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Anterior Impingement Syndrome (‘Footballers Ankle’):
This problem is caused by the opposing bones in the ankle joint repetitively coming into contact with each other at the front of the ankle when the foot is bent upwards, or ‘dorsiflexed’. This constant contact causes an inflammatory reaction in the outer layer of the bone and sometimes, cartilage damage. Impingement occurs when the ligamentous ‘capsule’ surrounding the joint is tight.
This tightness of the joint capsule is usually caused by poor rehabilitation following ankle injury, or chronic ankle injury. Pain will be felt as a dull ache and will be made worse during such activities as running, walking downhill or steps or during a lunge on the affected leg. Stiffness in the ankle joint will also be experienced.
Tibialis Anterior Tendonitis:
This problem is an inflammation of the tendinous part of the muscle that primarily pulls the foot upward, or dorsiflexes. The tibialis anterior tendon will commonly become inflamed, causing a tendonitis when the muscle is overloaded such as repetitively running downhill or steps.
It may also occur secondary to ankle joint tightness. Pain and a creaking feeling may be felt when bending the foot up or ‘dorsiflexing’. There may also be pain and tenderness at the front of the ankle joint and tightness in the muscle at the front, on the outside of the shinbone.
Early Injury Management
For approximately the first 72 hours following an injury, the RICE regime should be followed to ensure control of inflammation and pain relief.
R – Rest
I – Ice
C – Compression
E - Elevation
Rest from aggravating activity.
Ice should be applied in the first 72 hours or when inflammation persists. Ice should be applied for fifteen to twenty minutes at a time. Ice should not be applied directly to the skin, but through a wet towel or cloth.
Compression can be achieved with an elastic bandage.
Elevation is used to help swelling to return to the heart through the blood stream.
The injured area should be elevated above the level of the heart.
Strengthening programs should only be commenced when:
Exercises should be three sets of 8-12 repetitions.
Wobble Board Exercises – Balance one leg
2. Balance exercises
rotate tilt around in a circle, try not to touch the ground
Wobble Board Exercises – balance only
Wobble Board Exercises – Side to side
tilt board side to side, try not to touch the ground
Wobble Board Exercises – Forward and Back
tilt board forward and back, try not to touch the ground