The impingement syndrome in the upper ankle joint is caused by the jamming of bony or soft tissue (too much inner lining of the joint, scars, ligament parts). This causes pain and leads to restricted mobility.
Causes for the impingement syndrome of the upper ankle joint
The patients tell us that they have twisted their ankle quite often in the past. This can lead to scars or excessive bone growth on the front part of the shin (tibia) or the trochlea tali. This will cause an impingement in the joint cavity and even restricted mobility when lifting the foot. Sometimes there might be an impingement in the rear part of the ankle joint caused by a so-called os trigonum.
The diagnostics of an impingement syndrome of the upper ankle joint
The first step is a clinical examination of the ankle joint. With the help of ultrasound we can usually find an increased amount of fluid in the joint. The advantage of ultrasound is the fact that the mobility and instability of the joint can be seen and tested.
On X-rays it is possible to see the position of the joint in use and to find the bony tissue (bony parts, floating fragments) causing the problems.
For the planning of our therapy an MRI is quite often necessary as well. With the MRI we can clearly see possible bone problems (oedema) and soft tissues causing the problems.
Conservative therapy of an impingement syndrome in the upper ankle joint
It is our aim to reduce the inflammation in the joint and to improve its mobility.
Surgery of the impingement syndrome of the upper ankle joint
During the surgery (arthroscopy) a camera will be inserted into the joint and we remove the material responsible for the impingement (inflamed inner lining of the foot, floating fragments, bony surplus structures, ligament parts or scars). As a result the joint will become a lot more mobile again and the inflammation will go down. The pain will stop or can be alleviated at least.
In the case of major damage an operation of the ankle joint might be necessary.
Dr. Eva Wörenkämper (qualified surgeon for foot and ankle joint surgery) carries out these operations on site in our clinic RKM 740 with you as an inpatient for a very short time.
The post-operative treatment of an impingement syndrome in the upper ankle joint
Depending on the type of surgery you can put weight on your foot straight away or we might ask you to use a crutch for a few days. It is important to start physiotherapy and lymphatic drainage straight away.
The post-operative treatment will happen in our practice or you will see the orthopedic surgeon who referred you to us. The treatment involves regular checks on the wound. The threads can be removed within 12-14 days.
We also offer supporting measures such as cryotherapy, kinesiology taping, acupuncture or osteopathy. Dr. Eva Wörenkämper and her team who are specialists in sports medicine and science, will be very happy to support and guide you regarding the start of your sport activities.
What are the consequences of an impingement syndrome in the upper ankle joint?
The restricted mobility of the upper ankle joint, especially when lifting the foot, can lead to a shortening of the calf muscles. The different rolling movement of the foot causes an upward chain reaction in the connected bones, i.e. pain in the knee, hip, sacroiliac joint and spine.
It also leads to different strains on the foot possibly causing malpositions of the foot and damage due to overuse (metatarsalgia, fractures and oedema).
It could also entail long-term damage in the joint itself, e.g. arthrosis. The bony structures or floating fragments can scratch the cartilage causing its destruction over time. Chronic inflammations lead to a reduction of the cartilage.
