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Ankle Pain After Running: Causes and Treatments

running ankle pain



Ankle pain after running is a common complaint among runners, ranging from beginners to seasoned marathoners. This discomfort can not only hinder performance but also significantly impact the quality of life. Given the repetitive impact and stress running places on the lower extremities, it’s no surprise that the ankles are particularly vulnerable. 

Understanding the causes and treatments of ankle pain is crucial for anyone looking to maintain their running regimen without injury. Whether it’s a sharp pain after a sprint or a dull ache that follows a long jog, addressing running ankle pain promptly can prevent more severe injuries and ensure that runners can continue to enjoy their sport.

This article explores the complexities of ankle pain after running, providing insights into the common injuries, diagnosis, treatment options, and preventive strategies to help you stay on track.

Ankle Anatomy

The ankle is designed to offer both stability and flexibility. It consists of three main bones: the tibia, fibula, and talus, which work together to provide the range of motion necessary for walking and running. The tibia and fibula are the two long bones of the lower leg, forming a socket that the talus sits in. Ligaments, which are tough bands of tissue, help stabilize the ankle by connecting these bones and preventing excessive movement.

In addition to ligaments, the ankle region houses several tendons, which attach muscles to bones. Among these, the Achilles tendon is the most prominent, playing a pivotal role in running by connecting the calf muscles to the heel bone. This setup allows for the push-off motion essential for running. The interplay of bones, ligaments, tendons, and muscles makes the ankle an incredibly complex joint. Its health and functionality are crucial for absorbing the impact of each foot strike and propelling the runner forward.

Overview Of The Importance Of Ankle Health In Running

Ankle health is important in running due to the significant forces exerted on the lower extremities with each step. A healthy ankle absorbs the shock of landing, supports body weight, and allows for the push-off that propels a runner forward. Any compromise in ankle function can lead to a cascade of issues, affecting gait, causing compensatory injuries, or even leading to time away from running.

Maintaining ankle health involves several key aspects, including strength, flexibility, and proprioception (the sense of the relative position of neighboring parts of the body). Strong ankles can withstand the stresses of running, while flexibility helps to absorb and distribute forces effectively. Proprioception enhances stability and coordination, reducing the risk of missteps and falls. For runners, a combination of these factors ensures peak performance and minimizes the risk of injury.

Common Ankle Injuries in Runners

Common Ankle Injuries in Runners

If you’ve ever wondered, ‘Why do my ankles hurt when I run,’ you’re not alone. Ankle pain is a common concern among runners, often a signal of underlying injuries that require attention. Let’s delve into some of the most common ankle injuries in runners.

Ankle Sprains

An ankle sprain occurs when the ligaments that support the ankle stretch beyond their limits and tear, leading to one of the most common musculoskeletal injuries encountered not just among athletes but also in the general population. Acute ankle sprains are estimated to occur 2 million times annually in the United States alone. These injuries are categorized into three types: lateral (the most common, affecting the ligaments on the outside of the ankle), medial (involving the ligaments on the inside of the ankle), and high ankle sprains (affecting the ligaments that join the tibia and fibula above the ankle joint).

Causes and Risk Factors

The causes are varied but often involve twisting or rolling the foot, improper landing, or running on uneven surfaces. 


Symptoms include pain, swelling, bruising, and a reduced range of motion. Runners may notice a sharp pain at the moment of injury, followed by difficulty bearing weight on the affected foot.

Achilles Tendinitis

Achilles tendinitis is an overuse injury causing pain along the back of the leg, near the heel. It occurs when the Achilles tendon, which connects the calf muscles to the heel bone, becomes irritated and inflamed. 

Causes and Risk Factors

This condition is often the result of repetitive stress to the tendon, not allowing enough time for recovery between runs.


Symptoms include tenderness, stiffness, and pain along the Achilles tendon, especially in the morning or after periods of rest. The pain typically worsens with activity.

Peroneal Tendonitis

Peroneal tendonitis involves inflammation of the peroneal tendons, which run on the outside of the ankle and stabilize the foot and ankle. 

Causes and Risk Factors

This condition can arise from overuse, improper footwear, or abnormalities in foot structure. 


Symptoms often include pain, swelling, and warmth around the outside of the ankle. Runners may experience an increase in pain during activities that involve repetitive ankle motions or when pressing on the tendons.

Stress Fractures

Stress fractures in the ankle are tiny cracks in the bone caused by repetitive force, often from overuse, such as running long distances. 

Causes and Risk Factors

These injuries can also result from increasing activity too quickly, running on hard surfaces, or from the impact of the foot striking the ground. 


Symptoms include a dull ache that worsens with physical activity, swelling, and tenderness at the site of the fracture. It’s crucial to address stress fractures early to prevent further injury.

Plantar Fasciitis

Plantar fasciitis is characterized by pain in the bottom of the foot, especially near the heel. This condition is caused by inflammation of the plantar fascia, a thick band of tissue that connects the heel bone to the toes. 

