Impingement Syndromes in Dancers

ASK THE EXPERT Impingement Syndromes in Dancers

BY DR. JOHN GOODNER

Pain in the front or back of the ankle can occur from a dancer standing “en point” or “demi point.” Pain behind the ankle is due to a bone prominence that pinches the soft tissue or due to a fractured bone or cartilage in the back of the ankle (Os Trigonum). A deep pain in the back of the ankle is felt and is made worse if the foot points down.

Treatment includes rest, physical therapy and anti-inflammatory medication. If the pain does not improve, a Cortisone injection is given to decrease inflammation and scar tissue. Unresolved pain may be treated surgically, thus allowing a full return to dance. The back of the ankle is cleaned out and a small piece of bone may be removed with arthroscopic surgery to allow the dancer to return to full activity. Rarely an open procedure is needed.

Pain in the front of the ankle is usually caused by thickening of the ankle joint lining and can cause pain while moving the leg forward on the foot. This impingement syndrome is usually associated with an ankle ligament injury and can become very painful, especially the first thing in the morning when getting out of bed to walk or after sitting for a short period of time and getting up to walk. The inflammation and soreness usually lessen with activity but return later on in the day. Physical therapy and a short course of anti-inflammatory medication may be necessary to reduce the inflammation in the ankle joint.

If that does not improve, a Fluoroscopic Guided Cortisone injection may be necessary to reduce the thickening of the soft tissue. If conservative measures fail, a Platelet Rich Plasma (PRP) injection can be given into the joint to improve healing potential. In some cases, the impingement in the front part of the ankle does not improve and arthroscopic surgery may be necessary to completely regain the ankle mobility without discomfort.

In some cases, a small spur is present on the front part of the lower leg bone. This can cause chronic pain and stiffness in the ankle. If present, arthroscopic removal of the bone spur is also performed to allow the dancer to resume activity.

Prognosis is excellent with full return to dancing with proper treatment.

n Dr. John Goodner is a Board Qualified Reconstructive Foot and Ankle

Surgeon with the Foot, Ankle and Leg Specialists of South Florida and specializes in sports medicine foot and ankle injuries, foot and ankle arthroscopy, lower extremity trauma, and lower extremity deformities in infants, children, teens and adults. The South Florida Institute of Sports Medicine in Plantation is located at 220 S.W. 84th Avenue, Suite 102, 954-7201530. The practice website is www.SOUTHFLORIDASPORTSMEDICINE. com.Instagram @SouthFloridaSportsMedicine. Twitter @SFLSportsMed.

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