Summary

During looking for cause of forefoot pain in without any certain cause, found signs of anterior ankle impingement in MRI study which after anterior arthroscopic decompression of ankle, the forefoot pain resolved without any other intervention.

Abstract

Background

forefoot pain in athletes may cause some certain causes which can easily find with proper examination and studies but a few percent of forefoot pain may become unexplained which treat with ineffective methods. this problem may reduce the ability and skills.

Purpose

after a study about biomechanics of foot and ankle and the change of rocker stages and ankle motion graphic in gait analysis, changes in presence of anterior ankle impingement shows an over pressure in mid stance and pre swing phase of gait into the forefoot area. dorsiflexion limitation cause a plantar skin thickness in forefoot more than heel. we studied whether resolve of anterior ankle impingement (AAI) can resolve the forefoot pain or not.

Methods

28 athletes patients (M=22, f=6) with near normal foot and ankle anatomy and other previous problems who had forefoot pain with no certain causes for it were selected. at first according to their plain lateral ankle x - ray and Molley test and then a MRI study, detect a asymptomatic or occasionally symptomatic AAI with limitation of ankle dorsiflexion about 15 - 20 degrees.
after failed 3 months of shoe modification and conservative treatment, they had arthroscopic anterior ankle debridement and decompression and follow for 6 months with any other interventions. 20 patients (71%) had completely resolved their forefoot pain and in 3 patients pain was resolved more than 50% and others had pain like in the past.

Result:
anterior ankle impingement can be placed in the list of causes of forefoot pain which are unexplained. certain examination of both foot and ankle parallel to each others is mandatory for find any problem which cause another's.