Ankle Pain After Running: Causes, Prevention, and Exercises

Maybe you’re a long-time, committed runner who’s recently ramped up their training routine. Or perhaps you’re a newbie who decided to add a twice weekly short run to your exercise mix. Lately, however, along with that endorphin rush, you’ve been feeling ankle pain after running. In fact, some days it’s all you can do to hobble up the stairs after your workout so that you can shower and get ready for work. Sound familiar?

Ankle pain after running is common. Nearly 40 percent of runners report that they’ve experienced foot and ankle issues at some point in time, including ankle pain. “Running is a very high-impact activity, in which each leg has to support your full body weight as you stride,” says Vanessa Matos, PT, DPT, a physical therapist at Hinge Health. “That means a lot of force is going through your leg down into your foot and ankle, which can make you more vulnerable to aches and pains, as well as stiffness and limited range of motion if you’re not properly prepared.”

But ankle pain doesn’t have to derail your running goals. There are numerous health benefits to running, including reduced risk of heart disease, high blood pressure, type 2 diabetes, stroke, and osteoporosis, as well helping to build muscle strength, enhance mobility, and increase resilience to pain, stresses Dr. Matos. It also boosts your mood and helps to relieve stress and anxiety.

If you experience ankle pain after running, we have good news: There are several ways you can manage ankle pain and prevent it from cropping up in future workouts. Your leg muscles and ankle joints are designed to withstand the stress and strain necessary to run and there’s a lot you can do to support your body during exercise. 

Read on to learn more about what might be causing your ankle pain after running and get tips and exercises from our Hinge Health physical therapists to reduce your ankle pain and get you back to doing what you love.

Causes of Ankle Pain After Running

There are many reasons why you may experience ankle pain after running. Below, are a few main culprits:

• Ankle Tendinitis (Tendonitis). The muscles or tendons around your ankle joint can become irritated or inflamed if you push them a bit beyond what your body is ready for. This is especially likely if you’re new to running, or you’ve ramped up your speed or distance quickly, says Dr. Matos. One common cause of ankle pain after running is Achilles tendinitis, which is inflammation of the tendon that connects your heel bone to your calf muscle. This can lead to more strain on your ankle.

• Running surfaces. If you run on an uneven surface, force isn’t absorbed equally by your feet, ankles, and legs. This can cause excess strain, which may contribute to outer ankle pain after running. Uneven roads, gravel tracks, rocky terrain, or even muddy grass can make running more difficult, notes Dr. Matos.

• Weak ankle, foot, or leg muscles. Inner ankle pain after running may simply be due to weak ankle muscles that cause your ankle to turn out of its natural alignment, says Dr. Matos. Weak leg or foot muscles can lead to ankle pain, too. “The muscles that run along the outer side of your lower leg stabilize your ankle during movement, so weakness in that area can lead to overpronation, or less ankle stability,” she says.

• Footwear. Your foot is connected to your ankle. So if you aren’t wearing running shoes that support your foot where you need it, your ankle may have to pick up the slack. “Your foot muscles help with shock absorption, so if your shoes don't offer enough support, they may increase stress on the ankle,” says Dr. Matos. 

• Running form. There’s no one right way to run, but you may need to adjust your form if you're having issues. If you overstride, for instance, this can place a lot of stress on your ankle when your foot lands, explains Dr. Matos. The same is true if you land on your heel, rather than towards the front of your foot.

Treatment for Ankle Pain After Running

If you have ankle pain after running, don’t assume you need to stop. In fact, the best way to treat ankle pain after running is to continue doing activities that use your ankle. “This way, you’re improving the mobility and strength of the ankle joint,” explains Dr. Matos. “You’ll also help keep your ankle joint healthy, since movement encourages blood flow to the area.”

Here’s what to do when your ankle hurts after running:

• Adjust your activities. If your ankle hurts after you run, cut back slightly or adjust your terrain, recommends Dr. Matos. If you run five days a week, for example, swap out two workouts with activities that put less stress on your ankle, like biking or swimming. If pain is from running on an uneven surface, like grass or woodland trails, switch temporarily to a more stable surface, like a track or treadmill. As your ankle strength improves, you’ll be able to increase your activity and intensity and vary your terrain again.

• Exercise therapy. You’ll want to do exercises (like the ones below) that help to increase your ankle’s range of motion and flexibility, and strengthen your foot and ankle muscles, advises Dr. Matos. Physical therapy is another option. A physical therapist (PT) can work with you to develop an individualized exercise program. They can also do things like analyze your gait to figure out if you can tweak your running style to put less stress on your ankle. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

• Use ice or heat. Using heat, like a warm towel or hot water bottle, periodically throughout the day can relax tight ankle muscles and tendons. Some people find that ice — or even a combination of ice and heat — helps, too. Do whatever works best for you.

