title: Conservative management of posterior ankle impingement: a case report.
abstract: OBJECTIVE
  To describe the pain and functional improvements of a patient with posterior ankle impingement following a treatment plan incorporating soft tissue therapy, chiropractic adjustment and a progressive rehabilitation program.
  
  
  METHODS
  A 37-year- old male presented with posterolateral ankle pain exacerbated by plantar flexion two weeks after sustaining an inversion ankle sprain. Oedema was present and the patient was describing a sensation of instability while walking. The initial diagnosis of lateral ankle sprain was found to be complicated by a posterior ankle impingement caused by a tenosynovitis of the flexor hallucis longus sheath suspected during the physical examination and confirmed by MRI.
  
  
  RESULTS
  The patient was treated over a 14-week period. Soft tissue therapy, a rehabilitation program and cortisone injection were used to treat this condition. A precise description of the rehabilitation program that contains open kinetic chain, closed kinetic chain, proprioception, and conditioning exercises prescribed to the patient is given. After the treatment plan, the patient returned to play pain free and had no daily living restrictions.
  
  
  CONCLUSIONS
  A protocol including rest, soft tissue therapy, open and closed kinetic chain exercises, sport-specific exercises and cortisone injection appeared to facilitate complete recovery of this patient's posterior ankle impingement.
authors.affiliation: Sports Sciences Resident, Division of Graduate Studies, Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, Ontario, M2H 3J1.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Senécal
authors.affiliation: Associate Professor and Clinician, Chiropractic Department, Université du Québec à Trois-Rivières, 3351 boul. des Forges, Trois-Rivières, Québec, G9A 5H7.
authors.forename: Nadia
authors.initials: N
authors.lastname: Richer
keywords: ankle; chiropractic; posterior impingement