Os Trigonum Syndrome: Hidden Cause of Posterior Ankle Pain in Athletes

Quick answer: Os Trigonum Syndrome Posterior Ankle Pain has multiple potential causes including mechanical, neurological, vascular, and inflammatory. The most common causes we identify are overuse, ill-fitting shoes, and biomechanical imbalance. Red flags requiring urgent evaluation: warmth/redness (infection), inability to bear weight (fracture), and unilateral swelling without injury (DVT). Call (810) 206-1402.

Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Township, MI. Last updated April 2026.

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Medically Reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatrist, Balance Foot & Ankle Specialists, Michigan. Last updated April 2026.

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MICHIGAN PODIATRIST INSIGHT

The most important clinical decision with Os Trigonum Syndrome Posterior Ankle Pain isn’t which treatment to start with — it’s identifying the correct subtype. That changes everything. Call (810) 206-1402.

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PowerStep Pinnacle Insole

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Impact-absorbing recovery sandal — wear after long days on your feet.

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General Foot Care - Balance Foot & Ankle

When to See a Podiatrist

If foot or ankle pain has been bothering you for more than a few weeks, home care alone may not be enough. Balance Foot & Ankle offers same-week appointments at our Howell and Bloomfield Township clinics — no referral needed in most cases. Bring your current shoes and a short list of symptoms and we’ll build you a treatment plan in one visit.

Call Balance Foot & Ankle: (810) 206-1402  ·  Book online  ·  Offices in Howell & Bloomfield Township

In-Office Treatment at Balance Foot & Ankle

If home treatment isn’t providing relief for your foot and ankle injuries, our podiatry team at Balance Foot & Ankle can help with same-day evaluations and advanced in-office care.

Doctor Hoy’s Natural Pain Relief Gel

Natural topical pain relief I use in our clinic. Arnica + camphor formula — apply directly to the area 3–4x daily. ($20–25)

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Frequently Asked Questions

When should I see a doctor?

See a podiatrist if pain persists past 2 weeks, prevents normal activity, or is accompanied by red-flag symptoms (warmth, swelling, numbness, inability to bear weight).

Can I treat this at home?

Mild cases respond to RICE protocol (rest, ice, compression, elevation), supportive shoes, and OTC anti-inflammatories. Persistent symptoms need professional evaluation.

How long does it take to heal?

Most soft tissue injuries resolve in 2-6 weeks with appropriate care. Bone injuries take 6-12 weeks. Chronic conditions need longer-term management.

More questions patients ask

What is os trigonum syndrome?

Os trigonum is an accessory bone at the back of the talus, present in 7–25% of people. It causes posterior ankle pain with plantarflexion (pointing the foot) — especially in dancers and soccer players.

How is os trigonum syndrome treated?

Conservative: activity modification, immobilization, corticosteroid injection. Surgical excision cures >90% of refractory cases. Recovery 6–8 weeks post-surgery. Dr. Tom Biernacki DPM evaluates and treats os trigonum.

When should I see a podiatrist for os trigonum?

See Dr. Tom Biernacki DPM if symptoms persist >4 weeks or worsen. Same-day at Balance Foot & Ankle — Howell & Bloomfield Township. (810) 206-1402.

Does Balance Foot & Ankle accept insurance?

We accept BCBS, Medicare Part B, and most Michigan PPO plans. Call (810) 206-1402.

Still have a question about coverage or cost? Book online and we will check your benefits before your visit: Book in Howell · Book in Bloomfield Township. Prefer to talk it through first? Call (810) 206-1402.

Balance Foot & Ankle surgeons are affiliated with Trinity Health Michigan, Corewell Health, and Henry Ford Health — three of Michigan’s largest health systems.