← Back to Conditions→ العودة إلى الحالات

Posterior Ankle Impingement

---

Posterior ankle impingement occurs when the soft tissues or bony structures at the back of the ankle are compressed or pinched during plantarflexion (pointing the foot downward). It is common in dancers, gymnasts, and footballers, and is often associated with an os trigonum — an accessory bone at the back of the talus present in around 10% of people.

Symptoms

• Pain at the back of the ankle when pointing the foot down
• Tenderness behind the ankle, between the Achilles tendon and the heel bone
• Pain that worsens with ballet en pointe, kicking, or going downstairs
• Swelling at the back of the ankle
• A sense of catching or restriction during ankle movement

Causes

• Os trigonum — a small extra bone at the back of the talus that can become painful
• Hypertrophy or inflammation of the posterior joint capsule or soft tissues
• Repeated ankle injuries or sprains
• Repetitive plantarflexion in dance, gymnastics, or football

Non-Surgical Treatment

• Activity modification and rest from aggravating activities
• Anti-inflammatory medication
• Physiotherapy and ankle mobilisation exercises
• Ultrasound-guided steroid injection into the posterior ankle

Surgery — Arthroscopic Debridement

When conservative treatment fails, keyhole (arthroscopic) surgery is performed to remove the os trigonum and/or the impinging soft tissue. This is a highly effective procedure with excellent results and rapid recovery.

Performed as a day case under general anaesthetic through small posterior incisions. Patients are typically weight-bearing in a boot within a few days, with full return to sport expected at 8–12 weeks.

Recovery

Timeframe	What to Expect
0–2 weeks	Post-operative boot. Rest and elevation.
2 weeks	Wound review. Begin weight-bearing and physiotherapy.
4–6 weeks	Return to normal walking. Swelling settling.
8–12 weeks	Return to sport and dance.