Which history is characteristic of a lateral ankle impingement?

Updated: Mar 07, 2018
  • Author: Steven J Karageanes, DO, FAOASM; Chief Editor: Craig C Young, MD  more...
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This injury is chronic and commonly seen far out from an acute injury, such as a lateral ligament sprain. Many times, the patient will be better for weeks after a sprain, only to have the pain increase with activity without any provocation.

The patient has pain with loading the foot, but it may not always be consistent during the day and week. Pain may be more pronounced after being sedentary or waking up in the morning, but it improves over time.

The location of pain is either posterior to the lateral malleolus along the peroneus tendon or at the anterior talofibular ligament. The latter is typically seen in a patient with a history of ankle sprain. However, the sprain can be remote.

The patient often assumes impingement pain is a sprain that has not yet healed or is due to "weak ankles." The physician must not make that same snap judgment before evaluation. Often, the pain is in the same area as the injury (ATF sprain), but impingement occurs only in small part to the thickening of the ligament. Making the assumption the pain is related to an inability of a ligament to heal can make the true biomechanical reason for the problem difficult to uncover and treat.

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