18 Best Exercises For Posterior Ankle Impingement Syndrome

Introduction:

Pain in the rear of the ankle is known as Posterior Ankle Impingement Syndrome (PAIS), which often develops due to repetitive, forceful plantarflexion. Inflammation and pain may result from this compression, which may affect soft tissues, bone, or both.

Whether you are an athlete, dancer, or someone who experiences pain from daily activities, a well-planned exercise program for Posterior Ankle Impingement Syndrome can be an essential part of your recovery.

One important treatment option for posterior ankle impingement syndrome is physiotherapy. The goals of Exercises for Posterior Ankle Impingement Syndrome Are to reduce pain and inflammation, improve ankle strength and mobility, and restore the ankle to normal function.

It’s essential to consult with a doctor or physiotherapist before starting any new fitness regimen to receive an accurate diagnosis and a customized treatment plan. You shouldn’t have any problems while doing these exercises. If you have any severe pain, stop immediately.

Restoring ankle function is essential, and a comprehensive therapy plan should include strength and flexibility-focused activities that are suitable for Posterior Ankle Impingement Syndrome.

This gradual exercise program can help you restore function, control your Posterior Ankle Impingement Syndrome symptoms, and resume your favorite hobbies.

Causes:

Broken bones

• Impingement from damaged bones may result from talus or other ankle bone fractures.

Ankle Sprains

• Acute ankle sprains can increase a person’s risk of developing scar tissue and persistent instability, which can lead to posterior ankle impingement syndrome.

Impingement of Soft Tissue

• Thick or inflamed soft tissues, such as ligaments, the synovium, or the posterior joint capsule, may get stuck between bones when moving.

Injury to the Posterior Ligaments

• Impingement symptoms can occasionally be caused by injury or thickening of the posterior talofibular ligament or the posterior tibiotalar ligament following an ankle sprain.

Bony Deformities

• Impingement may result from bone spurs or an enlarged posterior talar process, which narrows the space in the rear of the ankle.

Past Ankle Injuries

• Chronic instability, formation of scar tissue, and altered ankle mechanics from acute ankle sprains increase the risk of Posterior Ankle Impingement Syndrome (PAIS).

Poor Rehabilitation

• Because of weakness, stiffness, or changed biomechanics, insufficient or poor rehabilitation following an ankle injury might make the ankle at risk of impingement.

Signs and symptoms:

Sensitivity

• By palpating (pressing) the region, a physician may frequently identify the exact point of pain, especially in the area on the outside of the ankle between the Achilles tendon and the peroneal tendons.

Swelling

• The rear of the ankle may have localized edema and irritation, which frequently becomes more apparent after exercise.

Ankle pain in the posterior region

• Pain in the ankles, especially before or following activities like taking a jump, jogging, or plantarflexion (pointing the toes).

Restricted Motion

• The ankle’s capacity to fully plantarflex painlessly may be restricted over time by the ongoing inflammation and possible bony growths.
• Patients may avoid this movement actively or involuntarily.

Touch Sensitivity

• Stiffness or soreness may result from applying pressure to the soft spot behind the ankle joint, close to the Achilles tendon.

Sensation of Pressing

• During plantarflexion, a patient with bony impingement may experience a “grinding” or “pressing” feeling inside the joint.

Instability

• Although it is less frequent, some individuals may feel as though their ankles are unstable.

Does Posterior Ankle Impingement Syndrome respond well to physiotherapy?

• Most people find that stretches and exercises help in their recovery.
• For six weeks, a sequence of ankle-strengthening exercises should be done three times a week to increase endurance and reduce pain.
• Additionally, it was shown that employing particular rehabilitation activities to increase flexibility and strengthen the ankles was more beneficial than using tape or ankle braces.
• Additionally, in some circumstances, strengthening activities may be more beneficial than using pain medication.
• A physiotherapist can assist you in selecting the exercises that will be most helpful for you based on your problem.
• Finding stretches and exercises that target specific areas may be made easier with their assistance.

Benefits of exercise:

Increased Blood Flow

• Exercise increases blood flow to the affected area, especially with gentle, low-impact workouts.
• This helps in supplying the tissues with vital nutrients and oxygen, which can promote healing and eliminate inflammatory waste products.

