Massage therapy · Kitchener–WaterlooAnkle Impingement (Anterior)

Anterior ankle impingement, once called "footballer's ankle" or "athlete's ankle", is a common cause of long-term (chronic) pain at the front of the ankle in athletes (Lavery et al., 2016). It often happens when bony growths called bone spurs (osteophytes) develop at the front of the ankle joint, so that the bones pinch against each other, or pinch the soft tissue between them, when the foot bends up. While it is not only an athlete's problem, it is generally considered an overuse/repetitive injury (Vaseenon and Amendola, 2012).

The condition is thought to be linked mainly to repeatedly bending the ankle upwards (dorsiflexion), which presses the front of the shin bone and the ankle bone together, and to previous ankle injuries such as sprains (Vaseenon and Amendola, 2012). It is often seen in people who have played sport for many years, including sports involving kicking (Lavery et al., 2016). This overuse injury tends to develop slowly over time. Some people with bone spurs develop pain, while others can compete without any difficulty.

Ankle Impingement Anatomy

How to Treat an Ankle Impingement

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

• Surgery for ankle impingement usually improves pain and function considerably, and in nearly all studies at least 70 percent of people returned to sport (Hamberger et al., 2025).
• People who already have arthritis in the ankle at the time of surgery tend to improve, but not as much as those without arthritis (Vaseenon and Amendola, 2012).
• If you think you have ankle impingement, get it assessed. I can assess your ankle and let you know if you should see your family doctor or nurse practitioner.
• If you have surgery, your surgical team will tell you when you can return to sport; follow their instructions.
• Avoid activities that make the injury worse, as they might be doing more harm than good.
• If you do have surgery, follow the rehabilitation plan from your surgical team. A physiotherapist can support you with this, and once your surgeon has cleared you, I can help you get movement back in your ankle.

Anterior ankle impingement is a pinch at the front of the ankle when the foot bends up, often linked to bone spurs and old sprains. I can't change the bone, but I can help calm the irritated tissue, keep the rest of your ankle and foot moving well, and build the strength and control you need to get back to your sport.

I start by assessing how your ankle bends up and down, where the pinch is felt, the strength and flexibility of your calf and foot, your balance, and how you walk or run. I'll ask about your sport, training and any previous sprains, as these shape the plan.

When It's Sore

• Cutting back the movements that bring on the pinch, such as deep squats, lunges and kicking, while keeping you fit with activities that don't
• Hands-on work for the calf, shin and foot to ease tension around the ankle
• Gentle joint mobilisation for the ankle and foot, staying out of the pinching position
• Warm or cool applications in the clinic, and I'll show you how to use ice safely at home
• Taping to support the ankle in the short term

As It Settles

1. Vaseenon, T. and Amendola, A. (2012) 'Update on anterior ankle impingement', Current Reviews in Musculoskeletal Medicine, 5(2), pp. 145–150. doi: 10.1007/s12178-012-9117-z
2. Lavery, K.P., McHale, K.J., Rossy, W.H. and Theodore, G. (2016) 'Ankle impingement', Journal of Orthopaedic Surgery and Research, 11(1), p. 97. doi: 10.1186/s13018-016-0430-x
3. Hamberger, M.A., Saller, M.M., Böcker, W., Polzer, H. and Baumbach, S.F. (2025) 'Impingement of the ankle joint—a systematic review on the expected outcome', BMC Musculoskeletal Disorders, 26, p. 678. doi: 10.1186/s12891-025-08785-8