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What causes ankle pain when running?

Running can be a great form of exercise but many people experience challenges with running. One of the more common questions with runners is what causes ankle pain when running? The simple answer is that there is no one cause but ankle pain could be due to footwear, sprains or strains, overuse, and other factors. To get an idea of why you might be having ankle pain though when you run, these are a few common causes.

Ankle Sprains or Strains

This is probably the most common reason why ankles hurt when you run. A strain is a condition where a muscle or a tendon is overstretched or may even be torn. A sprain is damage to the ligament. While may of the other causes of ankle pain can be traced back to simply overuse, sprains and strains are most commonly caused by a single traumatic event.

That doesn’t mean you always know what made the injury though. When you’re running, you could have a misstep or land incorrectly. Even a slight movement from your normal landing position can cause your ankle to roll. You may feel some discomfort but not recognize that you caused damage. Even if you get back on your feet and keep on going, the tiny tears in the muscles and ligaments in your ankle can add up over time. This may be the cause when you start to notice that pain is getting worse over time. The best solution is to take care of the problem early though as it can get worse over time.

Strains and sprains are the most common reason why ankles hurt when running but they’re also the easiest problems to treat. As with most of the other causes on this list, it’s easier to treat when you recognize and address the problem. If you take note of your body and take care of it at the first sign of pain, then you’ll be back on your feet in no time.

Ankle Stress Fracture

Stress fractures are a type of fracture that occur when your muscles can’t absorb the shock that you experience with a repetitive impact. Instead of absorbing the shock, you’ll have small cracks that form in the bones which will eventually lead to larger cracks. Not great, right? You can have a stress fracture in almost any part of your body but your feet are one of the more common areas.

Shin splints are the simplest form of a stress fracture. This refers to an irritation of the outside of the bone. When you have shin splints, then you just have the first symptom of a bone stress injury. If not treated, a stress fracture can derail your running rout9ine and even put you in a cast for a few weeks. If you notice that you start having sharp pains in your ankles, then you may have a stress fracture. Bruising and tenderness to the ankle area may also be a sign. Make sure that you see a doctor promptly and get x-rays as this is the best way to diagnose a stress fracture. In the meantime though, stop running! A running injury can take a few weeks to heal so the earlier that you take care of the problem, the earlier that you’ll be back on your feet again.

Instability and Biomechanics

This is an area that may be more difficult to treat since many people simply have weak ankles. Ankle instability means that your body’s biomechanics that allow you to walk upright give out when you place weight on your feet. If you have chronic pain and frequent injuries when running, then it’s possible that this is your problem.

Ankles which are weak and wobbly may be caused by overpronation. Overpronation will weaken the ligaments which support your foot and keep everything in place. When you overpronate while running or walking, the placement of your steps is going to be slightly off-balance. This will cause your foot to roll inward slightly when landing on the feet and the shock of impact won’t be spread out evenly. Some pronation is needed naturally in order for the foot to absorb shock. However, too much quickly can lead to problems.

Overpronation can lead to additional problems outside of the ankle area. It may spread upward and then impact the feet and legs. Many people who struggle with this will have chronic pain that doesn’t seem to go away, even when they’re not running. One simple solution is to use good running or motion control shoes to keep your feet balanced. A professional can assess your walking and running gait and then ensure that you have the proper footwear for your type of foot, injury, and activity level. Ankle exercises may also be recommended to help you work on this part of your running stance.


If you’re a younger person, you might think that arthritis couldn’t possibly apply to you! However, arthritis isn’t just for the elderly. Unfortunately, it can affect even younger people. To get an idea of which type you might have though, there are three types of foot arthritis that may lead to ankle pain when you run. Osteoarthritis, rheumatoid, and post-traumatic arthritis are all fairly common. Regardless of the cause though, they all lead to the same problem- a damaging or weakness of the joint which then leads to stiffness and limits your mobility over time.

Arthritis can happen to you if you run on a frequent or even not very frequent basis. It also can occur with experienced athletes so it may be possible to have arthritis over time. Depending on your symptoms and reactions, there can be a number of treatment options. The best way to keep your feet in good shape though is to keep track of any symptoms and notice if they get progressively worse. Since arthritis can lead to long-term damage that’s difficult to reverse, it’s best to see a doctor sooner rather than later. By being proactive, you’ll be able to intervene before it gets to be too late.

Ankle Tendonitis

This condition refers to inflammation of the tendon. It may cause it to tear, fray, or swell. This is a fairly common cause of ankle pain but there are a few different types of tendonitis that may lead to pain when running:

1. Tibialis anterior tendonitis

The tendon which runs down the front of the shin bone and inserts itself at the front of the ankle is an important one that plays a crucial role when running. Take note of where you feel ankle pain when you run. This is probably due to a more forceful flexion of your foot when you run. This may also lead to shin splints down the road so take note if you start to have pain in this specific area.

2. Achilles tendonitis

The achilles tendon is the one that connects the calf muscle to the back of the heel bone. If you start to feel pain in the back of the foot above the heel, this may mean that your achilles tendon is inflamed. Many people also start to feel more aching in the calf region so take note of pain in this area.

3. Posterior tibial tendonitis

This is a tendon which connects the tibial muscle to the inside of the foot. Since it wraps around your foot, you may start to experience pain along the inside of the ankle. Look for symptoms such as swelling, warmth, or redness. It may hurt when you’re running but also may start to worsen when you stop running so pay attention to both activity and after physical activity.

4. Peroneal tendonitis

If your outer ankle starts to hurt when you run, then it may be caused by swelling in the peroneal tendon. This connects the lower leg bone to the bony lump on the outside of your ankle.

Regardless of which type of tendonitis that you have, they have the same thing in common. They’re all caused by excessive use and typically occur when you increase your running regimen too quickly. People may also have tendonitis when they have bad running form, low arches or flat feet, and bad footwear. With tendonitis in the ankle, you can expect to feel symptoms early in the morning or pain after you’re coming down from a run. It may not occur when you’re running through so pay attention to how you feel around your run as well.

Dealing with Ankle Pain

We know that ankle pain is rough. Now that you know some of the common causes, it’s best to identify the pain, treat it, and then work on preventing it in the future. For most people who run on a frequent basis, they’re going to have one of these problems. However, with proper care and determination, you can get through it and head back on the path. As always, if you have pain when running, it’s best to stop and seek advice from a medical professional as it could lead to damage by continuing to run.

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