Nerve entrapments of the ankle
Posterior Impingement SyndromePosterior impingement syndrome (dancer’s heel)
"I have pain with pointing my foot and relevé."
Causes
Posterior impingement syndrome, commonly known as dancer’s heel, involves compression of soft tissues at the back of the ankle. A bony-formation or bump behind the ankle causes this compression. The dancer generally feels discomfort at the back of the ankle when the toe is pointed or in relevé.
Treatment
Dancers should use ice and anti-inflammatory medications to help reduce soft tissue swelling. Stretching of the tissues in the back of the heel (calf and Achilles) is important to reduce the stress placed on those structures.
A podiatry consult is indicated to identify joint mobility restrictions or other imbalances that might be contributing to the condition.
Some health-care professionals may recommend steroid injections to assist with local inflammation.
Finally, if non-surgical treatment does not help alleviate the discomfort, surgical intervention will be required to remove the bump that is compressing the soft tissue.
Anterior Impingement Syndrome"I can’t achieve full plié on one side. And when I do, it’s painful."
Causes
Anterior impingement syndrome involves the top of the ankle where the shin bone (tibia) meets the ankle (talus). There can be direct contact between these bony structures. With hundreds or thousands of pliés, this direct contact can eventually result in a bony formation at the front of the ankle. This bony formation compresses the soft tissue and creates pain. A dancer will typically notice pain with deep pliés, as well as significant swelling at the front of the ankle joint.
Treatment
Early recognition of symptoms is extremely important because anterior impingement syndrome is not reversible.
Ice and/or anti-inflammatory medications can be helpful to reduce local swelling.
A podiatrist can assist with re-establishing normal joint mobility or identifying areas of inadequate strength or flexibility.
A dancer may want to try some simple ideas to help relieve stress to the tissues during class or performances, including:
- perform in street shoes
- use one-quarter to half-inch heel lifts
- discontinue forced pliés
With advanced cases, surgery is sometimes pursued. It should be understood by the dancer that surgery very often leads to a recurrence of the bone formation within three to four years.
BOOK an assessment with our podiatrist who will provide treatment and identify and correct any underlying biomechanical issues and muscle imbalances and assist with rehabilitation.