Why are there many suggestions for fixing anterior ankle impingement by stretching/movements?
Prelude
Anterior ankle impingement as illustrated here (random example) seems to occur often enough that it has the name "Footballer's Ankle". It seems a pretty simple affair: some initial accident damages some part in/on or near the anterior ankle joint, leading to unwanted protective growth there (bone spur, calcific deposit etc.). Eventually, the movement is restricted simply for mechanical reasons - for example a bone spur on the talus or tibia hitting the other side during dorsiflexion. The blocking happens like "hitting a wall", not like a muscle or ligament that slowly goes into the stretch limit. It seems (according to my superficial research) that the issue is quickly diagnosed by ultrasound, x-ray or MRT/MRI, and fixed by arthroscopy, whereby the extraneous mass is easily shaved off, and the patient is in rehab after two weeks, and back to normal after two months.
So far so good. What I noticed is that many people (basically, everyone except "operating" doctors) seem to advocate manual therapy or training - diverse stretching routines forcing movement "into the pain", mostly, sometimes preceded by trying to stretch the talus a little bit away from the tibia to make more space. The root cause - physical growth where none should be - is mostly not even mentioned, or done aside with a half sentence. Mostly, it seems like it is treated like a usual stretching/mobilization problem.
I understand the dilemma of operating too quickly (for example, in complicated knee operations where there is a significant risk of doing more damage than good). But this specific injury seems to be almost trivial since - aside from the usual risks of infection, anesthesia and so on - arthroscopy seems inherently side-effect free, and the operation is not about restoring function to a damaged part, but about removing material that is not supposed to be there in the first place. While it certainly calls for a skilled operateur, the action itself seems almost trivial to me.
Instead, trying to somehow force the patient or client past the point of pain would not only be futile (a bone spur is not like a muscle, fascia or ligament that just needs to get stretched or "freed"), but possibly much more damaging if it leads to the other side of the joint (where the bone spur rubs against) becoming worn in and thus arthritic.
Questions
Are there other causes with the same symptom of "anterior ankle impingement" than what I described at length up there, and which can in fact be remedied by manual therapy or training techniques?
Is my assumption about it being useless or even damaging to try to get past the blocked range of movement wrong?
Do you know other reasons why repairing the issue is not prioritized higher by many professionals (trainers, therapists) instead of trying to fix it by moving through the pain? This seems a bit like advising someone with tooth pain to change their chewing habits instead of sending them to a dentist... surely, not all of them (including well-known people like Kelly Starrett) are hacks that just want to generate more customers for themselves.
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