Single-Leg Heel Raise Capacity is Lower, and Perceived Ankle Instability is Greater, in Dancers and Athletes With Posterior Ankle Impingement Syndrome

Abstract

Objective: To compare clinical assessment findings between elite athletic populations with and without a clinical diagnosis of posterior ankle impingement syndrome (PAIS). Design: Cross-sectional case–control study. Setting: Elite ballet and sport. Participants: Ten male and female professional ballet dancers and athletes with a clinical diagnosis of PAIS and were matched for age, sex, and activity to 10 professional ballet dancers and athletes without PAIS. Independent Variables: Posterior ankle pain on body chart and a positive ankle plantarflexion pain provocation test. Main Outcome Measures: Single-leg heel raise (SLHR) endurance test, range of motion testing for weight-bearing ankle dorsiflexion, passive ankle plantarflexion, and first metatarsophalangeal joint dorsiflexion, and Beighton score for generalized joint hypermobility. Participants also completed the Cumberland Ankle Instability Tool (CAIT) questionnaire. Results: The group with PAIS achieved significantly fewer repetitions on SLHR capacity testing (P = 0.02) and were more symptomatic for perceived ankle instability according to CAIT scores (P = 0.004). Conclusions: Single-leg heel raise endurance capacity was lower, and perceived ankle instability was greater in participants with PAIS. The management of this presentation in elite dancers and athletes should include the assessment and management of functional deficits.