Causes / typical injury mechanism: Tibiotalar impingement is caused by acute or repetitive trauma from subjecting the ankle to extreme ranges of motion. It can also be caused by repeated forceful contact with the foot and external objects. This repeated contact results in the development of synovitis, scarring of the joint capsule, and abnormal osseous or soft tissue growth. Impingement occurs when surrounding structures meet these abnormal outgrowths.

Classic history and presentation: Tibiotalar impingement typically affects individuals participating in sports and individuals who repeatedly subject their ankle to extreme ranges of motion.

Risk factors: Exposure to repeated dorsiflexion and/or hyperflexion of the ankle or to repeated forceful contact with the foot.

Athletes, particularly soccer players, long distance runners, and ballerinas, are at a higher risk for developing ankle impingement syndromes.

Pathophysiology: Tibiotalar impingement is caused by abnormal bone and soft tissue growth impeding the normal range of motion of the ankle.

Grade / classification system: Tibiotalar impingement is usually classified by location and by the type of impinging structure (ie, bone or tissue).

• Location –
  • Anterior:
    • Anteromedial
    • Anterolateral
  • Posterior:
    • Posteromedial
    • Posterolateral
• Osseous versus soft tissue impingement