Dancer's Heel

Dancer's Heel, medically known as Posterior Impingement Syndrome, occurs when the tissue become compressed at the back of the ankle. This pinching or compression is caused by a bony formation at the back of the ankle. The pain may be triggered by an ankle sprain or by the tissue being trapped between the ankle and heal bone. When the soft tissue at the back of the ankle is pinched it becomes inflamed and painful. Posterior Impingement Syndrome is common among ballet dancers.

Signs and symptoms of Dancer's Heel may include:

  • Pain at the back of the ankle.
  • Tenderness behind the bottom tip of the fibulabone
  • Pain which is worse when the foot is pointed down into plantar flexion (foot pointing downwards).

The doctor will move your ankle to see what movements or positions cause your pain. The doctor may push your foot downward or have you rise up on your toes if a posterior impingement is suspected. The doctor will probably order X-rays if impingement is suspected. You may be asked to squat down or rise up on your toes during the X-ray. This helps show if impingement is due to bone pinching the soft tissues.

A bone scan may be recommended in select cases, such as when surgery is being considered. In general, MRI scans are not helpful for impingement problems, but they may be ordered to check for other ankle problems that could be causing your pain.

You may be told to rest the ankle for a short time to reduce swelling and pain. A special walking boot or short-leg cast may be recommended to restrict ankle movement for up to four weeks. Mild pain medications and anti-inflammatory medicine may also be prescribed. An ice pack can also help alleviate swelling and may encourage a faster return of normal ankle movement.

Your doctor may recommend a steroid injection into the painful area, to help relieve irritation and swelling in the soft tissues that are being pinched, reducing their tendency to get pinched. Additionally, your doctor may suggest working with a physical therapist familiar with dance medicine to help you regain normal use of your ankle. Patients often progress in a series of exercises including stationary cycling, range of motion, and ankle strengthening. If nonsurgical treatments do not work, surgery may be recommended. The type of surgery will vary depending on the location and cause of ankle impingement.

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Reviewed by health care specialists at UCSF Medical Center.

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