How to Prevent Ankle Pain After Running

Sport & Activity

Ankle pain is a common yet frustrating issue for runners that could be a sign of something more serious. Here's how to prevent it.

Last updated: May 20, 2022
5 min read
How to Prevent Ankle Pain After Running

Experiencing ankle pain after running can be frustrating, and while sometimes it may just be as simple as a minor tweak, other times it can be a warning sign of a more serious injury. Ankle pain is often accompanied by inflammation or swelling that interferes with your ability to run. It can also be a symptom of a strain, sprain or stress fracture.

The ankle joint is a hinged joint, capable of dorsiflexion (pointing toes upwards), plantarflexion (pointing toes downwards), inversion (rolling the arch of the foot inwards), eversion (turning the edge of the foot outwards) and medial and lateral rotation (turning the foot in towards the centre of the body and away from it, respectively).

Understanding the movement capabilities of the ankle joint can help you pinpoint a potential cause. If all movements feel fine, it may be a muscle, ligament or tendon issue. The major muscles of the ankle are:

Calf muscles run down the back of the lower leg and are connected to the Achilles tendon.

Peroneal muscles are located on the outside edge of the ankle and foot.

Posterior tibialis muscles run down the inside of the calves to support the arches.

Anterior tibialis muscles go down the front of the calves, allowing dorsiflexion.

These muscles and tendons control movement to keep the ankle stable. Ankle pain attributed to a muscle or tendon injury might feel tender, swollen or sore to stand on.

When a runner experiences sore ankles or ankle pain, it can prevent them from performing at their best. But beyond this, it can leave lasting pain and discomfort that interferes with their ability to complete daily tasks.

What Are the Causes of Ankle Pain After Running?

  1. 1.Overuse

    The most common cause of ankle pain is overuse, characterised by inflammation, swelling, redness, bruising, reduced mobility and feeling warm to the touch. When a runner doesn't take sufficient time to recover between workouts or increases their mileage too quickly, they can become susceptible to an overuse injury.

    Here are some useful guidelines to help prevent overuse ankle injuries:

    • Stick to the 10-Percent Rule: Increase your weekly mileage by no more than 10 percent. That means going from 20 miles a week to 22. While this may seem minimal, it gives your body the chance to adapt.

    • Take a Rest Day Between Each Session: Ankle pain is your body's way of telling you it needs rest. Taking a day between sessions isn't a blanket rule, but it's a good place to start. For shorter runs, your body can typically handle more frequent training, but for longer runs, you'll need more rest.

    • R.I.C.E: You may have heard of the R.I.C.E method for treating injuries. You can also do it after every long run, to facilitate recovery and prevent ankle pain.

      R.I.C.E stands for rest, ice, compression and elevation. Anti-inflammatories like ice or ibuprofen can reduce inflammation, which may be causing redness or warmth in the ankle.

      You can try wearing an ankle compression sleeve to promote blood flow to the area. And keeping the ankle elevated helps reduce pain and swelling by moving excess fluid out of your ankles and accompanying your body's natural healing process.
  2. 2.Flat-Footedness

    Having flat feet causes the arch of the foot to collapse and the ankle to roll inwards. This is known as overpronation. Flat-footedness can be genetic, leading to posterior tibial tendon dysfunction (PTTD), or it can be adult-acquired, caused by PTTD.

    Running with overpronated feet can cause ankle instability. Over time, if you don't address the overpronation, it can lead to chronic ankle instability, which increases your risk of ankle pain and injuries. Here are some options to fix overpronation:

    • Special Running Shoes: Running shoes designed for overpronation contain extra cushioning and arch support. This prevents your ankles from rolling inwards and becoming unstable. It also helps your feet better absorb and dissipate the impact of hitting the ground. (Hint: Stability shoes may be best for you!)

    • Ankle Orthotic: If severe, you may be advised to wear an orthotic, a device that supports the structure of the foot. An orthotic can help control ankle instability by keeping the joints in proper alignment. Wear it in your shoes for added support when walking or running.

    • Physiotherapy: PTTD is most commonly treated with physical therapy. A physiotherapist may ask you to perform resistance band exercises, including inversions, eversions or rotations of the ankle to strengthen the joint.
  3. 3.Poor Technique

    A final cause of ankle pain after running is poor technique. If your strides are too long, you can cause ankle pain due to repetitive over-flexing. Similarly, if the ankle muscles are weak or imbalanced, this can affect their functionality.

    To address this, incorporate cross-training like strength training or yoga to build ankle strength and mobility.

Unaddressed Ankle Pain After Running Can Lead to Injury

Addressing any ankle pain as soon as possible can prevent it from getting worse. If ankle pain goes unaddressed, it can lead to:

Plantar Fasciitis: pain in the tissue that runs along the bottom of your foot, connecting your heel to your toes

Tarsal Tunnel Syndrome: compression of the posterior tibial nerve (the same as carpal tunnel syndrome but located in the feet)

Achilles Tendinopathy: pain and stiffness in the Achilles tendon

Other Ankle Injuries: any injury affecting the tendon, muscle, ligament or bone in the ankle (e.g. ankle sprain or stress fracture)

If you're looking for expert-backed tips on how to do intense workouts without risking injury, consider downloading the Nike Training Club App.

How to Prevent Ankle Pain After Running

Nike Run Club

Listen to the Guided Runs in the Nike Run Club App and run with some of the best coaches and athletes, like Eliud Kipchoge, Shalane Flanagan, and Mo Farah. Our Guided Runs give you the guidance you need to listen to your body, adapt to your training plan, and become your own best coach.

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