Ankle pain experienced during running, but not while walking, is a common concern for many individuals. While walking places relatively low stress on the ankle, the dynamic and high-impact nature of running can amplify existing vulnerabilities or introduce new stresses. Understanding the specific factors that differentiate the demands of running from walking is an important step in addressing and preventing this type of pain.
Why Running Triggers Ankle Pain
Running involves a distinct set of biomechanical forces that are significantly greater than those encountered during walking. When a runner’s foot strikes the ground, the impact forces can be several times their body weight, compared to 1 to 1.5 times during walking. This increased load places considerable stress on the ankle joint, its supporting ligaments, and surrounding tendons.
Running also requires a greater range of motion at the ankle, particularly for dorsiflexion (toes moving upward) and plantarflexion (toes pointing downward), especially during the push-off phase. The repetitive nature of these movements can lead to cumulative strain. Running engages ankle-stabilizing muscles and calf muscles more intensely than walking, making these structures prone to fatigue and overuse.
Common Causes of Ankle Pain When Running
Several specific conditions frequently cause ankle pain during running, often resulting from the unique stresses running places on the lower limbs. Tendinitis, an inflammation of a tendon, is a common culprit. Achilles tendinitis, affecting the large tendon connecting the calf muscles to the heel bone, often presents as pain and stiffness at the back of the ankle, particularly after or during running, or in the morning. Peroneal tendinitis causes pain on the outside of the foot or ankle, often worsening with activity, and involves tendons that stabilize the ankle and foot. Posterior tibial tendinitis affects the tendon supporting the arch, leading to pain on the inside of the ankle.
Stress fractures are tiny cracks in bones caused by repetitive impact and overuse. The weight-bearing bones of the foot and lower leg, such as the tibia, fibula, talus, and navicular, are particularly vulnerable to these micro-injuries in runners. Pain from stress fractures typically develops gradually and intensifies with weight-bearing activities like running, often subsiding with rest.
Chronic ankle instability can lead to pain during running. This condition often develops after previous ankle sprains, where ligaments may have healed improperly, leading to weakened support. An unstable ankle is more susceptible to recurrent pain and re-injury during the dynamic and often uneven movements involved in running.
Improper footwear or underlying biomechanical issues can contribute to ankle pain. Shoes that do not fit correctly, lack adequate support, or are worn out can alter foot mechanics and lead to unbalanced forces on the ankle. Abnormal foot mechanics, such as excessive pronation (foot rolling inward) or supination (foot rolling outward), can also place undue stress on ankle structures during the repetitive impact of running.
Immediate Care and Self-Management
When ankle pain arises during running, immediate self-care measures can help manage discomfort and prevent further irritation. The RICE method, which stands for Rest, Ice, Compression, and Elevation, is a first aid protocol for acute injuries.
Rest involves avoiding activities that worsen the pain, including running, to allow the injured tissues to begin healing. Applying ice to the affected area for 15-20 minutes every 2-3 hours can help reduce swelling and alleviate pain. Compression with an elastic bandage can also help minimize swelling and provide support, while elevation of the ankle above heart level aids in reducing fluid accumulation.
Activity modification is important, meaning a temporary shift to low-impact exercises like swimming or cycling can maintain fitness without stressing the ankle. Gentle, pain-free stretching, such as calf stretches, and light strengthening exercises like ankle circles, may be introduced if pain allows. Assessing running shoes for wear and tear is also a practical step, as inadequate cushioning or support from worn-out shoes can contribute to pain.
When to Consult a Professional
While many instances of ankle pain can be managed with self-care, certain signs indicate the need for professional medical evaluation. Ignoring these signals can lead to prolonged recovery or more serious complications.
Seek medical attention if the pain is severe, especially if it occurred suddenly or prevents you from bearing weight on the ankle. Significant swelling, bruising, or any visible deformity around the ankle are also red flags that require prompt assessment.
Persistent pain that does not improve after a few days of rest and self-care suggests a deeper issue. Numbness or tingling in the foot, or pain that progressively worsens over time despite activity modification, also warrant a professional consultation. These symptoms could indicate more serious injuries, such as a severe sprain, a stress fracture, or other conditions requiring specific medical intervention.
Strategies for Prevention
Proactive measures are important for runners aiming to minimize the risk of ankle pain and injury. Gradual training progression allows the body, including the ankles, to adapt over time; a general guideline suggests increasing weekly mileage by no more than 10 percent.
Regular strength and conditioning exercises are important for building resilient ankles. This includes targeted exercises for ankle stability, such as single-leg balance drills, and strengthening the surrounding muscles with calf raises, resistance band exercises for eversion and inversion, and single-leg hops. Improving flexibility and mobility through regular stretching, particularly for the calves and Achilles tendon, contributes to better ankle range of motion.
Selecting proper footwear that provides adequate support for your foot type and replacing worn-out running shoes regularly is also important. Cross-training with low-impact activities like swimming or cycling can reduce repetitive stress on the ankles while maintaining cardiovascular fitness. Consistently listening to your body and addressing minor discomforts promptly can prevent them from escalating into more significant injuries.