Anterior ankle impingement is a common injury seen between football players and ballet dancers. Due to the repetitive nature of pile and demi-pile within ballet and striking of a ball within football, the microtrauma caused by these motions cause the athlete to be at higher risk of attaining anterior ankle impingement than any other athletes (Kadel & O'Kane 2008; Slim et al. 2002). The repetitive microtrauma to the anterior aspect on the talo-crural joint may cause osseous bone formation, ligament and soft tissue entrapment, and even capsulitis (Kruse et al. 2012; Peterson & Renstorm 2005). Most commonly seen within a stereotypical anterior ankle impingement is an osseous formation (Bahr & Maehlum 2004; Brukner & Khan 2012). Hess (2011) and Kruse et al. (2012) state that osseous formations mainly occur due to the damage to the cartilage rims of the talus and tibia (talo-crural joint); unlike previously suggested by Bendall et al. (2003) that the source of this osseous formation is due to the repetitive stretch which is placed onto the synovial capsule.
Anatomy of the Ankle Joint
The Talo-crural joint consists of the congruent movement of the talus and the tibial plafond created by the tibia and fibula. This joint is commonly known as a hinge point due to its main movementís only being Plantarflexion and dorsiflexion. The joint is made stable by the lateral ligaments, deltoid ligaments as well as the surrounding capsules and muscles. On an individual bases there are three ligaments which support the ankle laterally, these are; the anterior talo-fibular ligament, the calcaneul-fibular ligament and the posterior talo-fibular ligament. Medially the deltoid ligaments consist of four individual ligaments which consist of the: tibio-navicular joint, talo-calacaneal ligament, anterior tibio-talar ligament and the posterior tibio-talar ligament.
In similarity to the talo-crural joint the sub-talar join is indirectly supported by both the lateral ligaments, the deltoid ligaments, the capsule and surrounding muscles. The sub-talar joint is a gliding joint which only allows for inversion and eversion. With both the sub-talar joint and the talo-crural joint working in conjunction with each other it allows for multidirectional movements such as plantarflexion and inversion as well as dorsiflexion and eversion. Commonly it is known that plantarflexion and inversion is the mechanism of injury for the tear/rupture of the anterior talo-fibular ligament (ATFL).
Other Possible injuries to the ankle
Posterior ankle impingement.
Ligament Tears (most common is a lateral ankle sprain of the ATFL)
Tenosynovitis of the tendon sheaths
(Above is only a few injuries which may happen to the ankle joint)
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Next In the Blogging
The next piece to be blogged will be the wrists (radio-carpal joint) anatomical figures and the possible injuries which can be sustained in the this area as well as the surrounding area.
Bahr, R. & Maehlum, S. (2004). Clinical guide to sports injuries. Champaign, IL: Human Kinetics.
Bendall, S.P., Molloy, S. & Solan, M.C. (2003) Synovial impingement in the ankle: a new physical sign. Journal of Bone & Joint Surgery, British Volume. 85 (3), p330-3.
Brukner, P. & Khan, K. (2012) Brukner & Khan's Clinical Sports Medicine. 4th ed. Australia: McGraw-Hill Medical.
Hess, W.G. (2011) Ankle Impingement Syndromes: A Review of Etiology and Related Implications. Foot & Ankle Specialist . 4 (5), P290-297.
Kadel, N. & O'Kane, J.W. (2008) Anterior impingement syndrome in dancers. Current Reviews In Musculoskeletal Medicine. 1 (1), p12-18.
Kruse, D.W., Koutedakis, Y., Russell, J.A. & Wyon, M.A. (2012) Pathoanatomy of Anterior Ankle Impingement in Dancers. Journal of Dance Medicine & Science. 16 (3), p101-109.