Ankle Impingement Syndrome Treatment & Management

Updated: Sep 17, 2018
  • Author: Marc A Molis, MD, FAAFP; Chief Editor: Craig C Young, MD  more...
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Acute Phase

Physical Therapy

The initial treatment of ankle impingement syndrome includes nonsteroidal antiinflammatory drugs (NSAIDs) as needed for pain, physical therapy, bracing, and orthotics.

Surgical Intervention

With the failure of conservative modalities, surgical intervention is indicated. Arthroscopic excision and debridement is the treatment of choice. [15, 16, 17, 18, 19, 20, 21]  

A study by Georgiannos et al reported lower complication rates and shorter return to full activities with endoscopic excision of the os trigonum compared to the open procedure. [22]

Other Treatment

Occasionally, steroid injection into the affected area may give relief. Intra-articular anesthetic (lidocaine) ankle injection can be used as a differential tool to distinguish between ankle pain and subtalar pain.

Electrotherapeutic modalities may also be helpful.

In ballet dancers, technique assessment is helpful and essential to prevent further pain and injury.


Recovery Phase

Rehabilitation Program

Physical Therapy

Postoperatively, advise posterior splinting for 1 week, as well as a supportive brace and elastic compression stocking. Physical therapy is initiated at 2-3 weeks for strengthening, range of motion, proprioception, and sport-specific rehabilitation.