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Identifying Ankle Pain and Injuries You May Be Experiencing From Running

There is nothing more frustrating to a runner than recurring injuries and nagging pain. Ankle pain can be one of those things. From ankle sprains to different tendonitis, ankle injuries can plague a runner and keep them on the couch.

We want to help you to run as pain free as possible. This blog will help you identify what injury you may be experiencing at the ankle and give some exercises to help.

Common Ankle Injuries

Ankle Sprain and Strains

Starting the list with one of the most common ankle injuries. A sprain is an injury to the ligaments (these connect bone to bone). A strain is used for an injury to a muscle. It is rare to sprain or strain any structures on the inside of the ankle because those ligaments are so strong. It’s more common to sprain the ligaments on the outside of the ankle or strain the fibularis muscles that run down the outside of the leg. With this you may have:

  • Pain and tenderness on the outside of the ankle
  • Swelling and, in some cases, bruising
  • A popping sensation or sound at the time of injury

Tibialis Anterior Tendonitis

The tibialis anterior muscle runs from the front outside edge of the shin and wraps around to the front inside edge of the foot. This muscle performs dorsiflexion – pulling the top of the foot toward the shin – and inversion of the foot – turning the foot inward. Tendinopathy is a common injury to this muscle and some signs and symptoms include:

  • Pain and tenderness in the front of the ankle or top of foot
  • Pain when pulling the foot up or when turning the foot in
  • Pain that worsens with increased activity, mostly with running or walking up hills
  • A cracking sound when the tendon is moved or touched

Posterior Tibial Tendonitis

The tibialis posterior muscle runs down the back portion of the leg with the calf, wraps around to the inside of the ankle behind the medial malleolus (the knobby thing on the inside of the ankle), and continues down under the arch of the foot. The action of this muscle is to plantarflex – point the foot – and invert the foot. More importantly, the function of this muscle is to support and control the arch of the foot (more on this later). Signs and symptoms include:

  • Pain and swelling along the ankle or inside of the foot
  • Pain when standing on toes
  • Ankle rolls inward excessively
  • Unusual or uneven wear on shoes

Achilles Tendonitis

The achilles tendon attaches the calf muscle to the back of the heel. This is one of the most common tendinopathies. Some signs and symptoms you may have are:

  • Pain and stiffness along the Achilles tendon in the morning
  • Pain along the tendon or back of the heel that worsens with activity
  • Severe pain the day after exercising
  • Thickening of the tendon
  • Bone spur formation
  • Pain on the back of the heel that rubs on shoes

Stress Fractures

A stress fracture is a small crack in a bone, or severe bruising within a bone. These can happen to the shin bone, the smaller bones in the midfoot, or the heel bone. We won’t focus too much on this, but wanted to mention it because we always want to rule it out. We can help with this, but in some cases needs to be referred to your primary care provider or an orthopedic doctor. Symptoms include:

  • Pain that goes away with rest
  • Pain with activity throughout the day
  • Swelling on the top of the foot or on the outside of the ankle
  • Tenderness to touch at the site of the fracture
  • Possible bruising


In our blog, “What to Address to Rehab Your Ankle Pain from Running and Prevent It From Coming Back“, we get into what things to address to rehab your injury and to prevent it from coming back again! If you are struggling with a running related injury, what are you waiting for? Send us a message at or fill out a form here to request a free discovery visit.


Dr. Brett Dick

PT, DPT, Owner of Limitless Performance Physical Therapy

We Help Active People ​Improve Pain And Performance ​In Their Favorite Sports And Activities.
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