Anterior Ankle Impingement is caused by repeated ankle dorsiflexion with resulting micro trauma to the anterior tibial plafond and corresponding talar neck.  This results in bone damage and periosteal bleeding leading to proliferative bone changes and spur formation. The bony spurs are not due to traction osteophytes at the attachment of the dorsal capsule. Secondary anterior capsular thickening and scarring, synovitis and loss of anterior joint cartilage develop.