Frequently Asked Questions

Our 13-year-old daughter is becoming a very outstanding gymnast. But she has developed ankle pain from pinched tissues that the surgeon wants to do surgery on. We hate to see her training interrupted. Can this be put off?

Your daughter may have a condition referred to as ankle impingement. Impingement is another word for "pinching". This is a fairly common problem among athletes of all kinds, including gymnasts. Most of the research indicates that surgery to remove the offending tissue is really the only answer. Putting it off only delays the inevitable and can potentially create additional problems. X-rays and/or MRIs are needed to identify the source of the problem. This helps the surgeon plan the specific steps needed in surgery. Sometimes there are bone spurs called osteophytes that form along the joint line. Every time the foot and ankle move, the extra bone jams up against the joint preventing full motion. T here can also be an overgrowth of joint synovium (lining with fluid to give smooth movement of the bones) called synovial hyperplasia. And in some cases, the Deltoid ligament of the ankle gets folded over and pinched between two bones. No amount of rest or conservative care will get rid of the underlying cause of the problem. Most dancers, gymnasts, and athletes with ankle impingement aren't willing to give up the extra six to eight weeks required for a nonoperative approach. Most surgeons don't recommend delaying surgery given all the studies that show the unsuccessful results to conservative care.

Christopher D. Murawski and John G. Kennedy, MD, FRCS (Orth). Anteromedial Impingement in the Ankle Joint. In The American Journal of Sports Medicine. October 2010. Vol. 38. No. 10. Pp. 2017-2024.

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