How can physiotherapy help with posterior ankle impingement?
Your physiotherapist will be able to help design a treatment plan to settle your pain. This will usually consist of a period of offloading from the aggravating activity, such as avoiding time en pointe or reducing kicking loads for a period. Medications may be advised to help settle any pain or associated inflammation if needed.
Your physiotherapist may perform mobilisation and distraction (gentle pulling on the joint to gap the irritated parts) techniques to the ankle joint that may also help to settle symptoms and improve joint mobility. Strengthening exercises will be prescribed for the calf, as well as for any deficits identified further up the leg. It will be important to initially avoid having the foot fully pointed during strengthening exercises.
Finally, it will be important to assess your technique, particularly in performance sports such as dancing or gymnastics. In ballet dancers, turning out of the foot while on toes may lead to the condition, and any issues should be identified and changed as part of rehabilitation. In some cases, the condition may persist and sometimes requires a corticosteroid injection to settle the pain. Your physiotherapist will be able to organise a referral for you, if this is required; however, this should not be the first line of treatment and should always be followed by a thorough rehabilitation of at least six weeks.