosteroid injections, nonsteroidal anti-inflammatory drugs (NSAIDs), orthotics, and surgery.

This article examines anterior ankle impingement, including its symptoms, causes, risk factors, diagnosis, treatment, and outlook.

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Anterior ankle impingement is a condition that occurs when the soft tissue around the ankle becomes caught between the shin bone and the front of the ankle.

Overuse of the foot can cause this condition and lead to inflammation and swelling. The anterior tibial tendon, which runs along the front of the shin bone, can also become inflamed and swollen. This can cause pain in the ankle joint and may limit a person’s ability to walk or stand for long periods.

A person with anterior ankle impingement will experience pain at the front of their ankle. Activities such as walking or running can worsen this pain.

Other symptoms may include:

  • pain around the front of the ankle joint,
  • pain when walking or running on uneven ground
  • pain when climbing stairs or hills
  • swelling and stiffness in the joint

Anterior ankle impingement involves compression of the ankle joint from the front. This can occur when the foot forcefully turns inward or when a person’s weight shifts to one side of the foot.

It is colloquially known as “footballer’s ankle,” but anyone can develop it.

The most common cause of anterior ankle impingement is overpronation, which happens when the foot rolls inward too much. An imbalance in the foot, leg, or hip muscles can lead to overpronation when running or walking. The other causes are flat feet, high arches, and tight calf muscles.

It can also occur when osteophytes, or bone spurs, form in the ankle. These occur due to repeated microtrauma to the ankle.

Anterior ankle impingement is a common cause of pain in athletes who perform repetitive dorsiflexion movements, such as football players and ballet dancers.

Other risk factors may include:

  • previous ankle sprains
  • wearing unsuitable footwear
  • not warming up before sports

Doctors diagnose anterior ankle impingement with the help of physical exams and imaging studies.

They will examine the foot, lower leg, and knee to check for signs of pain, swelling, and tenderness in the foot.

X-rays may check for other injuries that may have contributed to the symptoms, such as fractures. They can also show bone spurs.

Doctors may also order CT scans or MRIs to provide more information about any damage due to the injury.

MRIs will show irregularities in the structures surrounding and supporting the ankle joint, such as bones, cartilage, tendons, ligaments, and muscles. This helps determine the best course of treatment.

Doctors usually recommend conservative therapies as a first-line treatment. The main treatment for anterior ankle impingement is to avoid putting weight on the affected foot.

Other treatments include:

  • Analgesics: These drugs, such as NSAIDs, work by blocking pain sensations. The main function of NSAIDs is to reduce inflammation and swelling, which can help with anterior ankle impingement pain.
  • Ankle bracing: A brace is an orthopedic device that supports the ankle joint and prevents injury by stabilizing the joint. A doctor may recommend a brace if the person with anterior ankle impingement has high levels of instability in the ankle area. The brace will be custom-made for a person’s specific needs, which means a professional must fit it before use.
  • Corticosteroid injections: A corticosteroid injection involves injecting medication directly into the joint to reduce inflammation and pain.
  • Physiotherapy: A physiotherapist can help treat anterior ankle impingement by providing exercises and instructions on how to prevent it from happening again.

A doctor may recommend surgical options if the above methods fail.

These include:

  • arthroscopic bony debridement
  • arthroscopic soft tissue debridement

Arthroscopic bony debridement for anterior ankle impingement is a surgical procedure to remove the most painful bone spurs from the front of the ankle. A surgeon uses an arthroscope — a small tube with a light and a camera — to perform the procedure.

Arthroscopic soft tissue debridement is the same procedure but removes any soft tissue causing pain rather than bone spurs.

Learn more about arthroscopic surgery.

The outlook for anterior ankle impingement depends on the type of impingement and treatment.

For many people, symptoms will resolve with rest and conservative treatments alone. However, people who need surgery will likely experience longer recovery times.

A 2016 study found that range of motion was slightly better in people with soft tissue impingement than in the bony impingement group. People with soft tissue impingement took less time to return to sports or preinjury activity levels.

Anterior ankle impingement involves ankle joint compression due to overuse or injury.

The symptoms of this condition are pain and tenderness on the inside of the ankle, swelling, and difficulty walking.

Treatment for anterior ankle impingement involves resting from activities that cause pain, taking anti-inflammatory medications to reduce swelling, wearing a brace for support, and performing exercises that stretch the muscles in the front of the leg and foot.