Ankle Impingement Syndrome: Pain in the Gymnast Athlete

Most gymnasts can recall a time when they’ve landed a tumbling pass or vault and immediately experienced a painful stinging sensation in their ankles. As a former gymnast, I thought that feeling was just part of the sport, but ankle pain with landings in gymnastics is NOT normal.

The sport of gymnastics includes many skills that require jumping and standing in releve (or on toes). The combination of these activities leads to tight calf muscles with a great amount of explosive strength. When the calf muscles become tight in a gymnast, less motion is available in the ankle to absorb forces during landings. As a result, excessive force is placed on the front of the ankle joint when landing skills. The cumulative jumping that the sport requires combined with excessive forces placed on the front of the ankle can lead to a common gymnastics injury called anterior ankle impingement syndrome. 

In ankle impingement syndrome, the soft tissue structures in the front of the ankle become irritated and sometimes create bone spurs as a result of the pinching that occurs at the front of the ankle joint. Gymnasts who have this condition often complain of pain with landings (especially back tumbling), deep squatting, descending stairs, walking, and running. Tenderness in the front of the ankle is also present and occasionally swelling is also noted. Anterior ankle impingement syndrome can also occur as a result of an ankle sprain or recurrent ankle sprains.

Athletes with ankle impingement syndrome will typically present with painful and decreased ankle motion, poor single leg balance, and decreased ankle strength that limits their successful participation in sport. By increasing the motion in the ankle by focusing on calf flexibility and ankle joint mobility as well as improving the ankle’s ability to absorb force through slow, eccentric (or anti-gravity) strengthening, that stinging ankle pain on landings can decrease or even go away!

For more information on treatment and prevention of injuries in athletes, or to request an appointment with our Sports and Orthopedic Physical Therapy team, click here.