Os Trigonum Syndrome
In the “dance world,” it seems that there is a lot of talk about os trigonum syndrome. Os trigonum is fairly rare in the general population, but seems to be more discussed and noticed in dancers, specifically those that do ballet and pointe work.
What is Os Trigonum?
Os trigonum refers to a extra boney structure in the ankle joint. It may occur at birth, following trauma or acute injury to the ankle, or with repeated forceful plantar flexion (pointing the foot) or jumping. When this bone and surrounding soft tissue becomes pinched between the bone of the leg and the ankle bones, it causes irritation, inflammation, and pain. Pain is often felt in the back of the ankle especially with pointing the foot, with releve, and/or with jumping.
Is Surgery the Only Option?
Although for some it may be the only relief, in most of the population os trigonum does not cause any symptoms or pain. Thus, surgery is not always a necessity. Also, just having an os trigonum doesn’t mean that it’s the cause of your pain. If the pain was more so due to tendonitis of one of the tendons around the ankle, removing the bone may not actually alleviate the symptoms.
What to do?
As with any injury, it is important to not “self diagnose.” If you are experiencing pain in the back of the ankle that is impacting your ability to perform, contact a medical professional. If an os trigonum is present and is the cause of pain and limitation, strengthening surrounding musculature, working on ankle flexibility, and improving joint mobility may help reposition the ankle to change how it is taking and providing force which could decrease symptoms and prevent the need for surgery. At Elite PT, a physical therapist experienced in working with dancers would evaluate technique, evaluate any limitations in strength or flexibility, and determine a plan to decrease pain in order to return to full function.