Skip to Main Content




There are three steps you have to complete to become a professional dancer: learn to dance, learn to perform and learn how to cope with injuries.

David Gere


Sportspeople, particularly ballet dancers, footballers, and high jumpers, may complain of ankle pain that is not related to an acute ankle injury (Chapter 38). Clinical management is simplified if the presentations are further divided into:


  • medial ankle pain

  • lateral ankle pain

  • anterior ankle pain.


The region that might be considered “posterior ankle” pain is defined as the “Achilles region” in this book (Chapter 37). Note that, in real life, patients present with combinations of pain, such as lateral and anterior pain in soccer players. In those circumstances, the systematic clinical approach outlined below still aids in diagnosis and management.


Medial ankle pain


Clinical experience suggests that the most common cause of medial ankle pain is tibialis posterior tendinopathy.1 Posterior impingement syndrome of the ankle (Chapter 37) may occasionally present as medial ankle pain. Flexor hallucis longus tendinopathy is not uncommon and may occur together with posterior impingement syndrome. In the case of flexor hallucis longus tendinopathy, the patient is often suffering from loud—and painful—crepitation, behind not only the medial malleolus; but also may be projected further down the foot on the medial side. In some cases, patients feel that the crepitation is located in the big toe. The therapist should always look for tendinopathy in the region behind the medial malleolus. Flexor hallucis longus tendinopathy almost always needs surgery, which can be done with the aid of the arthroscope (i.e. hindfoot arthroscopy). Tarsal tunnel syndrome, in which the posterior tibial nerve is compressed behind the medial malleolus, may present as medial ankle pain with sensory symptoms distally. Causes of medial ankle pain are listed in Table 39.1. The anatomy of the region is illustrated in Figure 39.1).

Table Graphic Jump Location
Table 39.1

Causes of medial ankle pain

Figure 39.1

Medial aspect of the ankle

(a) Surface anatomy

Graphic Jump Location
Vedio Graphic Jump Location
Differentiating flexor hallucis longus tendinopathy from posterior impingement

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.


Create a Free MyAccess Profile

* Required Fields

Note: If you have registered for a MyAccess profile on any of the Access sites, you can use the same MyAccess login credentials across all sites.

Passwords must be between 6 and 40 characters long (no whitespace), cannot contain characters #, &, and must contain:
  • at least one lowercase letter
  • at least one uppercase letter
  • at least one digit

Benefits of a MyAccess Profile:

  • Remote access to the site off-campus on any device
  • Notification of new content via custom alerts
  • Bookmark your favorite content such as chapters, figures, tables, videos, cases and more
  • Save and download images to PowerPoint
  • Self-Assessment quizzes saved for quick review
  • Custom Curriculum access for both instructors and learners

Subscription Options

Clinical Sports Medicine Collection Full Site: One-Year Subscription

Connect to one of the most renowned references in sports medicine and explore all aspects of diagnosis and management of sports-related injuries and physical activity. Subscription includes access to a library of sports medicine videos.

$65 USD
Buy Now

Pay Per View: Timed Access to all of Clinical Sports Medicine Collection

48 Hour Subscription $34.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.