Why Do My Ankles Hurt When I Run?

If you’ve been running long enough, you’ve probably had that moment—your ankle starts talking to you mid-run.

First it whispers, then it yells.

Ignore it, and you might end up taking a taxi back (or worse, not finishing your race).

Here’s the truth: Your ankles aren’t optional—they’re carrying 13x your body weight every single stride.

When they start hurting, it’s a signal you’d better listen to.

So let’s cut the fluff and get to what matters:

• Why ankles hurt when you run
• How to tell the difference between soreness and injury
• When to stop, when to keep running, and how to fix it

You’re here because you want to run pain-free—not just now, but long-term. Let’s make that happen.

Stress on the Ankles

So what do you think is the main culprit behind ankle pain?

In my experience? Stress. A lot of it.

Your ankle joint is a complex thing—bones, ligaments, tendons, and muscles all working overtime every time your foot hits the pavement.

When any of those structures get overworked or messed up (even a little), your ankle fires a warning shot.

That’s the pain.

Most ankle issues fall into two buckets:

• Acute Injuries – The “Oops” Kind. You land weird, roll your foot, and bam—instant sharp pain. This is your classic ankle sprain.
• Overuse Injuries – The Slow Burn. You ramp up mileage too fast or run the same loop every day with a slight camber, and over time, things like Achilles tendinitis or stress fractures creep in.

Sometimes, it’s not even a full-blown injury—it’s just soreness from tight calves or weak ankle stabilizers.

But don’t blow that off. Most real injuries start small.

Let’s break down the big four ankle pain causes for runners:

1. Ankle Sprain

It’s a classic. You roll your ankle stepping off a curb, hit a root wrong on a trail, or land sideways mid-run.

That sudden twist stretches (or tears) the ligaments outside your ankle.

Usually, you’ll feel sharp pain on the outer side, maybe even hear a “pop.”

Swelling kicks in fast, followed by bruising and that uh-oh, something’s not right feeling.

How to Fix It (And Not Make It Worse)

First 48–72 hours: R.I.C.E.

• Rest: No running. Period. Crutches if needed.
• Ice: 15–20 mins, every couple hours
• Compression: Elastic wrap—snug, not tight
• Elevation: Prop it up above heart level

Anti-inflammatories like ibuprofen can help early on.

But after the first few days, movement is medicine—gentle range-of-motion drills, easy mobility, and low-load strength work.

Here’s the healing time to expect:

• Grade I (mild): 2–3 weeks
• Grade II (moderate): 4–6 weeks
• Grade III (full tear): longer, possibly surgery

Don’t return to running until:

• You can walk pain-free
• Swelling is down
• You can hop on one foot without wincing

💡 Pro Tip: Taping or bracing for the first few return runs can help you feel stable. But don’t rely on it forever—your goal is strong ankles, not bandaged ones.

The Rehab Most Runners Skip (But Shouldn’t)

Too many people ice, rest, then jump right back into training. That’s how you end up with chronic ankle instability or repeat sprains.

Take a few extra days to do the stuff that keeps you out of the injury cycle:

• Single-leg balance (stand on one foot, close your eyes = fun times)
• Resistance band ankle movements (side, up, down)
• Calf raises + eccentric lowers
• Short foot exercises for arch control

Train your ankle to react, stabilize, and handle uneven ground. That’s how you bulletproof it for the long haul.

Is It Just Soreness… or a Real Injury?

Here’s the test:

If your ankle’s sore for a day and it improves with rest? You’re probably good.

But if it’s not getting better—or getting worse—you’ve got to address it before it blows up into something worse.

2. Achilles Tendinitis

Feel that dull ache in the back of your ankle? That’s likely Achilles tendinitis.

The Achilles tendon is your running shock absorber.

It connects your calves to your heel and handles a ton of force with every step.

But here’s the thing—it’s not invincible.

Most Achilles issues don’t start with a bang—they creep in. Maybe it’s a little stiffness in the morning.

Or some tightness in the first mile that eases up… only to come back with a vengeance after your run.

That’s your warning sign. Ignore it, and you’re asking for more trouble. You don’t want that right?

What Causes It?

• Too much mileage, too fast
• Hill repeats or speedwork overload
• Crappy shoes with no heel support
• Biomechanics gone rogue (think overpronation or weak glutes)

In short, it’s an overuse injury. The tendon gets micro-tears, doesn’t get time to heal, and then starts rebelling—hard.

Treatment Game Plan

Here’s how to treat this annoying injury:

Step 1: Dial It Back

Rest or switch to biking, swimming, or elliptical for at least a week or two. Cross training can really help. You’re not being lazy—you’re letting the tendon catch its breath. Avoid hills, speed, and long mileage until things calm down.

