If you’re struggling with ankle pain from running, you’re not alone. In the USA, around 2 million acute ankle sprains occur in a year. Of those, there’s a high number of ankle injuries from running.
In this article, we cover the most common causes of ankle pain, why your ankles hurt after running plus what you can do to treat and prevent ankle pain.
Why does my ankle hurt when I run?
There are several reasons why your ankle might hurt when your run. It could be an ankle sprain or strain, tendinitis, stress fractures or even arthritis.
Ankle sprains are one of the most common injuries for athletes and non-athletes.
Up to 70% of people who suffer from an ankle injuries, will continue to have issues with their ankle which can even include chronic ankle instability. 
To prevent, ongoing issues, if the pain occurs every time you run, it’s best to seek medical advice and assistance.
Types of ankle pain from running
Here are the most common reasons why your ankles might hurt after running.
An ankle sprain occurs when the ligaments that connect bone to bone and provide stability to the joint are injured.
Sprains usually happen when the ankle is forced into an unnatural position, such as twisting, rolling, or turning the foot beyond its normal range of motion.
An ankle strain happens when the muscles or tendons around the ankle joint are injured. This can happen when a muscle is subjected to repetitive activities or excessive force which leads to micro-tears in the muscle fibers and tendons.
Tendonitis is the inflammation of a tendon. 
With ankle pain, tendonitis is most commonly in the Achilles tendon, which connects the calf muscles to the heel bone. Pain is usually in the back of the ankle above the heel.
Runners can develop Achilles tendonitis when they increase their training intensity too quickly or use improper running form.
They can also develop Peroneal Tendonitis (pain on the outside of the ankle) or Posterior Tibial Tendonitis (pain on the inside of the ankle or arch).
Due to repetitive impact of running or overuse, runners can develop small cracks in the ankle bones (tibia, fibula or talus) – also know as stress fractures. 
Runners with stress fractures may experience localized pain, swelling, and tenderness.
Ankle impingement syndromes
When soft tissues or bones are compressed during ankle movement, ankle impingement can occur. Runners commonly experience anterior impingement (front of the ankle) and posterior impingement (back of the ankle). 
The nerves around the ankle can sometimes become compressed. This can lead to pain and sometimes tingling or numbness.
Runners who have pre-existing joint conditions or injuries, or those who subject their ankles to prolonged stress may experience arthritis-related pain in the ankle joint.
What causes ankle pain from running?
Your ankles might hurt after running due to the following causes:
If you run frequently without resting adequately between runs, you can risk injury due to overuse. The excessive and repetitive stress on the ankle joint and surrounding structures and lead to injury and ankle pain after running.
Improper running form
Poor running technique, such as overstriding, landing too heavily, or having incorrect foot placement, can increase the risk of ankle injuries and pain
Instability or weak ankles
Weak ankle muscles or poor proprioception (awareness of the joint position) can cause ankle instability. This makes runners more susceptible to injuries and pain.
Unsuitable running shoes
Using shoes that don’t provide adequate cushioning and support can potentially cause ankle issues.
Make sure you have the correct running shoe for your gait to ensure that your feet and ankles are correctly positioned and supported.
Running on uneven terrain
Ankle sprains, strains and injuries can occur when running on uneven terrain due to the altered foot and ankle positions.
Previous ankle injuries
If you’ve had an old injury, you might experience ankle pain during or after running, especially if your ankle has been challenged. Arthritis from old injuries can also be a factor here.
Symptoms of ankle pain from running
The symptoms of ankle pain from running can vary. Specific symptoms may depend on the underlying cause of the pain, however, here are the most common ones.
- Persistent or intermittent pain in the ankle area
- Swelling around the ankle joint
- Bruising around the ankle area
- Limited range of motion
- Clicking or popping sensations during movement
- Numbness or tingling
- Pain is aggravated with activity
- Persistent pain even during rest
Any of the above symptoms can indicate ankle pain from running. If the problem persists, it’s best to get medical assistance.
Risk factors for ankle pain from running
Although ankle injuries during running are in the top 5% of common running injuries, there are certain factors that can put you more at risk of injury and experiencing ankle pain after running. 
As mentioned in the cause of ankle pain, factors such as wearing the wrong shoes, running on even terrain or the placement of your feet can put you at risk of developing an injury.
Here are a few more factors that can increase the risk of your ankles hurting from running.
With age comes natural wear and tear on joints such as the ankle which can lead to reduced flexibility and strength.
Age-related decline in joint function increases the risk of developing ankle pain when running.
If you are overweight, every step in running will place additional stress on your ankles. This can lead to overuse and strain on the ankle joint. Excess body weight increases the risk of pain in your ankles from running.
Individuals with high arches (supinators) or flat feet (pronators) may experience altered biomechanics while running. This can lead to improper weight distribution and instability in the ankles. This can contribute to the development of ankle pain during running.
Previous ankle injuries
If you’ve had previous ankle injuries, your ligaments and tendons might already be weakened. This can increase your risk of injuring your ankles again or developing chronic ankle instability and pain. 
