Back of Ankle Pain - Os Trigonum | Seattle Podiatrist

www.footankle.c... Causes and treatment for pain behind the ankle. Learn easy home treatment hints and when to get professional help for pain at the back of the ankle.
The os trigonum is an extra bone that occurs behind the ankle off of the back of the ankle bone (the talus). Sometimes this bone gets irritated, fractured or inflamed and causes pain behind the ankle. This is called “os trigonum syndrome”.
Os trigonum syndrome often occurs after an injury such as an ankle sprain or with repeated downward pointing of the toes (this is common in ballet). In fact, there is a type of os trigonum injury known as a “nutcracker injury” because the os trigonum is “crushed like a nut” between the ankle bone and the heel bone.
Os trigonum syndrome and other causes of pain behind the ankle are usually very amenable to treatment but often do not get better on their own. Surgery is very rarely necessary but sometimes the extra bone of the os trigonum must be removed.
If you are in the Seattle area appointments can be made from our website at www.footankle.com/.
Dr. Larry Huppin in a nationally renowned authority on orthotics and biomechanics and a podiatrist in Seattle specializing in treating active people. He has practiced podiatric medicine in Seattle for over 20 years and has a special interest in helping patients achieve complete relief of any foot problem without resorting to surgery.
We are located at:
Foot & Ankle Center of Washington
600 Broadway, Suite 220
Seattle, WA 98122
206-344-3808

[@DavidJohnson-qs9mk]

Best explanation I've seen. Appreciated the heads up about surgery.

[@Anthony-i6i]

I've been dealing with this for five years. Goodness, it hurts.

[@Footankle]

If you have experienced pain at the back of your ankle let us know what treatments have worked for you. Have you tried our suggestions and were they helpful?

[@martinc1548]

Thank you for the explanation. I planted my foot during a softball game and experienced what I think to be a sprain in this region. For a month now, the pain has lingered in precisely the area you described. I am itching to get back into running/the gym, and wonder what exercises I can do on my own to work toward full healing. Or is rest and immobilization the only treatment option? Is there a risk of re-injury with, say, light jogging (which I seem to be able to handle)? Or am I prolonging recovery time?

[@blueredpinkgreen]

Just received this diagnosis from my primary care doctor after an X-ray... not sure where to go from here...

[@maryjade1000]

sprained my ankle hard core in oct of 2017. never really fully healed. still hurts. had another mri this year to see what the heck is going on, and they think its the os trigonum syndrome - key word "they think" and anyways........had the foot bones realigned by a foot chiropractor and that gave me the first ability to walk in months immediatly following the adjustment but let me tell you it has been 2 yrs+ since the injury AND ive been getting my foot regularly adjusted by this chiropractor who specializes in feet, and am finally able to walk on my foot again but it constantly aches in the back of the heel and every symptom i read and every video i watch on this describes what i have EXACTLY. while id like to avoid surgery, i'd also like to know if i do NEED surgery - but im so torn, no pun intended, as to what to do. i can walk but can no longer run or even walk fast really. i have replaced and upgraded all of my shoe-wear and have been icing, elevating, using epsom salt soaks 2x a day, bought a 500$ cold laser online, doing a magnetic band on it, acupuncture, massage, and chiropractic. the heel still hurts. i feel like this surgery might actually be what is next. if i send you a copy of my MRI (written) would you look at that and tell me what you think???? i'm so panicked at the thought of surgery :/

[@nickg8118]

I am a pre-professional ballet dancer, and I've suffered from OS Trigonum Syndrom for years. 3 years ago, I started feeling pain in my left ankle whenever I would point my foot. This posed a big problem, as the pain worsened over time. After dealing with it for 2 years, I got it checked out by a doctor, and they wrongly diagnosed it as Achilles tendinitis. They recommended I stop dancing, so I stopped for about 4 months. No improvement. Then, I started physical therapy. I went several times a week for another 3 months. Still, no improvement. X rays were taken, as well as ultrasounds. I was then put on topical nitroglycerin and was required to sleep in a Strasburg Sock. I did this for 2 months. Still, no improvement. By this time I could barely point my foot without intense pain. Finally, they did an MRI on my ankle and found that it was not tendinitis, but OS Trigonum syndrome that I was suffering from. I then underwent a procedure to remove fluid in my heel, and then reduce the inflammation. I was then in a walking boot for two months, and on rest for another two. The pain is still there, though much reduced. Would surgery eliminate all of the pain? How long is the recovery time involved with surgery?

