There are two types of ankle impingement:

• Anterior (front) ankle impingement.
• Posterior (back) ankle impingement.

Anterior ankle impingement. This injury causes pain on the front side of your ankle. This type of ankle impingement can result from:

• Inflammation and swelling. These conditions can occur due to repeated stress at end-range positions of the ankle (when the foot is fully flexed upward with toes pointed toward the shin or extended downward with toes pointed toward the sole of the foot), such as when jumping, squatting, or going down stairs. This can lead to inflammation and swelling and the development of bone spurs (a bony overgrowth) in the ankle joint space.
• Ankle instability. This condition is a looseness of the ankle joint that develops after repeated ankle sprains. These sprains cause damage to ankle ligaments. The damage can result in compressed tissue and scarring that takes up more joint space. This causes pain during activities that require stretching your toes up toward your shin (ankle dorsiflexion). Examples of these activities include squatting, jumping, and climbing stairs.

Posterior ankle impingement. This injury causes pain on the back of your ankle, especially during activities that involve pointing your toes. It can result from:

• Compression of soft or bony tissue between the shin bone (tibia) and the heel bone (calcaneus). There are numerous soft tissue structures that could cause posterior impingement. Some people have a small extra bone in the back of their ankle called the Os Trigonum. This little bone can lead to impingement in the back of the ankle, and pain. It causes compression between the shin bone and the heel bone when the foot is pointed.
• Excess force on the ankle. Large amounts of force on the ankle sometimes can cause small pieces to break off of the ankle bone. This leads to compression when moving the foot or toes downward toward the sole of the foot (plantar flexion). The compression causes tissue inflammation and swelling that leads to pain.

Your physical therapist will work with you to achieve your functional goals. They will help you return to your prior activities without pain. Your treatment may include:

There is no way to completely prevent an injury. However, there are some actions that active and at-risk people can take to reduce the risk of ankle impingement. These include:

• Using correct techniques when doing physical activities.
• Wearing proper footwear. For example, basketball players can wear high-top shoes to improve ankle stability.
• Avoiding overtraining. Repeated stresses and overuse tend to bring on conditions like ankle impingement.

All physical therapists are prepared through education and experience to treat a variety of injuries and conditions. However, you may want to consider:

• A physical therapist who is experienced in treating people with ankle impingement. Some physical therapists have a practice with an orthopedic or sports focus.
• A physical therapist who is a board-certified clinical specialist, or who completed a residency or fellowship in orthopedic or sports physical therapy. This physical therapist has advanced knowledge, experience, and skills that may apply to your condition.

You can find physical therapists in your area with these credentials and clinical expertise on Find a PT, a tool built by the American Physical Therapy Association.

General tips when you're looking for a physical therapist (or any other health care provider):

• Get recommendations from family, friends, or other health care providers.
• When you contact a physical therapy clinic for an appointment, ask about the physical therapist’s experience in helping people who have ankle impingement.
• Be prepared to describe your symptoms in as much detail as possible during your first visit. Make a note of what makes your symptoms better or worse.

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