Ankle pain after running is surprisingly common, even amongst experienced runners.
The usual story is that it started for no reason, gradually creeping in over a number of runs or after one extra long run.
Ankle pain after running usually starts as an ache after cooling down or soreness for the first few steps of a run.
On your next session, it becomes painful sooner or stays painful for longer.
It might even be painful for the first few hours in the morning.
After that, it escalates quickly, affecting your running gait and making each run miserable.
You might also notice other warning signs along with ankle pain after running – sore/black toenails, very sore hip muscles or blisters on your feet (click on the issue to read more about its causes and fixes).
We’ve developed a three step plan to figure out why you get ankle pain after running, how to treat it and what you can do to make sure it doesn’t come back!
Part 1: figuring out why you get ankle pain after running
There are three primary reasons why you get ankle pain after running:
- Not enough ankle range
- Poor footwear condition
- Poor ankle strength
You’ll often find more than one of these issues at a time.
The trick is to work on all of them simultaneously.
Stronger ankles won’t solve the problem if you’re still in dodgy shoes!
1. Not enough ankle range
Stiff ankles will cause ankle pain after running because the running action forces them to the end of their range, jamming the joint.
It’s more likely if you’ve had a previous major ankle injury that injured the cartilage.
The main indicators of stiff ankles are compression at the front of the joint with dorsiflexion (forward bend) and limited range (…obviously…)
Compression is often noted during a classic calf stretch.
As you move into the stretch position, you don’t feel a muscle stretch at the back of the calf, only a squashing at the front of the joint.
A lack of joint range is best detected with a knee-to-wall test.
In this test, position your foot facing the wall and your big toe around 10-12cm away from the wall (depending on your height: taller = 12cm).
Push your knee towards the wall, directly above your toes, while keeping your heel down.
Good range is indicated when your heel stays down with your knee directly over toes and touching the wall.
Poor range is indicated with heel lifting, knee moving inwards of toes or not making it to the wall.
2. Poor footwear condition
We’re not talking about the brand, support level, heel-to-toe drop/offset or anything else.
Most of that stuff is personal preference.
This is about checking whether your shoes are still doing the job that you paid them for!
The simplest test by far is the desktop inspection.
Make sure your shoe outsole (the grip) is clean and place them on a bench or table.
Ensure the laces haven’t got stuck underneath the shoe.
Then step back and take a look at your shoes from the back.
Are they still symmetrical and upright?
Have they begun to tilt inwards, like an old slipper?
Is one more deformed than the other?
In the picture above, you’ll see what we’d consider a pass on the alignment test.
Although the cushioning at the base looks misaligned (that’s actually the design of the shoe), the heel cup is still upright and symmetrical.
If you have trouble picturing what it should look like, just look at the position of the centre of the heel cup (seen with an Asics logo here) relative to the centre of the heel cushioning.
If you need a new pair of shoes to avoid ankle pain after running, check out our series of the Best Running Shoes for a range of different conditions, from sore knees to wide feet and bunions.
3. Poor ankle strength
Weak ankle muscles are more common than you realise and probably the biggest cause of ankle pain after running.
If they’re not up to task, they can’t brace the joints during running and the joints will get compressed (much like in point #1).
How you test this depends on where you’re up to in your running training.
But the best method involves two tests, to cover strength and fatigue.
The 1st test involves doing heel raises to fatigue.
Standing on one leg and with your hands braced on a flat wall (not a bench or railing), perform as many heel raises as you can.
Between reps, just touch your heel to the ground – don’t rest completely.
And be honest with yourself about half reps – if you barely left the ground, don’t count it.
You should be able to perform at least 20 repetitions on each side, although 30+ would be more protective for runners.
Also compare sides and look for a difference of 20% or more (eg. Right leg can do 20 reps, Left leg can do 16 reps or less)
This test is great at spotting gross strength deficits and asymmetries.
The 2nd test is heel raises after a run.
It’s the same test as above, just perform it after a medium intensity/distance session.
This is better at detecting muscle fatigue due to asymmetries in your running technique.
Essentially it checks how much calf strength you’ve got in the bank at the end of a run.
If you can’t perform 10 repetitions per leg (15+ would be better), your calf fatigue is leaving your ankle joints vulnerable to overload.
And asymmetries of 20% or more are also a concern and increase your injury risk of ankle pain after running.