• Try a foam roller. Dr. Matos recommends a foam roller or tennis ball to rub back and forth on the arch of your foot and around your ankles for two to three minutes at a time. “Foam rolling releases muscle tension and increases blood flow to the area, which, in turn, can help with ankle muscle soreness,” she explains. Make sure that you do it at a tolerable intensity: “If you roll too hard, your muscles will tense up, and you won’t get the full benefit,” she explains.

• Switch up your footwear. The right shoe for you depends on your foot type, says Dr. Matos. But in general, she advises against a shoe with a lot of cushioning. “Many people with ankle pain after running do better with a less cushioned shoe that’s very firm,” she says. If pain persists, you may want to try shoe inserts, or orthotics. They help to minimize pressure on your ankle. A 2023 study in the journal World Journal of Orthopedics found that orthotics helped to improve comfort and speed among runners, while also reducing ankle pain and injuries.

You don’t have to give up running if you experience ankle pain after your cardio session. Instead, focus on strengthening and stretching all the muscles that support your ankle. The above exercises are recommended by Hinge Health physical therapists to improve lower leg, ankle, and foot strength and flexibility to help relieve and prevent ankle pain after running.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

How to Prevent Ankle Pain After Running

The best way to avoid ankle pain after running is to keep your ankles strong. Try to do the exercises above several times each week. “You also want to focus on your entire leg, including your quads, calves, and hips,” says Dr. Matos. “These will help to improve your overall strength, as well as your balance.” Other ways to prevent ankle pain include:

• Stretch before running. You want to increase blood flow to your ankle muscles to warm them up before your workout. “Stretching helps your muscles become more flexible, so they’re better able to support you during high-intensity exercise,” says Dr. Matos. You can do any of the ankle exercises above or simply walk briskly, or start at a slow jog and work up to a faster speed.

• Watch your terrain. If you are new to running, or are ramping up your training, avoid rocky or uneven terrain, says Dr. Matos. Start with a flat, less hilly route, and build up to hills or uneven terrain as your body gets used to your new workout and your ankles get stronger.

• Replace old footwear. The American Academy of Podiatric Sports Medicine recommends that you replace your sneakers after 300 to 500 miles of running.

• Eat a healthy diet. When you run a lot, you put stress on your body that can cause inflammation, especially around your ankle and foot joints, says Dr. Matos. “People who don’t fuel adequately often notice a number of nagging aches and pains, including ankle discomfort,” she notes. Eat a small amount of protein at each snack and meal, like eggs, low fat cheese, yogurt, or lean meat, to help muscles, tendons, and ligaments repair themselves. Vitamin C also helps to repair tendons and ligaments: citrus fruits, or strawberries, kiwi, baked potatoes, broccoli, and bell peppers are good options. 

• Listen to your body. “If your ankle hurts after you’ve done five miles of intense interval training, it’s your body’s way of telling you that’s enough,” says Dr. Matos. Cross train for the next couple days or let yourself take a day off to rest.

PT Tip: Follow an Online Program

Online running programs can be helpful if you’re looking to safely and gradually increase your mileage and intensity, so you don’t get injured. They can make training more fun too, says Dr. Matos. Or, if you prefer to run in a group, joining a running club can also help you build structure and support around your running goals so you can safely get better without risking injury.

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Arnold, M. J., & Moody, A. L. (2018). Common Running Injuries: Evaluation and Management. American Family Physician, 97(8), 510–516. https://pubmed.ncbi.nlm.nih.gov/29671490/ 

2. Adal, S. A., Mackey, M., Pourkazemi, F., & Hiller, C. E. (2020). The relationship between pain and associated characteristics of chronic ankle instability: A retrospective study. Journal of Sport and Health Science, 9(1), 96–101. doi:10.1016/j.jshs.2019.07.009

3. Jastifer, J. R. (2022). Contemporary Review: The Foot and Ankle in Long-Distance Running. Foot & Ankle Orthopaedics, 7(3), 247301142211254. doi:10.1177/24730114221125455

4. Suda, E. Y., Watari, R., Matias, A. B., & Sacco, I. C. N. (2020). Recognition of Foot-Ankle Movement Patterns in Long-Distance Runners With Different Experience Levels Using Support Vector Machines. Frontiers in Bioengineering and Biotechnology, 8:576. doi:10.3389/fbioe.2020.00576

5. Fortune, A. E., Sims, J. M. G., & Ampat, G. (2023). Does orthotics use improve comfort, speed, and injury rate during running? A randomised control trial. World Journal of Orthopedics, 14(5), 348–361. doi:10.5312/wjo.v14.i5.348

6. Furman, A. (n.d.). How Do I Know When It Is Time To Replace My Athletic Shoes? American Academy of Podiatric Sports Medicine. https://www.aapsm.org/replace_shoes.html