Support for Joint Structures

• For the joint, strong muscles serve as a protective support system.
• By absorbing shock and helping in movement control, they lessen the direct strain on the soft tissue and bony structures that are at risk of impingement.

Less Stiffness

• Gentle range-of-motion exercises prevent the joint from becoming inflexible and stiff.
• This lessens the pain that results from a constricted joint and helps to preserve ankle flexibility.

Enhanced Awareness of the Body

• This sensation can be affected by inflammation and impingement.

Building Up Your Muscles

• Strengthens the gastrocnemius, soleus, peroneal, and tibialis posterior muscles, supporting ankle function.
• Prevents muscle atrophy and helps in the recovery of functional movement patterns.

Go Back to Your Useful Tasks

• Uses movement patterns found in real life to support proper biomechanics.

Managed Loading

• Ankle load may be introduced safely and gradually using a progressive workout regimen.
• Over time, this regulated stress strengthens the ankle and reduces pain by strengthening the surrounding tissues without exacerbating the impingement.

Improved Stability

• Dynamic stability is achieved by strengthening the peroneal, tibialis anterior, and tibialis posterior muscles, which support the ankle.
• The uncontrollable motions that might cause impingement are less likely to occur in an ankle that is stronger and more stable.

Benefits for the Mind

• Reduces mobility anxiety, a common concern among those with injuries.
• Improves overall well-being and motivates to continue therapy.

Consider the following precautions before starting an exercise regimen:

• Make the most of the benefits and take a few precautions before beginning any fitness program.
• To find out which exercises are best for your specific problem, speak with your doctor or physiotherapist.
• Knowing what your body needs and not pushing yourself when it hurts are important.
• Exercise frequently causes pain, but severe or persistent pain may indicate overexertion.
• Start with low-impact exercises until you can tolerate additional pain before advancing to more demanding ones.
• Maintaining proper posture and form is crucial to avoiding recurrent injuries.
• If you’re not sure how to start exercising properly, consult a physician.
• Warm up before starting any activity to get your muscles and joints ready for the current task.

Exercises For Posterior Ankle Impingement Syndrome:

Patients with this illness are frequently advised to perform the following activities. Before starting these workouts, you should talk to your physiotherapist about whether they are suitable.

Ankle pump

• When you sit or lie down, your legs should be comfortably stretched.
• Keep your affected foot relaxed and supported.
• Point your toes forward as if you were pushing a gas pedal.
• Hold this position for a few seconds.
• Then return to your neutral position.
• Then relax.
• Repeat these exercises 5 to 10 times.

Ankle rotation

• Start with the seating position on the bed.
• One foot should be raised off the ground while keeping the other leg relaxed and straight.
• Rotate your foot slowly in a circular manner, starting at the ankle joint.
• Keeping the motion fluid and controlled, make the circle as large as you can without being uncomfortable.
• Rotate and repeat in a single direction.
• Then repeat in the opposite direction.
• Then return to your neutral position.
• Then relax.
• Repeat these exercises 5 to 10 times.

Seated calf raise

• Sit up straight in your chair.
• Next, raise your heels off the ground.
• Hold this position for a few seconds.
• Then return to your neutral position.
• Then relax.
• Repeat these exercises 5 to 10 times.

Ankle Plantarflexion

• Start with a seating position on the floor.
• Extend your legs.
• Next, take a resistance band.
• Then place the band over the front of your foot by grasping it with both ends.
• Point your toes forward slowly.
• Hold this position for a few seconds.
• Then return to your neutral position.
• Then relax.
• Repeat these exercises 5 to 10 times.

Ankle dorsiflexion

• Begin by lying on your back on the bed.
• Wrap one foot with the band after fastening it around the leg of a table or chair.
• Slowly point your toes toward yourself.
• Hold this position for a few seconds.
• Then return to your neutral position.
• Then relax.
• Repeat these exercises 5 to 10 times.

