This illustration discusses the various symptoms of ankle instability. What do the surgeons say about surgery and finally what you can do non-surgically to get back to a sport? What are we seeing in this image? In this article, we will look at the different types of ankle impingements, why the standard and conservative care treatments did not work for you. But why is the bone pinching in the first place? How come the bone has moved to a point in your ankle that comes into contact with your soft tissue, and instability? The bone compressing on the soft tissue causes pain, reduced mobility, and range of motion. Ankle impingement syndrome is an umbrella term to describe soft tissue getting pinched, caught, or impinged upon by bone. Maybe this treatment program did not address what was really wrong with your or their ankle. If you are reading this article “these people,” probably includes you. Why did these treatments fail these people? The point we stress is that what we see in our clinic are the people who did not benefit from these treatments and for them, arthroscopy of the ankle is recommended. We see the patient for whom cortisone provided short-term relief but whose effects eventually “wore off.” We usually do not see these patients at our clinic. For some people, the injection did the trick and they, the patient, got back on their way back to their activities. The one thing that may have worked was a cortisone injection. We see the patient exploring surgery and/or waiting for a surgical date because in addition to the treatments above, the extra strength anti-inflammatories, painkillers, heel lifts, and other shoe inserts and weeks maybe months of rest did not fix their problems. These programs include physical therapy for their range of motion problems and limitations, ankle strengthening exercises, and exercises to help restore balance and gait. Some people do get great success with a program of conservative treatments for their ankle impingement problems. When extra strength anti-inflammatories, painkillers, heel lifts, and other shoe inserts and months of rest did not fix your problems We see the people for whom treatments, up until now, have not alleviated their problem. These are the people we typically do not see. Let’s point out that some people have very successful surgeries and very successful physical therapy. If you are reading this article it is likely that you are one of these frustrated people. They are frustrated that they cannot run or even walk without significant pain. People with ankle impingement syndrome are typically very frustrated people. This has been going on for more than ten years and I already had a surgery that did not help. I was told the surgery helped, “but it all came back.” Now I am being told to consider a more extensive surgery. Before having any more cortisone I decided on an arthroscopic surgery to “clean” things out and cut away the tissue and bone that may have been causing the impingement.Īfter the surgery, I felt pretty good for a little bit but the stiffness, limited range of motion, and pain returned. In fact, my ankle blew up so much that I had to be given cortisone on more than one occasion. I was also given a couple of “heavy-duty,” anti-inflammatories to try to calm things down as after the physical therapy my ankle kind of blew up. Maybe break down some scar tissue that formed over the ten years. I was prescribed physical therapy to see if I could improve my range of motion. My doctors were all in agreement that we should try the conservative care options first and see if this could help me avoid surgery. I have been from doctor to doctor and the general opinion is that I have an anterior ankle impingement. The injury never healed correctly and I still have pain from it. I suffered a pretty bad sprain over 10 years ago. They are talking to us because these treatments have been mostly “miss.” Here is an example where surgery was a “miss.” I am nervous about the surgery, I am looking for one last chance.”īefore someone becomes a patient, they will tell a story, unique to them, typical for others about their hit and miss treatment programs. When we ask, “ why are you going to wait for the surgery,” they will say, “because I need the ankle surgery.” When we ask, “why do you need the surgery?” “Because,” they will say, “I have tried everything else. Some of these patients come into our center waiting on a surgical date. Over the years we have seen many people with ankle impingement syndrome. Ankle impingement non-surgical treatment options
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