Pathoanatomy of Anterior Ankle Impingement in Dancers

Articles from the anatomy, orthopaedic, and radiology literature since 1943 were reviewed, and possible sources of anterior ankle impingement were identified therein. There are both osseous and soft tissue causes of impingement symptoms. Anterior impingement in dancers may be induced by repetitive dorsiflexion during demi-plié, where the anterior edge of the distal tibial articular surface contacts the dorsal neck of the talus. It also can be associated with the sequelae of lateral ankle sprain, including a hypertrophic tissue response, or simply by impingement of anatomically normal ligamentous structures. Dance medicine clinicians should be familiar with the pathoanatomy and etiologies of this clinical entity in order to provide effective care for dancers who suffer from it.