Anterior Ankle Impingement in Gymnastics: Listen to Your Ankles
Anterior ankle impingement is something I see in athletes, especially gymnasts, frequently. It is especially common as we near competitive season, because we are doing more landings/activity on hard surfaces. This typically happens with hyper dorsiflexion- having your foot come back toward your shin, like when landing a skill short.
Much like back pain, having sore ankles is something that gymnasts also just think is "normal" and comes with doing gymnastics. This is NOT true! The thought that there is nothing you can do about it leads to often having bigger problems. Of course there will be short landings every now and then, but if this is a frequent problem and we can never get our ankles feeling better there are likely more things we need to fix like revisiting basics, increasing lower body/core strength, improving technique/landing mechanics, focusing on improving air awareness, and improved endurance.
So what is actually happening?
When we land short we are allowing the tibia and talus to collide, often pinching the cartilage, joint capsule, tendons,and ligaments between the bones.
In mild cases, the bones hitting against each other cause bruising and boney inflammation. Also, when the soft tissue (joint capsule, tendons, and ligaments) get pinched they become inflamed and often create scar tissue. This inflammation is problematic because then it is more likely to continue getting pinched- which is that discomfort you feel.
If we allow poor landings to continue, things can get much worse. If the bones repeatedly pinch the ligaments, joint capsules, and tendons in the front of the ankle they will have more damage. If this happens enough you can even end up with increased bone growth ( bone spurs) that will lead to even more pinching.
What can I do about it?
Unfortunately this usually means you need to limit activity (something no gymnast likes to hear). While you have this inflammation (it’s there even if it doesn’t look swollen!) you want to avoid having another short landing. I like for people to avoid hard landings until they have normal ankle motion without any pinching. The earlier you catch it, the less time it usually takes to improve. (It goes that way with most things!)
Depending on severity you might need a period of time in a boot to help let the tissue calm down. In bad cases sometimes surgery is needed to correct the impingement.
The best way you can help this NOT be a problem for you is
Ensuring you have good ankle motion (without any pinching)
Having good leg strength
Working leg strength with ankle dorsiflexion
Proper landing technique & being ready for landings
Good air awareness to know where you are when going into a landing
Go through good skill progression and having good basics
If you are experiencing pinching in the front of your ankle with stretching or landings I encourage you to see a rehab professional (bonus if they know gymnastics well!) ASAP! I am always happy to help if you don’t have someone you already work with! Don’t just let this linger and become a super limiting problem! Listen to your ankles!