Ankle inversion

• To begin, choose a comfortable seat on the ground.
• Then spread your legs.
• Tie one end of the band beneath the affected foot on the floor and the other end around the inside of the foot to create a long loop.
• Next, bend inward your affected foot.
• Hold this position for a few seconds.
• Then return to your neutral position.
• Then relax.
• Repeat these exercises 5 to 10 times.

Towel curls

• Take a seat in a chair.
• A small towel should be placed on the floor in front of you.
• Make sure the length of the towel is sufficient for curling.
• Make sure you are barefoot for this exercise so you can feel the muscles in your feet contracting.
• Position the toes of one foot on the edge of the towel while maintaining a level heel on the floor.
• The cloth should be stretched flat beneath your foot.
• The towel may be pulled and curled in your direction by extending and grasping with your toes.
• Attempt to use the plantar flexor muscles in your foot to draw the towel toward you while holding it with just your toes.
• Then return to your neutral position.
• Then relax.
• Repeat these exercises 5 to 10 times.

Seated toe taps

• First, get comfortable in the chair.
• Your toes should be relaxed and slightly apart.
• Raise your toes.
• Meanwhile, keep your heel planted on the floor.
• Gently tap your toes up and down five to ten times each foot.
• Then return to your neutral position.
• Then relax.
• Repeat these exercises 5 to 10 times.

Ankle Alphabet

• Either sit in a chair with your feet flat on the floor or lie down with your legs extended.
• While maintaining a relaxed ankle, one foot should be lifted just a little bit off the ground.
• In the air, use your big toe as a “pen” to trace the letters A through Z.
• Ensure that your motions are regulated and smooth.
• You should focus on moving the ankle and toes rather than the full leg.
• Repeat one whole alphabet for every foot.
• Then return to your neutral position.
• Then relax.
• Repeat these exercises 5 to 10 times.

Standing heel raise

• Stand upright with your feet hip-width apart.
• Keep your toes pointed forward.
• If you need assistance with balance, position yourself near a counter, a sturdy chair, or a wall for support.
• Use your core and maintain your knees straight but not locked for stability.
• Without compromising form, try to raise your heels as much as you can.
• Hold this position for a few seconds.
• This promotes improved activation of the muscles.
• Make sure your feet don’t drop back down.
• Then return to your neutral position.
• Then relax.
• Repeat these exercises 5 to 10 times.

Seated towel stretch

• Start with the seating position on the bed.
• Your legs should extend after that.
• Fold a piece of towel in half.
• Wrap a towel over one foot’s heel to extend that leg.
• Gently draw the towel closer to you.
• You ought to feel stretched.
• Hold this position for a few seconds.
• Then return to your neutral position.
• Then relax.
• Repeat these exercises 5 to 10 times.

Soleus stretch

• Position yourself in front of a wall.
• In a standing stance, put both feet flat on the ground with the toes facing forward.
• Take a small step back while bending your back knee with one leg.
• You should also bend your front knee a little.
• Both feet should remain flat on the floor, and your heel should touch the ground.
• Lean forward slightly while keeping your back knee bent.
• The stretch should be felt in the lower calf area, just below the knee.
• In the bottom part of your calf, you should sense a little pulling sensation rather than pain.
• Hold this position for a few seconds.
• Then return to your neutral position.
• Then relax.
• Repeat these exercises 5 to 10 times.

Toe-to-wall stretch

• Start with standing position on the floor.
• Place your toes on the wall.
• Your heel should remain strongly planted on the ground as you move forward.
• One leg forward against the wall.
• Put your toes pointing forward against the wall.
• The other leg is behind you.
• Hold this position for a few seconds.
• Then return to your neutral position.
• Then relax.
• Repeat these exercises 5 to 10 times.

Foam rolling

• As you sit on the chair, place a small, soft foam roller under the arch of your foot.
• Roll the foam roller under your foot softly, starting at the heel and working your way toward the toes.
• Use gentle to moderate pressure and roll for one to two minutes.
• For ten to thirty seconds, stop and apply pressure to a particularly tight spot.
• You can even use the other foot to apply more pressure if needed.
• Then return to your neutral position.
• Then relax.
• Repeat these exercises 5 to 10 times.

