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Ankle Pain While Running: Causes, Assessment, and Recovery

Ankle pain during or after running has several distinct causes — and the approach differs significantly between them. Here's how to identify yours.

5 February 2025

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Ankle pain during running is not a single diagnosis. The location, character, and behaviour of the pain tells you a great deal about the structure involved — and the approach to fixing it differs significantly.

The main causes by location

  • Back of heel (Achilles): Tendinopathy — responds to progressive loading, not rest
  • Outer ankle: Lateral ligament complex — often residual instability from an under-rehabbed sprain
  • Inner ankle: Posterior tibial tendinopathy — associated with flat foot mechanics
  • Front of ankle: Anterior impingement — often from a forefoot strike pattern or previous injury

When gait analysis is essential

Many ankle issues during running are driven by what's happening higher up the chain — hip drop, overstriding, or asymmetric loading. RunScribe analysis lets us see exactly where force is being distributed and identify the upstream cause of ankle stress.

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If your ankle pain appears after a specific mileage threshold on your long run, this is a load tolerance problem. We can identify your current threshold and build a progressive programme that expands it.

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