As summer brings longer days and warmer weather to New Zealand, many of us are heading outdoors to make the most of it. Beaches are bustling with runners, volleyball players, and families enjoying the sand, while parks are alive with football matches and other sports. However, with the increased activity comes a heightened risk of injuries, one of the most common at this time of year being posterior ankle impingement, also known as “footballer’s ankle.”
What is Posterior Ankle Impingement?
Posterior ankle impingement is a condition where the structures at the back of the ankle become compressed, leading to pain, inflammation, and reduced mobility. This compression typically occurs when the foot is repeatedly or forcefully pointed downwards (plantarflexion). Activities like running on soft, uneven sand, kicking a football, or diving onto the beach can increase the likelihood of this condition.
This injury often affects footballers, dancers, gymnasts, and beach sports enthusiasts, as their activities involve significant stress on the back of the ankle. Despite being called “footballer’s ankle,” this condition isn’t exclusive to athletes—it can also affect anyone increasing their activity level during summer.
How Does It Happen?
Running on sand is fantastic for improving fitness, strength, and balance, but it also puts unique demands on your body. The soft, shifting surface forces your feet and ankles to stabilize with every step. To propel forward, your toes dig into the sand, placing extra strain on the posterior ankle.
In football and other sports, the repetitive force of kicking, jumping, or pivoting can repeatedly compress the structures at the back of the ankle. A single high-impact event, such as landing heavily on your toes during a dive or sprint, can also lead to immediate inflammation and pain.
Anatomy Behind the Pain
The back of the ankle, or the posterior ankle, houses several important structures:
Bones: The talus and tibia meet here, forming part of the ankle joint. Repeated compression in this area can lead to irritation.
Soft tissue: Tendons, ligaments, and bursa are also present and can become inflamed with overuse or improper movement patterns.
Os trigonum: A small, extra bone present in some people can make the posterior ankle more susceptible to impingement.
When these structures are compressed repeatedly or with great force, pain, swelling, and reduced range of motion can follow, creating a cycle of discomfort.
Symptoms of Posterior Ankle Impingement
Posterior ankle impingement typically presents with:
Pain at the back of the ankle, particularly during or after activity.
Swelling or tenderness in the affected area.
A pinching or sharp sensation when the foot is pointed downwards.
Limited range of motion or stiffness in the ankle joint.
A feeling of instability or weakness in the ankle.
These symptoms may develop gradually with repetitive movements or occur suddenly after a high-impact event.
Prevention Tips
To enjoy a pain-free summer, consider these strategies to prevent posterior ankle impingement:
Warm up thoroughly: Prepare your body with dynamic stretches and gentle exercises before engaging in sports or beach activities.
Gradual progression: Increase the intensity of your activities slowly to avoid overuse injuries.
Strengthen your ankles: Incorporate exercises like calf raises, ankle stability drills, and balance work into your routine to build resilience.
Choose appropriate footwear: Opt for supportive shoes when playing football or running on sand to reduce strain on the ankles.
Treatment and Recovery
If you suspect you have posterior ankle impingement, don’t ignore the pain. Early intervention can prevent the condition from worsening. Physiotherapy is a key step in recovery and may include:
PEACE & LOVE: Initial management is key to kickstart recovery – See our Blog post for more information - PEACE & LOVE
Restoring Mobility: Gentle stretches, manual therapy techniques and range guidance can improve range of movement in the ankle.
Strengthening Exercises: A tailored exercise program will help rebuild ankle strength and prevent re-injury.
Activity Modification: Guidance on adjusting your activity level to avoid further aggravation.
Enjoy Summer Without Pain
New Zealand summers are made for activity, whether it’s running along the beautiful beaches, playing football with friends, or enjoying family games in the sun. Don’t let posterior ankle impingement stop you from making the most of the season.
There are a range of conditions that can cause pain in the back of the ankle, such as Achilles or peroneal tendinopathy, plantar fasciopathy or bursa inflammation. So, if you are experiencing pain at the back of your ankle, contact our team of physiotherapists for a thorough assessment and personalized treatment plan. We’ll help you get back on your feet and enjoying the summer in no time!
For more information or to book an appointment, contact us at [email protected]