Standing calf stretch

• Face the wall.
• Next, rest your hands on it for support.
• Maintain a small bend in the front leg and a straight behind leg while placing one foot behind the other.
• Keep your toes pointed forward.
• Both feet should be flat on the ground.
• Slightly lean against the wall.
• Hold this position for a few seconds.
• Then return to your neutral position.
• Then relax.
• Repeat these exercises 5 to 10 times.

Big toe stretch

• Start with seating position on the floor.
• Your fingers can be used to gently stretch the big toe up and down.
• Hold this position for a few seconds.
• Then return to your neutral position.
• Then relax.
• Repeat these exercises 5 to 10 times.

Seated Plantar Fascia Stretch

• Take a seat on the chair.
• Cross one leg over and place the injured foot on the other thigh.
• Pulling your toes back should cause a stretch in the arch of your foot, especially in the area of the plantar fascia.
• To avoid overstretching the tissue, maintain the stretch modestly.
• Feel your foot’s arch being slightly pulled.
• Hold this position for a few seconds.
• Then return to your neutral position.
• Then relax.
• Repeat these exercises 5 to 10 times.

Single-Leg Balance

• You may maintain proper posture by keeping your feet hip-width apart and standing tall.
• Make use of your core muscles to increase stability.
• Elevate your knee and slowly raise one foot off the ground.
• Have your standing leg slightly bent.
• Focus on keeping your balance.
• Remain still and refrain from shaking or trembling.
• Try to keep your hips level and avoid leaning to one side.
• Hold this position for a few seconds.
• Return the elevated leg to the floor with caution.
• Then return to your neutral position.
• Then relax.
• Repeat these exercises 5 to 10 times.

What precautions must be followed when working out?

Taking the proper precautions is essential when completing exercises for Posterior Ankle Impingement Syndrome (PAIS) in order to optimize the advantages of your rehabilitation program, prevent additional damage, and guarantee a safe and effective recovery.

The following are important safety precautions to consider:

Guidelines

• Your physiotherapist will show you the proper method.
• If you have any questions, ask them and pay close attention.

Customized Approach

• Your specific exercise regimen will be determined by the type of PAIS you have, the intensity of your pain, and how well you respond to treatment.
• You can be guided through the proper stages of recovery by a physiotherapist.

Get warmed up

• Do a quick warm-up that lowers the chance of damage by preparing the tissues for action and increasing blood flow to the muscles.

Cool-Down

• Stretch your calves and other important muscles gently after your workouts.
• This helps enhance flexibility and lessen post-exercise pain.

Keep Your Eye on Controlled Motions

• Early on, concentrate on quiet, controlled workouts rather than quick or fast motions.
• To lessen the strain on the affected tissues, give them shape and balance.

Begin slowly and quietly.

• Start with the shortest range of motion, the least amount of resistance, and the fewest repetitions. Avoid rushing your recovery.

Move Forward Methodically

• Repetitions, sets, resistance, and complexity should be gradually increased only once the current level can be completed comfortably.

Prioritize Quality Over Quantity

• Don’t attempt to do too many repetitions; instead, concentrate on doing each exercise correctly.
• A bad technique might make the problem worse or do more damage.

Supportive Footwear

• Put on supportive, well-fitting sporting shoes that don’t tighten your ankles.

Adjust or Stop

• If an exercise causes pain, try a different one or quit and consult your therapist.

Consistency

• The secret is consistency.
• Even on days when you feel better, keep to your workout regimen.
• Missing sessions might make recovery take longer.

Long-Term Dedication

• It may take some time to recover from PAIS, particularly if it is a chronic illness or involves bone problems.
• Be patient and understand that effects take time to appear.

When did you stop exercising?

Increased Swelling or Inflammation

• If you notice growing swelling or noticeable pain in the leg after activity, it may indicate that the tendon is being overworked.

Pain While Performing Daily Tasks

• It’s an indication that you are overworking yourself if, after exercise, you get pain when doing routine activities like standing, walking, or climbing stairs.

Severe or Acute Pain

• While a little pain is normal, sharp, piercing, or worsening pain is a sign of re-injury.