Step 2: Calm the Fire

• Ice 15–20 mins post-activity
• Elevate when you can
• Maybe take anti-inflammatories for a day or two (but don’t rely on them long-term)

Step 3: Start Gentle Movement

Once pain eases:

• Try ankle mobility (like tracing the alphabet with your toes)
• Begin eccentric heel drops—stand on a step, rise with both feet, lower slowly on the affected side. This is gold for tendon healing.

Start with both feet. Build to single-leg. Aim for 3×15, once or twice a day. Don’t push through sharp pain, but mild discomfort is okay.

You can also try:

• Calf raises
• Calf raises with a small ball between your heels (activates inner calf and stabilizers)

Coming Back to Running

Use the “pain scale” rule:

• Pain during a run = 0–2 out of 10? Probably okay.
• Worse the next morning? Not okay.
• Pain during running goes above a 3? Shut it down.

Think of tendon pain like a blinking check engine light. You might be fine, but ignore it, and you’ll stall out hard.

What If It Won’t Go Away?

Still limping after doing all the right things? Time to call in the pros:

• Heel lifts to reduce tendon strain
• Night splints
• PRP injections (that’s Platelet-Rich Plasma)
• In worst-case scenarios? Surgery. But that’s rare.

Most runners recover just fine with rehab and smart adjustments.

Mild cases = a few weeks. Chronic cases? 2–3 months. Tendons are stubborn, but they heal.

You just gotta give them the time.

Don’t rush it. Rehab like it matters—because it does.

3. Stress Fractures

Every runner’s nightmare: the stress fracture.

One day it’s a dull ache in your ankle or foot.

A few runs later, it’s stabbing pain that won’t let up—even when you’re just walking to the kitchen.

Unlike a sprain, this doesn’t come from a fall or twist.

It builds up quietly, then boom—sidelined for months.

How to Know It’s a Stress Fracture

Here’s the pattern:

• Pain is localized—you can point to the spot
• Pain increases with impact
• You might feel it even when walking
• Tender to the touch
• Maybe mild swelling

If you’ve been pushing mileage, upping intensity, or skipping rest days, this pain could be your bone saying: “I’m done.”

High-Risk Bones

Stress fractures often hit:

• Tibia (shinbone)
• Fibula (outside of lower leg near the ankle)
• Talus (deep in the ankle)
• Metatarsals (top of the foot)

Some of the common triggers include:

• Big mileage spikes
• Poor fueling (especially low calories, calcium, or vitamin D)
• Menstrual issues in female athletes (RED-S / female athlete triad)
• Repetitive hard surface running
• Worn-out shoes or bad mechanics

This injury doesn’t show up overnight. It builds—then breaks.

What to Do if You Suspect One

• Stop running. Immediately.
• Get checked—X-ray or MRI (many don’t show up on X-ray early on)
• Follow the timeline—most heal in 6–8 weeks with rest
• Fuel up—focus on protein, calcium, vitamin D
• Cross-train smart—ask your doc what’s safe (bike, pool, elliptical)

Don’t run through it. Don’t bargain with it. Stress fractures are one of those injuries where “toughing it out” backfires hard.

Here’s what healing looks like:

• 6–8 weeks of no running or impact. Let the bone knit itself back together.
• Boots or crutches may be needed—depends on where the fracture is.
• Something like a fibula fracture? Might just need rest and a brace.
• Talus or tibia? You’ll likely need to stay off it completely.

And don’t forget your nutrition. Calcium and vitamin D need to be dialed in—ask your doc if supplements make sense. Bones can’t heal without the right building blocks.

Can You Cross-Train?

Yes, but only if it’s pain-free. Deep water running, swimming, or maybe even cycling (if and only if it doesn’t stress the injured area) can keep your cardio up.

But don’t assume every cross-training option is safe. For example, even cycling might irritate a foot fracture if pushing on the pedals hurts. When in doubt, ask your doc. This is one of those “don’t guess” situations.

4. Tarsal Tunnel Syndrome 

Ever feel burning, tingling, or numbness creeping into your heel, arch, or toes—especially mid-run?

Like your foot’s falling asleep in a painful way?

That’s not plantar fasciitis.

That could be Tarsal Tunnel Syndrome (TTS).

It’s basically carpal tunnel… in your ankle.

There’s a tiny space on the inside of your ankle called the tarsal tunnel.

Nerves, tendons, and vessels run through it.

When that space gets tight or inflamed, the posterior tibial nerve gets squeezed—and starts throwing a fit.

