How To Treat Posterior Ankle Impingement Syndrome (PAIS)

If you are a dancer or an athlete, you may oftentimes find your foot in what’s known as the plantar flexion position. This is the movement your ankle makes when you point your foot downward, and it’s common in ballet dancers, soccer players and competitive runners. If your foot is exposed to repetitive stress when your foot is in this position, you can develop a condition called posterior ankle impingement syndrome. Below, we take a closer look at the condition, and how the team at The Orthopaedic Foot & Ankle Center can help you overcome the issue.

Causes And Symptoms Of Posterior Ankle Impingement Syndrome

We touched on the mechanism of injury a bit in the intro, but posterior ankle impingement syndrome occurs as a result of repetitive strain on the ankle when it’s in a plantar flexed position. When your foot is in this position, the bones in the back of your ankle compress. Regular and forceful compression of your ankle can cause soft tissues in the area to get trapped between the bones, or it can lead to problems like ligament damage or joint capsule swelling. Continuing to flex the foot only tends to make symptoms worse.

Symptoms of posterior ankle impingement syndrome include:

• Pain in the back of the ankle
• Pain near the Achilles tendon
• Worsening discomfort when the foot is in a plantar flexion position
• Swelling or tenderness near the back of your ankle
• A feeling of instability or lack of confidence in your foot to handle certain movements

If you’re dealing with any of the above symptoms, especially if you are a dancer or athlete, it’s imperative that you connect with a foot and ankle specialist. As we mentioned, symptoms only tend to get worse if left untreated, and treatment tends to be much more effective if the issue is caught at an early stage.

Diagnosing And Treating Posterior Ankle Impingement Syndrome

The diagnostic process begins with the specialist learning more about your symptoms. They’ll ask you what actions cause symptoms and where symptoms are presenting, and they’ll review your medical history before getting into lifestyle habits that may be contributing to the discomfort. From there, they’ll jump into the physical exam, which will involve assessing the ankle with their eyes and having you perform a few movement exercises to see how your body responds to these motions. Imaging tests in the form of an X-ray or MRI may be ordered to get a more detailed look at the bones and soft tissues in the ankle.

With the assessment and images complete, your specialist will be able to come to a clear understanding of what’s going on in your ankle. If you are dealing with posterior ankle impingement syndrome, they’ll explain the condition and walk you through some treatment techniques. PAIS treatment typically begins with conservsative techniques, and they tend to be quite effective at helping the patient find relief. Some of the most common non-operative treatments include rest/short-term activity avoidance, cold therapy, compression, elevation, physical therapy and anti-inflammatory medications. Used in combination with one another, many patients find relief in just a few weeks, but it depends on what type of activity you’re hoping to return to following treatment.

In the event that your discomfort does not respond well to conservative techniques, more hands-on treatment may be recommended. This may involve a corticosteroid injection or a minimally invasive procedure to debride the offending area. While few people progress to the need for surgery, a corrective operation tends to have fantastic results, with roughly 90 percent of patients describing their results as good to excellent.

So if you are an athlete or competitive dancer and you’ve been dealing with discomfort at the back of your ankle, don’t keep pushing through the pain while hoping that it will resolve on its own. Symptoms are only going to get worse, and that can make treatment less effective. Instead, connect with a team of foot specialists who can help you recover and keep issues from returning once you get back to the activities that you love. For more information, or for help with a different foot or ankle issue, reach out to the team at The Orthopaedic Foot & Ankle Center today at (703) 584-2040.