Excessive running or abruptly increasing running mileage or average running speed without proper conditioning and training can overwhelm the ankle joint, causing overuse injuries. These errors in training can lead to inflammation, strains, and stress fractures in the ankle region.
How to fix ankle pain from running
The treatment of ankle pain from running is usually a combination of conservative measures aimed at relieving pain, promoting healing, and preventing further injury.
Here are a few key things to do to help heal your ankles.
Rest is vital to allow the injured ankle to heal. Avoid activities that exacerbate the pain and giving the ankle sufficient time to recover.
Runners may need to reduce or completely stop running and other high-impact activities until the pain subsides and the ankle regains its strength and stability.
Applying ice to the affected area can help reduce inflammation and ease pain. Ice constricts the blood vessels, reducing blood flow to the injured area, which can help reduce swelling and bruising.
Ice should be applied for about 15-20 minutes every 2-3 hours during the initial 48 hours after the injury or whenever there is acute pain or swelling.
Using a compression bandage or ankle brace can help control swelling and provide support. Compression garments apply gentle pressure to the injured area, which can prevent fluid buildup and reduce inflammation. However, it’s important not to wrap the ankle too tightly to avoid impairing blood circulation.
Elevating the injured ankle above the heart level can help to reduce swelling. Gravity will help to facilitate the drainage of excess fluids away from the affected area. This can help alleviate pain and promote faster healing. It’s important to elevate the ankle whenever possible, especially during rest periods.
Physical therapy plays a vital role rehabilitating an ankle injury. A physical therapist will provide a customised exercise program to help you work on ankle strength, flexibility and stability. Proper rehab can also help prevent future issues related to ankle pain from running.
Over the counter medication can help manage pain and reduce swelling especially when the ankle pain is acute and due to an injury. Always use medication as directed and consult a healthcare practitioner if the pain persists.
How to prevent ankle pain from running
Preventing ankle pain from running is important for running to become a sustainable and enjoyable activity. Here are some ways to prevent injury and ankle after running.
Warm up before running
Warming up helps increase blood flow to the muscles and prepares the ankles for the upcoming activity. Dynamic stretches and light exercises can improve ankle flexibility and reduce the risk of injuries.
Wear proper shoes
Invest in well-fitting, supportive running shoes because it’s crucial for ankle health. Shoes with appropriate support, cushioning and stability can provide proper support and reduce the impact on the ankles during each stride.
Stretch your ankles
Regularly stretch your ankle muscles and tendons to improve flexibility and range of motion. This reduces the risk of strains and sprains during running. Ankle stretches should be included in both warm-up and cool-down routines.
Gradually increase your mileage
Avoid sudden spikes in running distance or intensity. This can overload the ankles and lead to overuse injuries. Gradually increase your mileage or training intensity so that your ankles and the rest of your body can adapt to the demands of running.
Avoid uneven terrain
When possible, avoid running over uneven terrain as this increased the risk of the ankle twisting and spraining. Choose smooth and even running paths to reduce the change of tripping or rolling your ankle.
Strengthen your ankles
Include ankle-strengthening exercises into your training routine to improve stability and reduce the risk of injury.
Exercises like calf raises, ankle circles, and resistance band exercises can help strengthen the ankle muscles and tendons.
Maintain a healthy weight
Excess body weight puts additional stress on the ankles, and increases the likelihood of ankle pain and injuries. Maintain a healthy weight through a balanced diet and regular exercise.
Wear stability shoes
If you have a history of ankle injuries or instability, you might want to use stability shoes designed to provide additional support and control pronation. These shoes can help improve ankle alignment and reduce the risk of injury.
During long-distance running or intense training sessions, take breaks to rest and allow your ankles to recover. This can prevent overuse injuries and give the ankles time to recuperate.
Listen to your body
Pay attention to any signs of pain or discomfort in the ankles during running. If you feel pain or suspect an injury, stop running and rest. Ignoring pain and pushing through it can worsen the condition and lead to more serious conditions.
A mild ankle pain should go away within a few days if you rest it and bring the swelling down. More severe ankle pain will take longer to heal – up to 6 to 8 weeks – depending on the injury.
Prevent ankle pain from running by: warming up, wearing proper footwear, strengthening and stretching your ankles, gradually increasing your mileage, and avoiding running on uneven surfaces.
If you experience any of the following symptoms, consult a doctor right away: Severe pain, swelling that is not going down, bruising, inability to put weight on your ankle, and numbness or tingling in your foot.
The first thing to do is to stop running and rest your ankle. Apply ice to the area for 20 minutes at a time, several times a day. You can also wear an ankle brace or compression sleeve to help support your ankle. If the pain is severe or does not improve with rest, you should see a doctor.
Ankle injuries from running include: ankle sprains, strains, stress fractures, tendonitis, and arthritis.
- Ankle pain from running can be caused by several factors
- If your ankles hurt from running and the pain is persistent, seek medical assistance
- You can prevent ankle pain from running by warming up and cooling down, wearing proper running shoes, working on your form and stretching and strengthening your ankles
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