Symptoms to Watch For

• Burning or tingling near your arch or heel
• Weird numbness that lingers
• Vague aching that gets worse after long runs
• Foot feels “off” or “electrical” but not in a sharp way

It’s sneaky. Some runners mistake it for plantar fasciitis or just a cranky arch.

But this is nerve stuff—not tendon or bone. And if you keep running through it? It’ll just get worse. Way worse.

What Causes It?

• Overpronation (foot rolling inward too much)
• Flat feet or collapsing arches
• Swelling from a nearby tendon injury or old sprain
• Tight calves or ankle structures
• Rarely: bone spurs, cysts, or even systemic issues like arthritis or diabetes

Bottom line: if your foot mechanics are off, your nerve takes the hit.

Treatment: Relieve the Pressure

Take the following steps to treat what’s ailing you:

• Support your arch – Get into stability shoes if you’re overpronating. Add an orthotic or arch support insert. The goal: stop that inward collapse so the nerve isn’t getting crushed with every step.
• Back off running – At least for now. Don’t run through nerve pain. That burning and tingling? Your body waving a red flag.
• Reduce inflammation – Ice the area to shrink swelling. NSAIDs can help in the short term, but they won’t fix a mechanical issue.

Still hurting? See a doc or podiatrist. They might try a corticosteroid injection into the tunnel. Worst-case scenario: surgery to release the nerve—but that’s rare.

Bonus Tips

• Work on calf mobility—tight calves can tug on structures around the nerve
• Compression socks might help reduce fluid build-up
• Cross-train with low-impact stuff like swimming or cycling (if it doesn’t trigger symptoms)

Be patient—nerve stuff heals slow. If you rush it, it’ll just bounce back louder.

How to Treat Running-Related Ankle Pain (Step-by-Step)

Let’s say the damage is done and you’re hurting. What now? Time to go into fix-it mode.

Step 1: Immediate First Aid – R.I.C.E.

Classic protocol still works. Hit it hard for the first 48 hours.

R – Rest. Get off it. That doesn’t mean lie in bed for three days. But avoid loading the ankle. If it’s bad, maybe crutches for a day or two.

I – Ice. Throw some cold on it. 15–20 minutes at a time, 3–4 times a day. Bag of frozen peas works just fine. Cold numbs the pain and tamps down swelling.

C – Compression. Wrap it. Elastic bandage, compression sleeve, or KT tape—whatever gives support without cutting off circulation. Keeps the swelling in check and reminds you not to push it.

E – Elevation. Kick your foot up above your heart. Lay back, prop it on a pillow, let gravity help. Especially useful early on when swelling’s at its worst. Here’s the full guide to injury recovery.

Extra Notes:

• Don’t switch to heat too early—only after the swelling is gone.
• Kinesio tape can be helpful if you know how to apply it (or get a PT to do it).
• If walking hurts, don’t run. That’s not toughness—it’s self-sabotage.

Getting Back to Running (Without Screwing It Up)

So you’ve rested, done your rehab homework, and your ankle finally feels decent.

Awesome. But before you sprint back into your old routine like nothing happened—pause. I’ve seen too many runners rush this and wind up back at square one.

Start slow. Think run-walk, not tempo runs.

Your first outing back? Try something like: jog 1 minute, walk 2 minutes, repeat for 10–15 minutes. See how the ankle feels that day—and more importantly, the next day.

If it’s all clear (no new pain, just a little stiffness), next run might look like 2 minutes running, 2 walking for 20 minutes. Then 5 run / 1 walk. You get the picture.

Take it one step at a time. Only bump one variable at a time—either the total time or how long you run between walks. Not both.

Stick to flat, predictable surfaces early on. I’m talking treadmill, smooth road, or track.

Save the rocky trails and hills for later—especially if you’ve had Achilles or ligament issues.

Hills = more strain. And leave the speedwork out of the picture for now. All your early miles should be at a pace where you could hold a conversation.

A lot of coaches (myself included) use the 50% rule: start at half of your pre-injury weekly mileage during week one. If that feels good? Bump it by 10–15% per week. If not? Back off.

Some mild discomfort early on is totally normal—as long as it’s low-level (think 1–2 out of 10) and doesn’t get worse over time.

But if you’re limping, gritting your teeth, or waking up swollen the next morning? You’re not “toughing it out”—you’re risking a setback. Take the hint and slow down.

Here’s the full guide to returning to running post injury.

Don’t Just Rehab the Ankle 

Here’s something runners don’t realize until it’s too late: your ankle might be the site of the pain, but the problem could be coming from upstream.

Weak hips, sloppy core control, lazy glutes—they all mess with your form and pile stress on your lower legs.

Use this downtime to shore up the rest of your body.

