The wider talus at the front explains that the deficit in dorsal flexion of the ankle is a factor of instability. Therefore, anterior osteophytosis (impingement exostosis) or anterior synovial hypertrophy (fibrous impingement) are factors aggravating instability and should be integrated into therapy. This limitation in dorsiflexion can also have a functional cause such as retraction of the sural triceps or the gastrocnemial muscles or even a muscle belly extended too far distally. For Barouk et al. [53], short gastrocnemials lead to a sensation of overall instability in 67% of patients and ankle instability in 25%.