TECHNIQUEFlexor Hallucis Tendonitis and Posterior Ankle Impingement in the AthleteDE ASLA, RICHARD J. M.D.; O'MALLEY, MARTIN M.D.; HAMILTON, WILLIAM G. M.D.Author Information Commonwealth Orthopaedics and Rehabilitation, Arlington, Virginia, U.S.A. Hospital for Special Surgery, New York, New York, U.S.A. Orthopaedic Associates of New York, New York, New York, U.S.A. Address correspondence and reprint requests to William G. Hamilton, M.D., Orthopaedic Associates of New York, 345 West 58th Street, New York, NY 10019. Techniques in Foot & Ankle Surgery: December 2002 - Volume 1 - Issue 2 - p 123-130 Buy Abstract Posterior ankle pain is a common complaint in athletes who perform in the equinus position. These include swimmers, divers, figure skaters, gymnasts, soccer players, and dancers. The epitome of the “equinus athlete” is the ballet dancer, who, to conform to the “line” required by the art form, must achieve maximum plantarflexion in the foot-ankle-subtalar-midtarsal joint complex. As a consequence of such an extreme and unnatural position, posterior ankle pain may result from sudden injury or, more commonly, chronic overuse. The focus of this article is on the surgical treatment of two conditions that present as posterior ankle pain: flexor hallucis tendonitis and posterior impingement of the ankle. When conservative measures fail, surgical intervention can be considered. A medial approach to the ankle should be used when both conditions occur concurrently. A lateral approach is used to treat isolated posterior impingement. The results of the described operative treatment of these conditions performed by the senior author showed good or excellent results in thirty of forty cases at an average of 7 years follow up. © 2002 Lippincott Williams & Wilkins, Inc.