Causes and Risk Factors

Runners with tight calf muscles, a high arch, or who run on hard surfaces are at increased risk of ankle pain.


Symptoms include sharp heel pain with the first steps in the morning or after sitting for long periods, and the pain may decrease with activity but return after resting.

Diagnosis of Ankle Injuries

Diagnosing ankle injuries involves a thorough history and physical examination by a healthcare professional. Imaging tests, such as X-rays, MRI, or ultrasound, may be necessary to determine the extent of the injury and to rule out fractures or other conditions. It’s essential for runners to seek medical advice if they experience persistent ankle pain or symptoms that do not improve with a week of rest.

Treatment Approaches

Treatment Approaches

Immediate Care (R.I.C.E. Method)

The RICE method (Rest, Ice, Compression, Elevation) is recommended for the initial treatment of ankle injuries to reduce pain and swelling. Rest involves avoiding activities that cause pain, ice packs help reduce inflammation, compression can minimize swelling, and elevation helps drain excess fluids from the ankle area.

Physical Therapy

Physical therapy is often prescribed to restore strength, flexibility, and function to the injured ankle. A physical therapist may use ankling exercises, stretching, and other modalities to rehabilitate the ankle and prevent future injuries.


Over-the-counter pain relievers and anti-inflammatory medications can help manage pain and reduce inflammation. However, it’s important to use these medications as directed and to consult with a healthcare professional if the pain persists.


In severe cases, or when conservative treatments fail to provide relief, surgery may be necessary. The specific procedure depends on the type and extent of the injury but may involve repairing or reconstructing damaged ligaments or tendons.

Prevention of Ankle Injuries

Preventing ankle injuries is paramount for runners to maintain consistency in training and performance. It’s noteworthy that most ankle injuries were caused by running, Understanding the importance of adopting preventive strategies tailored specifically to runners. Several strategies can significantly reduce the risk of injury.

  • Importance of Proper Footwear: Shoes should fit well and provide adequate support, particularly for an individual’s foot type and running style. Regularly replacing running shoes to ensure they offer sufficient cushioning and support is also essential.
  • Strengthening and Flexibility Exercises: Incorporating pre running exercises that strengthen the muscles around the ankle and improve flexibility can help stabilize the joint and prevent injuries. Calf raises, ankle circles and towel stretches are beneficial.
  • Running Form and Technique Tips: Proper running form, including landing softly and avoiding overstriding, can minimize the impact on the ankles. A running coach or physical therapist can offer personalized advice on improving running mechanics.
  • Importance of Gradual Progression in Training: Increasing mileage or intensity too quickly is a common cause of injuries for runners. Following a well-structured training plan that allows for gradual progression helps the body adapt safely to increased demands.

Are You Suffering From Ankle Pain When Running? Peak Endurance Performance & Physical Therapy Can Help You With That

For runners experiencing persistent ankle pain running, seeking professional help is crucial. Specialized physical therapy and sports medicine clinics like Peak Endurance Performance & Physical Therapy offer targeted treatments and rehabilitation programs. 

These services are designed not just to alleviate pain but to address the underlying causes of injuries and prevent recurrence. Tailored exercise programs, gait analysis, and education on injury prevention are among the comprehensive approaches used to help runners achieve and maintain optimal ankle health.


Ankle pain in runners is a significant issue that can impact performance and enjoyment of the sport. Understanding the common causes of ankle pain and effective treatment and prevention strategies is key to managing and overcoming these injuries. Rehabilitation and recovery processes play a crucial role in returning to running safely, while preventative measures, including proper footwear, ankle strength training, and attention to running form, are essential for long-term ankle health. 

For those struggling with ankle issues, professional guidance from clinics specializing in sports medicine and physical therapy can provide the support needed to navigate the recovery journey successfully.


How do I know if my ankle is sprained?

A sprained ankle typically presents with pain, especially when bearing weight on the affected foot, swelling, bruising, and a restricted range of motion. You may have heard a popping sound at the time of injury. If your ankle feels unstable or if you’re unable to walk without significant pain, it’s likely sprained. Consulting a healthcare professional for an accurate diagnosis and appropriate treatment plan is essential.

How do I know if my ankle pain is serious?

Ankle pain is considered serious if it persists despite rest and home treatment, significantly limits your ankle mobility, or is accompanied by severe swelling, bruising, or deformity. Pain that worsens over time or does not improve with standard care measures, such as the R.I.C.E. method, warrants professional medical evaluation. Additionally, seek immediate medical attention if you experience numbness or tingling in the ankle or foot.

What happens if you ignore ankle pain?

Ignoring ankle pain can lead to worsening symptoms and potentially chronic conditions. Without proper treatment, what might begin as a minor issue can evolve into more serious injuries, such as prolonged ankle instability, chronic pain, or even arthritis. Persistent ankle pain can also alter your gait, leading to secondary injuries in the knees, hips, or back due to compensatory movements. Promptly addressing ankle pain not only facilitates quicker recovery but also helps prevent long-term damage and recurrent injuries.