Anterior impingement syndrome in dancers

Anterior impingement is a common problem in dancers occurring primarily secondary to the repetitive forced ankle dorsiflexion inherent in ballet. Symptoms generally occur progressively and may respond to conservative treatment including addressing biomechanical faults that contribute to the problem. As impingement progresses, movements essential to ballet may become impossible and arthroscopic ankle surgery is often effective for both diagnosis and treatment, allowing athletes to return to dance

The distal fascicle of the anterior inferior tibiofibular ligament as a cause of tibiotalar impingement syndrome: a current concepts review

Impingement syndromes of the ankle involve either osseous or soft tissue impingement and can be anterior, anterolateral, or posterior. Ankle impingement syndromes are painful conditions caused by the friction of joint tissues, which are both the cause and the effect of altered joint biomechanics. The distal fascicle of the anterior inferior tibiofibular ligament (AITFL) is possible cause of anterior impingement. The objective of this article was to review the literature concerning the anatomy, pathogenesis, symptoms and treatment of the AITFL impingement and finally to formulate treatment recommendations. The AITFL starts from the distal tibia, 5 mm in average above the articular surface, and descends obliquely between the adjacent margins of the tibia and fibula, anterior to the syndesmosis to the anterior aspect of the lateral malleolus. The incidence of the accessory fascicle differs very widely in the several studies. The presence of the distal fascicle of the AITFL and also the contact with the anterolateral talus is probably a normal finding. It may become pathological, due to anatomical variations and/or anterolateral instability of the ankle resulting from an anterior talofibular ligament injury. When observed during an ankle arthroscopy, the surgeon should look for the criteria described to decide whether it is pathological and considering resection of the distal fascicle. The presence of the AITFL and the contact with the talus is a normal finding. An impingement of the AITFL can result from an anatomical variant or anteroposterior instability of the ankle. The diagnosis of ligamentous impingement in the anterior aspect of the ankle should be considered in patients who have chronic ankle pain in the anterolateral aspect of the ankle after an inversion injury and have a stable ankle, normal plain radiographs, and isolated point tenderness on the anterolateral aspect of the talar dome and in the anteroinferior tibiofibular ligament. The impingement syndrome can be treated arthroscopically

Anatomy of the ankle ligaments: a pictorial essay

Understanding the anatomy of the ankle ligaments is important for correct diagnosis and treatment. Ankle ligament injury is the most frequent cause of acute ankle pain. Chronic ankle pain often finds its cause in laxity of one of the ankle ligaments. In this pictorial essay, the ligaments around the ankle are grouped, depending on their anatomic orientation, and each of the ankle ligaments is discussed in detail

Social dynamics of community resilience building in the face of climate change : the case of three Scottish communities

Meeting global targets that maintain temperatures at 1.5 °C above pre-industrial levels while adapting to the growing impacts of climate change requires significant and rapid societal change. Within this context, there has been growing interest in building community resilience to shocks and stressors and as a forward-looking process. Yet while there has been extensive attention to conceptual aspects, there has been much less on how this can be achieved in practice. This research worked with three communities in Scotland (UK) regularly exposed to flooding and other integrated challenges to learn from action about community resilience building. A carefully developed four-tiered transdisciplinary approach was applied that included: relationship-building; enhancing capacities to work with interconnections; enabling processes; and supportive action-oriented research. The findings of the analysis of the system dynamics that were occurring during the resilience-building process highlight that it is a complex and messy social process. Yet, it also shows that if quality and sufficient quantity of support and time to help surface and deliberate on underlying assumptions about communities and change is provided, it can be possible to stimulate emergence of beneficial reinforcing social dynamics that begin to support collaborative and systemic action. To further advance know how about resilience building, much greater focus will be needed on the ‘how’ of resilience. This, in turn, will require new framings of, and approaches for, community resilience and new framings of research, knowledge and knowing