Do you suffer from ankle pain after running but can’t figure out what could be causing this?
There can be a number of causes — and each cause has a unique solution.
Ligament Strain or Sprain
Ankle ligaments. Laboratoires Servier, CC BY-SA 3.0 creativecommons.org
Most runners have “rolled” an ankle at some point, and this can result in the overstretching or the micro-tearing of a ligament.
“The most common cause of ankle pain after running is an ankle sprain,” says Dr. Dave Candy, a board certified specialist in orthopedic physical therapy.
“This would happen after ‘twisting’ your ankle from stepping off a curb wrong or stepping on some other uneven terrain.
“This stretches or tears ligaments, usually on the outside of the ankle.”
Tarsal Tunnel Syndrome
Tarsal tunnel. Nicole Williams, Jake Willet, Damian Clark, David Ketteridge/creativecommons.org
Another cause of ankle discomfort following a running session would be tarsal tunnel syndrome.
“Tarsal tunnel syndrome is an irritation or compression of the tibial nerve at the ‘tarsal tunnel’ — which is behind the bump on the inside of the ankle (medial malleolus),” says Dr. Candy.
“Most commonly, symptoms of tarsal tunnel syndrome are pain, numbness or tingling in the feet.
“This can sometimes be mistaken as plantar fasciitis. However, it is possible to have pain locally on the inside of the ankle as well.”
Osteochondral Defect or Arthritis
“Occasionally, if you run a lot of excessive mileage over a long period of time, you can develop an injury to the cartilage in the ankle joint,” says Dr. Candy.
“An osteochondral defect is an acute injury to the cartilage in the ankle joint, whereas arthritis is a gradual wearing down of the cartilage over time.”
Lack of Structured Motion
Another cause of ankle pain after some running may be simply due to lack of structured motion in the foot.
You may think you’re getting plenty of this when jogging all over the place, but jogging or running takes place in a linear path.
Unresolved Past Injury
When running causes ankle pain, this may also signal a past, unresolved injury to the foot, such as an ankle sprain that you only thought had resolved.
Sure, everything feels fine when you’re on the job, for instance, but once the feet get pounding on the pavement or treadmill, pain sets in from a not fully healed sprained ankle or strained tendon from the past.
Solutions to Ankle Pain After Your Run
Dr. Candy explains, “Adjusting mileage and frequency of running are always the first-line treatments for any of these problems. You should not run through pain.
“Ankle braces can help in the short-term for ankle sprains.
“Orthotics and/or shoes with good arch support can be helpful for tarsal tunnel syndrome and/or arthritis.”
You’ll want to try Birkenstock arch supports — these are durable, very long-lasting, comfortable and effective.
Birkenstock arch supports
“Additionally, stretching your calves and improving ankle stability through doing heel raises and balance exercises can be helpful for any of the above ankle problems.
“Outside of that, consider seeing a physical therapist to get recommendations that are more specific to your particular problem so that you can get back to running pain-free as quickly as possible.”
A great ankle ligament strengthening exercise is to walk backwards on the balls of your feet: with feet facing foward, facing outward and then facing inward.
Don’t delay if the discomfort in your ankle doesn’t seem to be diminishing once you’ve begun taking corrective measures such as new footwear, arch supports, jogging on softer terrain, stretching, cross-training, etc.
Dr. Dave Candy, PT, DPT, is a specialist in orthopedic physical therapy and owner of 