Not Able to Support Weight

• With time, pain gets worse rather than better.
• Shows that the current treatment is not working or that there may be a misunderstanding.

A feeling of numbness or tingling

• This might lead to decreased blood flow or nerve involvement, both of which require medical care.

Continual tension or cramps

• If you still feel constricted, cramped, or uncomfortable after stretching or modest activity, it’s best to quit.

Symptoms do not improve with time.

• If, following several workouts, you are not seeing any improvement in your pain or functioning, it could be time to relax and contact your doctor if your symptoms seem to be getting worse or remaining the same.

Which exercises should you avoid if you have Posterior Ankle Impingement Syndrome?

The following exercises and activities should be avoided, particularly in the early and subacute stages of recovery:

Excessively Forceful Stretches

• Stretching your muscles lightly is beneficial, but you shouldn’t do it too much.
• Avoid stretches that force your ankle into a pointed posture.

Deep or Strong Plantarflexion

• These compress the posterior ankle region, especially when the posterior talus is impacted.
• The heel elevates when there is too much plantarflexion.
• Gymnastics or dance routines, including a lot of toe-pointing.

Elevated Heel Deep Squats

• Especially when combined with ankle dorsiflexion restrictions that result in pressure shifting backward, heels-elevated squats may unintentionally increase posterior compression or plantarflexion.

Running on Inclined or Uneven Surfaces

• Stepping off a hill or walkway increases plantarflexion.
• The back of the ankle may experience increased strain and tiny instability due to rough surfaces.

Jumping and High-Impact Plyometrics

• These include quick push-offs or powerful landings in plantarflexion. During the push-off and landing stages of these activities, the posterior ankle becomes subjected to significant loads.

• Box jumps
• Jump rope

Summary:

You can reduce pain, increase blood flow, enable improved joint mechanics, and enhance your capacity to resume everyday activities by gently stretching the muscles in your lower legs and ankle joint. Make an effort to include these exercises in your routine to treat posterior ankle impingement. Gymnasts, ice skaters, and ballet dancers are among the athletes who experience this as they are always on their toes.

Consult your physician to ensure that the exercises are right for your stage of recovery. Refrain from painful activities. Warm up with some simple range-of-motion exercises before working out. To prevent pain, exercise should be done gently and carefully.

The most crucial advice is to avoid any workout that gives you pain. A successful rehabilitation program should be difficult, but it shouldn’t cause severe, localized ankle pain. It’s obvious that you are either not prepared for the workout or are doing it improperly if a certain movement or activity hurts.

A physiotherapist should always be consulted in order to modify your program and make sure you are making safe progress.

FAQ:

References:

• June 19, 2025: Bariya, D. Posterior Ankle Impingement Syndrome: The Top 15 Exercises. Physical therapy, exercise, and treatment. This page contains exercises for posterior ankle impingement syndrome.
• Ankle impingement, poster back (n.d.). Poster-ankle-impingement-back Ankle and foot pain: https://bexleymsk.engage.gp/conditions
• M. Louw, Nov. 10, 2024. Signs, examinations, and therapies for posterior ankle impingement. Take care of my weakness. The signs, examinations, and management of posterior ankle impingement are covered in this article.
• Dpt, J. V. P. (March 1, 2021). Exercises for ankle impingement. Vive Health. This article can be found at https://www.vivehealth.com/blogs/resources/ankle-impingement-exercises?srsltid=AfmBOorHseXq8fJHqAMkv4ZQw8KtXzdif6WBtyuARYtoMBezzun_3u2H.
• Ruth, A. and Try Physiotherapy and Sports Medicine (2021). Exercises for dancers with posterior ankle impingement. PAI-for-dancers.pdf, Physiotec. https://striveto.ca/wp-content/uploads/2021/09/
• Ankle Impingement Posterior (back) (n.d.). Poster-back-ankle-impingement https://bexleymsk.engage.gp/conditions/foot-and-ankle-pain
• The Rehabilitation Manual for Posterior Ankle Impingement by PhysioAdvisor (2022, March 1). https://physioadvisor.com.au/injuries/achilles-heel/posterior-ankle-impingement PhysioAdvisor for you