Ankle Pain While Running Long Distance

Ankle problems are common among long-distance runners. Many factors raise the risk of ankle problems, including overpronating, running on worn-out shoes, failing to warm up properly, adding too much distance too quickly and running on uneven ground. Common causes of ankle pain include stress fractures, tendinitis, sprains and tarsal tunnel syndrome. Consult a doctor for an accurate diagnosis if you have ankle pain.

Stress Fracture

A stress fracture can cause ankle pain. Fractures of the medial malleolus, or inside portion of your tibia, are most common in distance runners. The tibia is your larger shin bone. This fracture will cause persistent inner ankle pain that's aggravated when you run. When this bone is fractured, you must avoid putting weight on your affected leg for six weeks. In rare cases, surgery is needed.

Achilles Tendinitis

If the pain is in the rear portion of your ankle, Achilles tendinitis might be to blame. Running when you are not sufficiently warmed up, worn-out or inadequate running shoes, hill running and overpronation raise risk for this condition. Your Achilles tendon connects your calf muscles to your heel bone, and tendinitis occurs when the Achilles becomes inflamed. Pain usually comes on gradually and worsens over time. Rest, ice, elevation, pain medication and stretching exercises are common treatments for non-severe cases. Your doctor also might recommend orthotics. In extreme cases, such as with an Achilles rupture, surgery is needed. You raise your risk for a rupture when you run with an inflamed tendon.

Sprain

An ankle sprain might be the cause of your problem, notes "A World-Class Marathon Runner" author Haydn Middleton. Running on uneven ground raises risk for a sprain, which occurs when your ankle ligaments are stretched beyond their normal range. Typical treatment for a slight sprain includes rest, ice, compression and elevation followed by stretching and strengthening exercises. A moderate sprain in which your ligament tears partially typically is treated with immobilization of your ankle with an air splint followed by stretching and strengthening exercises. A severe sprain might require surgery or a long period of immobilization. The healing process typically lasts four to six weeks for ankle sprains.

Tarsal Tunnel Syndrome

Tarsal tunnel syndrome, in which your tibial nerve becomes entrapped or compressed in the tunnel, leads to ankle pain while running. Your tibial nerve passes through the tarsal tunnel, just under the bony part of the inside of your ankle. Overpronation raises risk for this syndrome. This area might be tender to the touch when you have tarsal tunnel syndrome. A burning pain typically radiates into your heel, foot arch and sometimes even your toes. Your pain likely will be relieved by rest and aggravated by running or standing for long times. You might have tingling and numbness as well. Rest, ice and anti-inflammatory medicine followed by physical therapy are common treatments. If conservative treatment fails, your doctor might recommend surgery.

Posterior Tibial Tendinopathy

Posterior tibial tendinopathy will cause ankle and mid-foot pain. This tendon runs behind your ankle bone. Poor footwear and rapid increases in distance are common causes of this overuse injury. Excessive pronation, running on tight bends and a tight tibialis posterior muscle raise risk for this condition. Your tibialis posterior muscle, which functions to point your foot downward and also inward, goes from behind your shin bone to the posterior tibial tendon that passes behind the bony portion of your ankle. Rest, cold therapy and physical therapy are usual treatments. Your doctor also might recommend orthotics, anti-inflammatory medicines or massage. If the tendon is ruptured, you'll need surgery.