Pain at the Back of Your Ankle when Dancing - Posterior Ankle Impingement Syndrome 跳舞時腳踝後方痛症 - 後踝夾擠症
Updated: Mar 24
Author: Dr. Raymond P. Lee - Orthopaedic Surgeon
作者：李必達醫生 - 骨科醫生 Translation: Chloe Mo - Registered Physiotherapist (HK)
中文翻譯 ： 巫柔潔 - 香港註冊身物理治療師
Foot and ankle injuries are very commonly seen in professional dancing. Studies have shown that more than 50% of the injuries were involved in this region. It is not hard to imagine different types of dance would also put a lot of pressure on the foot and ankle. Among all dancers, the most studied one was ballet. The En Pointe (Figure 1) and Demi Relevé (Figure 2) require the ankle joint to point downwards at its maximum while dancing. This can cause a lot of discomfort and pain at the backside of the joint, hence the term “posterior ankle impingement syndrome” (PAIS).
Radiological studies of the ankle using MRI and CT scans allowed us to better visualize the impact during such foot and ankle maneuver. Findings include inflammation of the nearby ligaments and tendons, bony and soft tissue that is being impinged and various anatomical variations around the backside of the ankle joint which predisposes to such condition.
Clinical assessment by orthopedic surgeons and radiological assessment would allow us to make the diagnosis. Most of the patients can be treated with non-operative methods, such as anti-inflammatory medication, physiotherapy, and steroid injection. However, the operation would be needed if these measures failed to relieve the symptoms.
Recent advancements in surgical instrumentation and techniques allow us to use a minimally invasive approach if surgery is needed. We open up small holes (a few millimeters wide) at the back of the ankle and remove any soft tissue or bony structures that cause the impingement. We can correct the anatomy by removing excessive bony growth. Inflammed tendons can also be debrided to allow better gliding of the toes during dancing movements. The recovery is shorter and easier compared with the traditional open procedure. Up to 90% high patient satisfaction rate has been reported.
In order to prevent PAIS, proper training and supportive exercises are important. It is always useful to have stretching exercises before and after any dance practice or performance. Muscle power should be built up so that the joint is not under excessive loading. Early consultation of doctor or physiotherapist can often relieve early symptoms, and allow you to enjoy a longer dancing career.
足部和腳踝受傷在專業舞蹈中很常見。研究顯示，該身體部位涉及超過50％的傷患。不難想像，不同類型的舞蹈也會給足部和腳踝施加很大壓力。在眾多舞蹈中，研究最多的是芭蕾舞。全足踮立 En Pointe（圖1）和半足尖踮立 Demi Relevé（圖2）時要求踝關節在跳舞時往下方指至最大幅度。這個動作會在關節後方引起許多不適和疼痛，因此稱為“後踝夾擠症候群”（PAIS）。