The most likely reason your ankle hurts when you point your toes (plantarflexion) is posterior ankle impingement.
What is Posterior Ankle Impingement?
Posterior ankle impingement is a condition characterized by pain at the back of your ankle, particularly when you point your toes. This pain arises from the compression of either soft tissues or bony structures between your shin bone (tibia) and your heel bone (calcaneus).
Causes of Posterior Ankle Impingement
Several factors can contribute to posterior ankle impingement:
- Compression: The primary cause is the compression of soft tissues or bony structures in the back of the ankle when the foot is plantarflexed (toes pointed).
- Os Trigonum: Some people have an extra bone in the back of their ankle called an os trigonum. This bone can get pinched between the tibia and calcaneus during plantarflexion, leading to pain.
- Soft Tissue Impingement: Soft tissues like ligaments or the joint capsule can become inflamed and thickened. This inflammation can then be compressed during plantarflexion.
- Bone Spurs: Bone spurs that develop on the back of the tibia or calcaneus can also cause impingement when the ankle is pointed.
Symptoms of Posterior Ankle Impingement
The primary symptom is pain in the back of the ankle, especially when:
- Pointing your toes (plantarflexion).
- Performing activities that require repetitive plantarflexion, like dancing, kicking, or running downhill.
- You might also experience swelling, stiffness, and tenderness in the back of the ankle.
Diagnosis and Treatment
If you suspect you have posterior ankle impingement, it's important to consult a healthcare professional for proper diagnosis and treatment. Diagnosis typically involves a physical examination and imaging tests such as X-rays or MRI.
Treatment options may include:
- Rest: Avoiding activities that aggravate the pain.
- Ice: Applying ice packs to the affected area.
- Physical Therapy: Exercises to improve ankle range of motion and strength.
- Anti-inflammatory Medications: To reduce pain and inflammation.
- Corticosteroid Injections: Injections to reduce inflammation (administered by a physician).
- Surgery: In some cases, surgery may be necessary to remove the os trigonum, bone spurs, or inflamed soft tissues.