Stuff like clamshells, glute bridges, side planks, single-leg squats—yeah, it’s not glamorous, but it’s how you build better mechanics and run smoother.

If your hip stabilizers are weak, your form falls apart as you fatigue, which means your foot collapses inward and your ankle pays the price.

Want to run pain-free long-term? Treat your core and glutes like part of your “ankle plan.”

I’ve seen runners come back from ankle injuries stronger than they were before—because rehab forced them to address all the weak links they were ignoring.

How to Not End Up Injured Again

Let’s be real—rehab sucks. You don’t want to go through that again.

Here’s how to make your ankles more bulletproof moving forward.

Strengthen the Whole Support Squad

Ankles don’t do it alone. They rely on solid backup from your calves, peroneals, tibialis posterior, and even the tiny muscles in your feet. Weakness in any of these is a disaster waiting to happen.

Here’s what to strengthen on the regular:

• Calves (Gastrocnemius & Soleus): Handle your push-off. Do both straight-leg and bent-knee calf raises a few times a week. Strong calves = stronger Achilles = less overload on your ankle.
• Peroneals: Run along the outside of your lower leg. They help stop ankle rolls. Hit them with lateral band walks, resisted eversion, and side-to-side hops. Research shows weak peroneals are linked to a higher sprain risk. Don’t skip this one.
• Tibialis Posterior: Deep muscle on the inside of your ankle. Controls pronation and keeps your arch lifted. Try heel raises with a ball between your heels or banded inversion.

And don’t forget your foot muscles. Towel curls, toe spreads, barefoot balance work—it’s all part of building a stable foundation. Strong feet = better shock absorption = less ankle strain.

Honestly? I coach most of my runners to include 1–2 ankle-focused strength drills in their warm-up or cooldown year-round. Keeps things tight without adding big time commitments.

Train Your Balance (Like, Every Day)

You don’t need to be on a BOSU ball at the gym for an hour. Start simple.

• Stand on one foot while brushing your teeth.
• Add hop-to-balance drills post-run.
• Do lateral skater hops or yoga balance poses like tree or warrior III.

Balance training isn’t just for rehab—it prevents you from needing it again.

Studies show athletes who train balance have way fewer ankle sprains. It teaches your body how to catch itself when things get wobbly.

Try a 5-minute ankle circuit after your run:

• Single-leg stands
• Single-leg hops in place
• Lateral skaters
• Slow controlled toe walks

Fun, simple, and effective.

Don’t Sleep on Your Shoes

Shoes matter. No magic pair will prevent every injury, but the wrong ones can absolutely make things worse.

What to look for:

• If you’ve got low arches or overpronation, try stability shoes or custom inserts. They can prevent your foot from collapsing inward too much and straining the ankle.
• Got high, stiff arches? You probably need more cushioning to absorb shock.
• Most important? A study showed runners who picked shoes based on what felt best had fewer injuries. Trust your body here.

And if something feels off—too tight, too sloppy, rubbing your ankles raw—fix it. Hit up a proper running store, get your gait checked, and find what works.

What Ankle Pain Is Telling You (And Why You Should Listen)

Your ankles might seem like background players in the running world, but trust me—they carry the show.

Literally.

And when they start talking, you better pay attention.

Most ankle pain isn’t random. It’s feedback. It’s your body saying:

• “Hey, those shoes are shot.”
• “Your stabilizers are weak.”
• “You ramped up mileage too fast.”
• “This terrain is wrecking me.”

Ignore those whispers, and they turn into shouts. Don’t wait until it’s a full-blown injury to respect the warning signs.

Sore vs. Injured: Read the Signs

You can run with a mildly sore ankle—if:

• The pain is low-grade
• It doesn’t change your stride
• It improves as you warm up
• You’re modifying pace, volume, and terrain

You should not run if:

• Pain sharpens or worsens during your run
• Your form is compensating
• Swelling or instability is increasing
• You’re limping or avoiding load

This isn’t about being soft—it’s about being smart.

Share Your Lessons

Got a go-to ankle drill that saved your training cycle? A shoe that helped stabilize your stride? A brutal mistake you swore you’d never repeat?

Share it.

We’re a community, and your story might be exactly what another runner needs to hear to avoid their own injury spiral.

Final Word: Your Ankles Are Talking—Are You Listening?

You don’t have to fear every ache—but you do have to respect what your body’s telling you.

Tune in early. Train smart. And remember:

Tough runners don’t push through pain blindly. They adjust, adapt, and show up consistently. That’s what builds longevity.

Here’s to strong ankles, smarter decisions, and many smooth miles ahead.

Have you battled ankle pain during training? What helped the most in your recovery or prevention? Drop your tips or story below—your experience might save another runner’s season.