Ankle Pain Running - Causes, Treatment & Prevention | Pain Care

Ankle Pain Running – Causes, Treatment & Prevention

A lot of runners often complain of ankle pain after running some distance. Most runners run approximately 160 to 180 steps in a minute, enough to stress the ankle and foot, therefore causing ankle pain.

Ankle pain while running is a very common and uncomfortable problem, especially when one is training for an important race. This article discusses the causes, associated symptoms, methods of treatment, and ways of preventing ankle pain while running.

Causes of Ankle Pain Running

There are certain factors that place a runner at risk of ankle pain while running. There are also certain musculoskeletal diseases which can cause ankle pain on running.

Generally, the risk factors for ankle pain while running include the following and these may occur singly or in combination with each other:

Bad Running Shoes – Our running shoes affect the alignment of the bones of the foot and ankle, as well as absorb shock and stress from the ground as we run. If shoes are not changed after they wear out, the bones of the foot are placed in more stress, making them vulnerable to damage.

Muscle Imbalance – Tightness or shortening of the muscles of the ankle, calf, ankle, foot, or thigh is a very common cause of ankle pain while running. If some muscle groups are tight or not well stretched, they may affect other muscle groups and joints leading them to overcompensate for the weak muscles.

Overuse – This is a very common cause of ankle pain when one is running. It occurs when the feet and ankle are overstressed.

Bony Problems – Preexisting bony problems such as bunions in the foot, metatarsal fractures, bone spurs, and abnormal growths would affect the movement of the foot, causing pain while running or walking.

Previous Injuries – Often times, injuries to the foot and ankle are not allowed to fully heal before athletes return to play. When this happens, the resolving inflammation is re-initiated and further damage occurs resulting in pain as one runs or even walks.

In addition, placing too much pressure on previously injured areas of the foot and ankle may cause damage to the area leading to ankle pain while running.

Musculoskeletal Diseases that Cause Ankle Pain while Running

The following musculoskeletal diseases cause ankle pain while running;

Ankle Sprain

Ankle sprain occurs when the ankle ligaments are overstretched resulting in ankle pain while running. Ligaments are strong tissues which connect bone to bone, and sprains occur if they are stretched suddenly or beyond what they can handle. The lateral ligament of the ankle is most commonly sprained.

Ankle sprains result in pain of sudden onset, the severity of which depends on the intensity of the injury.

Ankle sprains can be treated conservatively with rest, application of ice packs, compression, elevation of the foot, and stretch exercises. A brace or support may also be necessary.

Peroneal Tendonitis

The peroneal tendons are strong tissues on the outer surface of the ankle attaching muscles of the leg to the ankle. They play a major role in plantar flexion of the foot. Peroneal tendonitis is inflammation of the tendon, often resulting from overuse and acute injuries.

Peroneal tendonitis causes side ankle running pain of gradual onset and worse with activity and resolved with rest. It can be treated conservatively with rest, ice therapy, compression, physical therapy & using the specially designed peroneal tendonitis braces.

Tarsal Tunnel Syndrome

Tarsal tunnel syndrome can be described as the lower limb equivalent of carpal tunnel syndrome. It is caused by compression of the posterior tibial nerve as it courses within the tarsal tunnel in the inner aspect of the ankle. It is often caused by abnormal foot positioning and acute injury.

Tarsal tunnel syndrome presents with burning side ankle pain, as well as tingling sensation and numbness in the sole of the foot. It also causes pain on the inner side of the ankle while running.

Tarsal tunnel syndrome can be treated effectively with rest of the ankle, stretch exercises, ice therapy, and use of analgesics.

Achilles Tendonitis

The Achilles tendon is a tough fibrous tissue at the back of the leg attaching the calf muscles to the heel bone. Achilles tendonitis is wear and tear of this tendon caused by overuse.

Achilles tendonitis causes pain at the back of the ankle before, during, and after running.  The pain of Achilles tendonitis is usually worse after long periods of rest such as after a night’s sleep and resolves with activity.

Achilles tendonitis can be effectively treated with rest, cold therapy, exercises, and intake of mild analgesics.

Retrocalcaneal Bursitis

The retrocalcaneal bursa is a small fluid-filled sac located between the heel bone and the Achilles tendon where it serves to absorb shock and prevent friction.

Acute injury, overuse, or heavy pressure on the heel often irritate and inflame the bursa causing retrocalcaneal bursitis.

Retrocalcaneal bursitis presents with pain at the back of the ankle when running or walking. It may be treated with rest, cold therapy, compression, elevation of the ankle, and exercises. The pain often resolves within weeks.

Plantar Fasciitis

Plantar Fasciitis

Plantar fasciitis is an inflammation of the plantar fascia, a thick fibrous band extending from the heel to the toes beneath the sole of the feet. It results from overuse and bad footwear

Plantar fasciitis usually causes pain on the sole of the feet. The pain of plantar fasciitis is worse with rest and resolves with activity. It resolves with rest, cold therapy, analgesics, and physical therapy.

Shin Splints

Shin splints are tears and inflammatory changes occurring in the muscles and bones of the leg. It is often a result of excess training, poor warm-ups before training, muscle tightness, and running on unleveled surfaces.

Shin splints cause dull shin and ankle pain which becomes sharp as one continues. The pain is worse with activity and relieved by rest. Shin splints may be treated conservatively with rest, cold therapy, wearing proper footwear, and exercises.

How to Prevent Ankle Pain Running

 The following tips would help a runner prevent this discomforting symptom

  • Ensure proper warm-ups before commencing routine training exercises
  • Engage in calf and thigh stretch exercises to make the hip, knee, ankles, and associated muscles strong enough to bear weight and move more efficiently
  • Avoid wearing uncomfortable or tight-fitting sports shoes
  • Ensure to exercise on leveled surfaces
  • Avoid running if you suffer from ankle or foot injuries until your doctor recommends so.
Bottom Line: Ankle pain while running is an all too common symptom that most runners have experienced.

Most times, this symptom results from faulty biomechanics, bad fitting shoes, tightness of calf muscles, and previous foot injuries.

While most of the musculoskeletal diseases such as plantar fasciitis and Achilles tendonitis causing ankle pain running can be treated conservatively is essential that one ensures proper warm-ups before training, wear proper-fitting footwear, and avoid excessive exercises to avoid ankle pain running.

Dr. Sachin

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