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What to Address to Rehab Your Ankle Pain from Running and Prevent It From Coming Back

In our blog, “Identifying Ankle Pain and Injuries You May Be Experiencing From Running”, we talk about common ankle pain and injuries associated with running. Now, let’s get into the ways to rehab your ankle pain and prevent it from coming back when your shoes hit the pavement. .

Ankle Mobility

  • Improve Dorsiflexion: Tight calves will place excess strain on the achilles. It can also make you twist and turn your foot when you walk or run, causing strain on the other muscles and ligaments.
  • Improve Pronation: We need to be able to flatten the foot when our foot lands. High arches are very susceptible to ankle sprains because they are always on the outside edge of the foot.
  • Improve Supination: If we can’t get out of a foot flat position, then this will put strain on the muscles and ligaments.

Ankle Strength and Stability

Having flexibility and mobility is important, but being able to control it is key. Strengthening the muscles is how we accomplish this. Focusing on strengthening each direction of ankle movement (dorsiflexion, plantarflexion, inversion, and eversion) and the individual muscles of the foot. Stability basically means balance, so exercises that challenge your balance reactions are also important.

Running Form

Running form is often overlooked in physical therapy clinics. If your PT does not assess your running form, then run! (Literally, as far away as you can). Many times an issue with running form can be the key to preventing re-injury. Here is a short list of the most common faults.

  • Overpronation: If we flatten the foot too much when the foot lands and absorbs force, this can put too much strain on muscles including the posterior tibialis.
  • Crossover Gait: This is when you swing your leg in front of you and it lands across your body. It can be subtle or exaggerated. Sometimes it looks like you are running on a tightrope. This can cause overpronation because the foot will need a longer time to flatten out. It can also lead to ankle sprains because you will land on the outside of your foot.
  • Overstriding: Taking too long of a stride will increase the time spent with your feet. This can lead to tendinopathies.


​Many people have heard of the term overuse. Overuse injuries are very common in running because it is a repetitive sport. Another term I like to use is misuse. This is when your mileage isn’t too high but you still develop an overuse injury because of the unnecessary stress being placed on a muscle. For example, if you are overpronating you are going to overuse the posterior tibialis muscle because it just has to work harder at a lower mileage.

Mileage: Doing too much, too quickly. Usually big spikes in mileage are an issue. Our bodies have an amazing ability to adapt, but they need time. A general recommendation is to not increase mileage by more than 10% a week.
Poor Recovery: Not taking rest days, not focusing on nutrition, and not getting enough sleep will decrease your ability to recover properly. Essentially it will lower your threshold for what your body can tolerate.


  • Poor ROM: If certain muscles are tight and don’t allow your leg or foot to get into the positions that it needs to, then certain muscles are going to have to compensate and get overworked.
  • Poor Form: A breakdown in form can cause certain muscles to work harder than they should be or they could even be substituting for a muscle that can’t do it’s job properly. For example, if you are overpronating you are going to overuse the posterior tibialis muscle because it just has to work harder at a lower mileage.
Be sure to check out our blog, “Exercises for Ankle Pain During Running”, as we dive more into the exercises you can do for your ankle pain as a runner. If you are struggling with a running related injury, it’s time to 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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