Ankle Pain While Running

What’s causing pain on the outside of your ankle? One possible running issue is peroneal tendonitis, which is a fancy way of saying an inflamed tendon.

Runners unfortunately are prone to things like tendonitis to because we ask our muscles to fire repetitively in the same motion. But it is something you can resolve and prevent!

What causes ankle pain in runners? There are a few possibilities which depend upon foot strike, running form and any past ankle injuries, which we can dive in to below.

The potential outcomes of ankle pain while running:

Sprained Ankle
Achilles tendonitis
Plantar fasciitis
Stress fracture
Peroneal Tendonitis

Of course those are the injury results, but some aches are just the body getting stronger. If it’s not changing your running form, shooting pain or swollen it could be standard runner discomfort. Ease up a little on the mileage and know your body is going to keep getting stronger.

The causes of most runner pains from shin splints to the bigger issues stem from the same things:

Adding too much mileage
Adding too much speed work
Not doing enough hip, glute and core strength
Only moving our bodies forward and not maintaining that ability to move side to side
Life incidents like stepping off a curb wrong

Sprained Ankle

Unfortunately, a sprain can be a bigger problem than we realize as they often take longer to heal than a stress fracture! Possibly because we don’t stay off it in the same way that we would a fracture.

This article isn’t specifically to address sprains, but you will need to stay off of it and compression can help to manage swelling and increase blood flow.

What is Peroneal Tendonitis?

Without getting too deep in to anatomy, let’s say that these tendons run along the outside of your foot and help to create that downward force you need to push off and to turn your foot outward. Pain will run right under the bony part of your ankle that you can feel, often in to the foot.

This is not an injury that will magically go away. Instead, it’s one that continues to get worse without attention.

Symptoms of Peroneal Tendonitis:

Pain on the outside of the ankle just below the ankle bone
Could also be swollen
Pain that improves with rest
Painful to push on the area

What causes ankle pain while running?

Quick increase in mileage
A big change in surface. I.e. road to technical trails that require more ankle strength
Often running on the same side of the road – leading to running on a slope constantly
Lack of hip, core and glute strength
Tight calves and feet muscles reducing mobility

How to Resolve Peroneal Tendonitis?

You’ve heard me say work on your hip strength a million times, but I’m going to say it again. Before I get in to that, let’s start with some of the pain management things you can do.

Stop running if you are having SHARP pain
Only use ice to inhibit pain, otherwise use heat to loosen tight muscles
Don’t take anti-inflammatories and run
Use compression socks (my favorites)
Foam roll to help release tension up the leg
Changing shoes or considering a running orthotic

Let’s cover somethings to deal with immediate pain and then a long term plan.

Taping Ankle Pain

If you’re attempting to keep running or even having issues walking, this step could be very useful.

You know by know that I’m a huge fan of RockTape (stays on so much better). It was a lifesaver prior to my knee surgery and I’ve found it really useful for many other little aches pains or injuries my runners have gone through.

Watch this video for exact instructions.

Improving Mobility and Flexibility

Tight calves are a common issue for runners, in this case leading to pulling on muscles all the way in to your ankle and foot creating pain.

Do standing calf stretches against a wall – remember you aren’t stretching to the point of pain. Hold at least 30 seconds.
Try getting in to a deep Buddha squat to improve ankle range of motion and a full hip to foot stretch
Roll your foot over a PT ball prior to any run to help loosen muscles
Try the peroneal muscle stretch in the video below

Long term plan prevent ankle pain while running:

Start working through these strength and flexibility pieces to make them part of your weekly routine. Then begin to look at tools from the right shoes to insoles to see if they could help improve things.

Tips to resolve tight calves while running
Improving Hip Strength – a number of workouts here
Reviewing Your Footstrike – learn how to best land
Ankle stretches – similar to those for shin splints
Utilize a massage gun to help release ongoing tightness

Best Shoes for Peroneal Tendonitis

Underpronation is one potential cause and while I always LOVE for us to start by fixing our weak hips, glutes and stride, sometimes we need a little extra support from the right shoe.

Insoles are an option to make your current shoe work. By picking one that provides more arch support to help your foot stop rolling inward you could get relief, but these shoes also have other benefits like the larger heel height.

While many of these have a higher heel to toe drop than I often recommend, they can be useful for Achilles or ankle pain because you’re shortening the amount the ankle has to stretch. Additionally most of these are designed to help with under pronation.