[@damianciba5921]

I have the same suffering story like you. All the same. I think you should remove the Os Trigonum because it triggers your hallucis longus teneon all time which causes your pain. Wish you good luck. I have in 2 weeks my surgery. I hope it wil be everything alright after

[@theamantk7232]

@@damianciba5921 how was your surgery. And what is the condition now

[@Ou_dembele]

Can this cause excess supination?
I got and mri and have this injury and a good amount of bodyweight of my right leg moves towards instead of my foot and this causing a lot of knee pain and inability to do exercises and sport properly

[@DhankumarSunuwar-u5y]

Please prescribe elopathic medicines for prominent os trigonum Sir

[@jasons8756]

Can the OS Trigonum also trigger inflammation into the sinus tarsi area?

[@WhitneyDawnCarlson]

I know now that I have this bone, but it has been a daily source of pain for years. Immobilization doesn’t seem like it would fix that, would it?

[@Footankle]

Here is detailed information on os trigonum (about half way down the page), including home treatment options:
www.footankle.com/accessory-bones-and-extra-bones-of-the-feet/

[@jessebrito11]

I play soccer but my injury occurred as I was sitting down. I had my legs crossed and when I uncrossed them my ankles kinda popped a little and at first it wasn't that bad but later like a minute later I couldn't even step on my foot because the back of my ankle hurt I can't point my toes up only doing. It's really weird

[@Footankle]

You need to see a foot doctor and get this worked up.

[@jessebrito11]

It's better now. I stretched and massaged my whole leg and now I can step but there is still some pain and notable inflammation. I still not sure what it could be tho

[@doronshapir503]

Dr. Huppin, Hello! Is there any way to send you an email/request a telemedicine with you(a non-Washington state resident)?

[@Footankle]

I'm so sorry, but I am licensed only in Washington State, so I can only provide treatment to those in Washington.

[@doronshapir503]

@@Footankle Thank you. If that's ok, I will pose my question here then: Since November 2020, I suffer from a pain in my left foot. I always had issues with that foot(flat feet, kept spraining ankle, tendinosis). After some PT, cortisone injections and etc. I was told that os trigonum surgery is needed. That being said, an MRI didn't indicate I actually have an extra bone, though that I do have "prominent stieda process/posterior talar process" and bone island(without marrow edema pattern, though).
Two questions:
1. If the MRI says one thing and two orthopedic surgeons say another thing, what's the best thing to do? Can it be that the MRI is... wrong? The report itself says "no MRI evidence of os trignoum syndrome", but there is a lot of white around the bone.
2. You said in this video that surgery is most often not the right call, and I just wonder what else I can do to relieve the pain. I never used a boot, but did use a brace - didn't help, and PT doesn't seem to do the trick for me.
Thank you. I know it is super hard to answer questions like this online - if you think coming to Seattle is a logical thing, I will. (I am in the East Coast)

[@Rene-uz3eb]

What the Dr said re ballet dancers, talus spurs (which can lead to ankle impingement) seem to be common, in 4 out of 9, so a sports/shoes related problem.
Magnetic resonance imaging of the ankle in female ballet dancers en pointe, 2010
(no mention of os trigonum, so seems to be rather infrequent in comparison)
White around the bones might be soft tissue thickening, which is a symptom of impingement of the ankle

[@randyr6610]

Short to the point good information and great video.

[@Footankle]

Glad it was helpful!

[@buddysally886]

Had surgery on this yesterday

[@ΠάνοςΑτσωνιος]

I am about to have surgery..i have it 4 months i cant walk just a little steps...you are ok now?

[@buddysally886]

@@ΠάνοςΑτσωνιος yea I can run etc, just range isn’t great still

[@dejirii]

Pug face sally please respond to him.