Ankle pain during or after running usually reflects load, mobility, or strength imbalances rather than structural damage. Here’s why it develops and what helps.
Bayley Forbes is an osteopath and strength & conditioning coach based in Ringwood, Victoria. He founded Summit Osteo & Performance to help people bridge the gap between treatment and performance — combining hands-on care with tailored movement and strength programs to support long-term recovery and better performance.
Ankle pain is a common issue in runners and can show up as stiffness, sharp discomfort, or a dull ache during or after runs. Because the ankle absorbs large forces with every stride, even small changes in load, mobility, or strength can influence how it feels.
Most ankle pain is not caused by structural injury — it reflects irritation from repetitive loading that exceeds tissue tolerance.
Here are the key contributors to ankle pain in runners and what helps improve it.
Restricted ankle dorsiflexion (the ability to move the knee over the toes) is one of the biggest contributors to ankle discomfort.
When dorsiflexion is limited, runners often compensate by:
• Increasing foot pronation
• Overloading the inside of the ankle
• Overstriding
• Increasing tibial shock
• Shifting load to the knee or hip
This increases tissue stress around the ankle joint and surrounding tendons.
Mobility doesn’t need to be perfect — just enough for efficient movement.
The calf complex (gastrocnemius + soleus) absorbs a huge portion of impact forces during running.
Weakness here can lead to:
• Early fatigue
• Ankle collapse
• Reduced shock absorption
• Increased tibial load
• Achilles irritation
• Foot pain
Strengthening both straight-knee and bent-knee calf movements is essential.
Overstriding — landing with the foot too far ahead of the body — increases braking forces and places greater demand on the ankle and foot.
Signs of overstriding include:
• Long stride length
• Low cadence
• Loud foot strike
• Feeling “heavy” on the ground
Increasing cadence by 5–10% is one of the simplest ways to reduce ankle stress.
Ankle pain often appears after:
Increasing weekly distance too quickly
Adding hills or speed sessions suddenly
Transitioning into new footwear
Running more frequently without recovery
Returning from time off
These spikes overload tissues before they have time to adapt.
The tendons around the ankle — including the posterior tibialis, peroneals, and Achilles — can become sensitive if they’re overloaded.
Tendon irritation often feels like:
• A dull ache during or after running
• Morning stiffness
• Mild swelling
• Pain with hopping or push-off
These symptoms are highly responsive to strengthening and gradual load progression.
✔ Bent-knee calf raises (soleus focus)
Builds the tissue that absorbs the most running load.
✔ Straight-knee calf raises
Strengthens gastrocnemius for propulsion.
✔ Tibialis anterior endurance work
Supports mid-stance control.
✔ Foot intrinsic strengthening
Improves arch support and reduces excessive pronation.
✔ Hip strengthening
Reduces compensations at the ankle.
Useful areas to target:
✔ Ankle dorsiflexion mobility
✔ Big toe extension (important for push-off)
✔ Calf flexibility
✔ Soft tissue mobility around the foot and ankle
Gentle mobility work improves efficiency and reduces tissue strain.
✔ Increase cadence slightly
Reduces braking forces and ankle load.
✔ Avoid excessive downhill running initially
Downhills increase eccentric stress.
✔ Choose softer surfaces while symptoms settle
Grass/trails reduce impact.
✔ Improve trunk and hip stability
Better control above = less compensatory load below.
Modify running (usually safest option) when:
• Pain warms up
• Stays mild (1–3/10)
• Doesn’t affect technique
• Settles within 24 hours
Stop temporarily when:
• Pain increases as you run
• Affects push-off or landing
• Causes limping
• Persists strongly the next morning
• There is swelling or instability
The information in this article is general in nature and does not constitute personalised medical or health advice. Always consult a qualified healthcare professional for assessment and guidance tailored to your individual needs.
