• Os Trigonum Syndrome: Floating Bone in Back of Ankle

    What is Os Trigonum Syndrome?

    Os Trigonum Syndrome refers to pain in the back of the ankle that is caused by impingement of soft tissues on a bony prominence at the back of the talus bone. This prominence is present in 1 in 20 of the population but, in professional footballers, it is reported to be present in 1 in 5. This is thought to be due to repeated hyper plantar flexion (pushing the ankle forwards) during footballing activities. Due to the impingement, the soft tissues at the back of the ankle become inflamed and painful.

    Signs & Symptoms of Os Trigonum Syndrome 

    Pain in the back of the ankle is the first indicator of Os Trigonum Syndrome. On examination by a doctor or chartered physiotherapist the area in front of the achilles tendon can be painful to touch, and the bony prominence may even be palpable. The diagnosis of Os Trigonum Syndrome can usually be confirmed by x-ray views of the ankle from the side

    What you can do

    • Consult a sports injury expert
    • Apply ice packs/cold therapy to reduce swelling
    • Wear an ankle brace for protection

    Os Trigonum Syndrome Treatment

    Rest from the activities that aggravate the condition is required for 4 to 6 weeks, to allow the soft tissues to settle down and heal. Physiotherapy treatment consists largely of ice therapy. Ice packs applied for twenty minutes every couple of hours may help with the pain. An at home cryotherapy cuff is the most effective method of providing ice therapy as it can provide continuous ice cold water and compression for 6 hours and significantly reduce ankle pain and swelling.

    A doctor may prescribes anti-inflammatory medication, or administer a corticosteroid injection to reduce the soft tissue inflammation. If there are persistent symptoms of ankle pain and swelling from Os Trigonum Syndrome, an orthopaedic consultant may operate to remove the offending bony prominence. Rehabilitation with a physiotherapist following this procedure usually takes between 4 and 8 weeks before full sports activities can be resumed.

    Os Trigonum Syndrome Prevention

    In individuals who have a bony prominence at the back of the Talus bone, then success in preventing Os Trigonum Syndrome may be limited. However, using an ankle brace that prevents excessive ankle plantar flexion (pushing the foot down, like pressing the pedals of a car) may help to prevent soft tissue impingement and the development of Os Trigonum Syndrome.

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