Special FocusPosterior Ankle Pain After Ankle Sprain: Bony and Soft Tissue Impingement and Flexor Hallucis Longus (FHL) TenosynovitisChao, Wen MD*; Lee, Wonyong MD†Author Information *Department of Orthopaedic Surgery, University of Pennsylvania School of Medicine, Philadelphia †Guthrie Clinic, Department of Orthopaedic Surgery, Sayre, PA The author declares no conflict of interest. Address correspondence and reprint requests to Wen Chao, MD, University of Pennsylvania School of Medicine, Department of Orthopaedic Surgery, Clinical Associate Professor, 230 West Washington Square, 5th Floor, Philadelphia, PA 19106. E-mail: [email protected]. Techniques in Foot & Ankle Surgery: March 2021 - Volume 20 - Issue 1 - p 14-18 doi: 10.1097/BTF.0000000000000318 Buy Metrics Abstract The proper diagnosis of posterior ankle pain after ankle sprains is often missed. This can occur as an overuse injury or as a result of acute trauma in patients performing repetitive forced plantar flexion sports. An understanding of various causes of posterior ankle impingement, both bony and soft tissue, is critical to make the proper diagnosis and provide appropriate treatment. Nonoperative treatment should be considered as the initial treatment for the posterior ankle pathology. Surgical intervention is indicated if pain persists despite nonsurgical treatment, particularly for athletes or dancers who want to continue to train and perform their sport. Surgery can be performed using an open or arthroscopic approach. Level of Evidence Level V—expert opinion. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.