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Ankle Scar Tissue (Impingement)

Ankle impingement occurs when soft tissues around the ankle are pinched or nipped.

This painful condition can affect the front or the back of the ankle, leading to ongoing pain, limited range of motion and possibly even bone spurs and other complications.

Ankle impingement problems near the front of the joint, anterior, are usually associated with past ankle sprains. Pinching in the back of the ankle, posterior, occurs most often in ballet dancers and is usually due to irritation around a bony prominence on the back of the ankle.

Anterior impingement:

  • Ankle pain that continues long after a sprain
  • Weakness in the ankle during routine activities
  • Pain and tissue thickening felt in front and slightly to the side of the ankle
  • Pain worsens as the foot is forced upward
  • Throbbing pain and swelling from inflammation may be present

Posterior impingement:

  • Pain behind the heel or deep in the back of the ankle
  • Tenderness just behind the bottom tip of the fibula, by the outer ankle bone
  • Pain worsens when the foot is pointed down into plantarflexion
  • A painful clicking sensation may also be felt as the foot is twisted in and out

If left untreated, ankle impingement caused by sprains could eventually lead to the formation of small projections of bone called bone spurs. These spurs may begin to jab into the soft tissues along the front edge of the ankle joint, causing increased pain.

Non-surgical and Surgical Treatment

Your physician can determine the severity of your ankle impingement and recommend the correct treatment schedule for your unique situation.

Nonsurgical Treatment

Treatment usually begins with rest to reduce swelling and pain. A special walking boot or short-leg cast may be recommended to restrict ankle movement for up to four weeks. Mild pain medications and anti-inflammatory medicine, such as ibuprofen, may also be prescribed. In severe cases, a steroid injection may be used to reduce swelling. An ice pack (link to cold therapy products) can also help alleviate swelling and may encourage a faster return of normal ankle movement.

Working with a physical therapist will also help you regain normal use of your ankle. Patients often progress in a series of exercises including stationary cycling, range of motion, and ankle strengthening.


If nonsurgical treatments do not work, surgery may be recommended. The type of surgery will vary depending on the location and cause of ankle impingement.

Regardless of which type of treatment you receive, you may need to follow a program of rehabilitation exercises. Your physician and physical therapist will makes sure that you follow the most appropriate program for effective recovery. The goal is to get you back on your feet, pain free, by improving strength and coordination in the ankle.

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