Posterior Ankle Impingement in Dancers

Posterior ankle impingement is a very common injury in dancers that can be managed and treated by physiotherapists. It is caused when the ankle joint is constantly forced into excessive plantarflexion or pointe, thus why its common in ballerinas who dance in pointe shoes. The bones at the back of the foot impinge and compress the tendons and muscles in this area causing pain and restriction when pointing the foot. The repetitive trauma created by the impingement can cause scar tissue to form, thickening the tendons in the area and restricting movement of the ankle further. In some rare cases, posterior ankle impingement is caused by an os trigonum, which is an extra piece of bone attached to the back of the ankle and is present at birth in some individuals. Most of the time people are unaware they have this extra piece of bone until it becomes an issue. 

Common signs and symptoms can include:

  • Localised pain at the back of the ankle during excessive ankle plantarflexion or pointing 
  • Tender to touch at the back of ankle
  • Restricted plantarflexion or pointing 

While this injury can be quite painful and sometimes a significant issue especially in ballerinas, it can be easily treated by a physiotherapist. Initially, some rest and avoidance of painful activities may be needed to reduce inflammation, however a rehabilitation program needs to be developed in order to reduce pain and improve function in the long term. This can include mobilising the joints of the ankle to create more space within the joint, strengthening and stretching the surrounding and deep muscles and improving balance and proprioception in the ankle. 

If you are experiencing similar ankle issues or have any concerns, contact us today at [email protected]. At Capital Physiotherapy, we have a special interest in dance injuries so book an appointment today and we can have you back in pointe shoes in no time.