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Jorge Polanco to resume baseball activities: What is ankle impingement?


Lucas Seehafer PT

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blog-0061305001579540978.jpgAccording to KSTP's Darren Wolfson, Minnesota Twins shortstop Jorge Polanco will likely resume "baseball activties" - often hitting off a tee, fielding drills, etc. - as early as this week after undergoing an arthroscopic procedure in November to address impingement in his right ankle. This good news follows the report last week by the Minneapolis Star Tribune's Phil Miller that centerfielder Byron Buxton was on track in his recovery from a left shoulder labrum repair.

 

Ankle impingement is a broad term that refers to structures in the ankle being "pinched" due to soft tissue injury, boney deformity, and/or excessive/restricted joint motion; there are multiple joints in the ankle: the talocrural joint allows for dorsiflexion and plantarflexion (pointing the foot up and down) and the subtalar joint allows for inversion and eversion (rolling the ankle in and out).

 

There are various locations within the ankle in which tissues can become impinged upon, though the most common locations are at the anterior (front) and posterior (back) ankle, with anterior impingement being the most common.

 

Anterior impingement - also known as anterior impingement syndrome - often arises due to repetitive microtrauma (many instances of small trauma built up over time) and occasionally after lateral ankle sprains - also known as inversion or "rolling" ankle sprains. Anterior impingement syndrome isn't a very serious diagnosis, though it is often painful and can hinder an athlete's ability to perform at peak levels. Anterior impingement syndrome is often exacerbated by end range and/or repeated bouts of dorsiflexion.

 

This condition is often treated conservatively (i.e. rehabilitation) at first with emphasis placed on restoring pain-free range of motion, with arthroscopic surgery conducted if conservative rehabilitation fails. The arthroscopic procedure is often termed "debridement" as the structures causing the impingement are resected to open up more space. Outcomes following arthroscopic debridement of anterior impingement syndrome are good.

 

Posterior impingement syndrome is similar in concept, though it is often exacerbated with end range and/or repeated plantarflexion and may involve the Achilles tendon.

 

In all, Polanco appears to be recovering in line with the typical timeline following arthroscopic debridement procedures. This isn't a condition that is likely to be a long-term concern for Polanco and he should be return to game action in plenty of time for the beginning of the regular season.

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