Ankle Pain with Running

By Justin Carmel, DPT

Ankle Pain with Running

There’s nothing more frustrating than persistent, nagging ankle pain with running.  The repeated impact of each step when running puts increased stress on the body which can result in sprains, tears, fractures, and chronic ankle pain.  Luckily, with the right preventative measures in place, you can avoid a host of ankle-related challenges.  Many runners run pain-free all the time because they take the proper steps to avoid and prevent injury. Watch this VIDEO about 5 foot and ankle symptoms you shouldn’t ignore.

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Ankle pain with running is one of the most common obstacles that can stop runners in their tracks.  What may start as an annoying twinge can quickly turn into a throbbing mess if you don’t take the proper steps to nip it in the bud.  So, how do you cope with consistent ankle pain with running?  Let’s take a look at the 5 of the most common reasons you may be experiencing ankle pain with running.

1. Ankle Strain or Sprain

Strains and sprains are usually the most common reason your ankles hurt when running. An ankle strain happens when a muscle or tendon is overstretched or torn. An ankle sprain is when a ligament is overstretched or torn. Ankle pain can stem from overuse, ankle sprains and strains are often caused by a single traumatic injury.

Whether you’re on smooth pavement or an uneven trail, one little misstep or awkward landing can cause you to painfully roll your ankle.  Even if you’re able to get right back on your feet, tiny micro-tears in your muscles and ligaments could add up over time to create a serious injury. The best advice is to take care of it now.

Strains and sprains might be the most frequent reason your ankles hurt when running, but they’re also the most treatable.  The painful acute symptoms of rolling your ankle will be easier to treat the quicker the injury is attended to. If you want to learn more about ankle sprains you can watch this VIDEO.

2. Ankle Stress Fracture

Stress fractures form when your muscles can no longer absorb the shock of repetitive impact. Instead, tiny cracks form in your bones which eventually crack under the stress.  “Shin splints” are the most primitive form of a stress fracture, which is an irritation of the outer lining of the bone.  When someone has shin splints they have the first symptom of a bone stress injury.  When left untreated, stress fractures have the potential to completely derail your daily runs. Shin splints can potentially put you in a cast for weeks. If you’re experiencing intense bruising, tenderness, or can’t run without a sharp pain in your ankle, you should see a doctor and get X-rays, and most importantly stop running.  This injury can take about six weeks to heal, so the sooner you’re seen, the better.

3. Ankle Tendonitis

Tendinitis means inflammation of a tendon that forces it to fray, tear, or swell.  There are several different types of tendinitis in your foot region that might be causing your ankle pain with running

• Tibialis anterior tendonitis – This tendon runs down the front of your shin bone (the tibia) and inserts at the front of your ankle.  If this is where you feel ankle pain from running, it’s probably due to repetitive, forceful flexion of the foot.  Problems with your tibialis anterior tendon may also cause those dreaded shin splints.
• Achilles tendinitis – Your Achilles tendon connects the calf muscles to the back of the heel bone (called the calcaneus).  If your ankle pain from running is felt on the back of your foot above the heel, it could mean your Achilles tendon is inflamed.
• Posterior tibial tendonitis – This tendon connects the posterior tibial muscle at the back of your shin to the inside of your foot.  When it gets irritated, you might feel swelling, warmth, or redness along the inside of your ankle that worsens after running.
• Peroneal tendonitis –  If you have pain in the outer region of the ankle with running, it could be caused by a swollen peroneal tendon, which connects your lower leg bone (the fibula) to that bony lump on the outside of your ankle (the lateral malleolus).

No matter which type of ankle tendinitis you’re struggling with, they all have similar causes: excessive use, ramping up your mileage too quickly, improper running form, bad footwear, low arches, flat feet, and tight calf muscles.  With ankle tendonitis, you’ll typically feel symptoms first thing in the morning or experience sharp pain while cooling down from a run.

4. Ankle Arthritis

While you might associate arthritis with older athletes, this chronic form of pain can affect runners at any age.  Three different types of foot arthritis can cause ankle pain with running: osteoarthritis, rheumatoid arthritis, and posttraumatic arthritis. In each scenario, the joint can have damage, leading to stiffness and a lack of mobility.

Arthritis isn’t exclusively reserved for hardcore runners, and it doesn’t turn a blind eye toward experienced athletes either.  If you notice symptoms, keep track of whether or not they get progressively worse so you can try to intervene before it’s too late.

5. Ankle Instability and Biomechanics

In some cases, your ankles might just be weak.  Ankle instability causes your body’s natural biomechanics to “give out” whenever weight is on it, causing chronic ankle pain with running.

Weak and wobbly ankles could be the result of overpronation. Overpronation weakens the supporting ligaments in your foot with excessive motion.  When you overpronate, the placement of each step is slightly off-balance.  This causes your foot to roll inward and the absorption of the shock of impact is painful.  Some degree of pronation is essential in running for shock absorption, but too much too quickly can cause ankle pain with running.

This type of injury can spread upward and outward through your feet and legs, causing chronic ankle pain with running that can be debilitating if left untreated.  Stability running shoes or motion control shoes might be something to consider to keep those wobbly ankles in check.  Have your shoes fitted by a professional to ensure you have the proper footwear for your foot type, injury, and chosen activity.  Ankle exercises can also help you work this often ignored, but crucial, part of your body. These exercises can help you improve your ankle mobility and strength.

Related Article: Foot Pain in Athletes, Ankle Sprain and Foot Orthotics.

Related Video: Basic Ankle Ankle Exercises Video 

Where do I go to Treat Ankle Pain?

The quick answer, JOI has a team of experts to treat ankle sprains.  Come see the injury experts!  Click HERE for JOI’s Foot and Ankle Doctors. From lower back muscle stretching, sciatic nerve stretching, and pain, to minor fractures and sprains… We are Where the Pros Go!!

JOI and JOI Rehab

JOI Physicians continue to offer online new patient appointments. This is another option to make it more convenient to make new patient appointments with less phone hold times. Follow the link below to select your JOI MD and schedule online.  JOI has the most experienced team of Foot and Ankle Physicians and Clinicians to help you.

You can still call 904-JOI-2000 to make new patient JOI Physician Appointments if that is your preference. A new option, you can now schedule and cancel follow-up appointments with your physician at the JOI Patient Portal. 

To make appointments with JOI Rehab, please call 904-858-7045.

By: Justin Carmel, PT