While ankle bruises are typically associated with contact sports such as football or soccer, they may also appear after activities that involve no contact, such as running. A bruise, also known as a contusion, is an accumulation of blood just below the surface of the skin that causes discoloration. There are multiple reasons for ankle bruising to occur from running, some of which are quite serious and require medical treatment.
Bruising may arise from either a direct blow to the ankle or from injury to the ligaments, muscles or bones. Although some causes are easy to identify, such as a sprained ankle after stepping in a pothole, others may present with no obvious sign of injury. Direct trauma to the inner ankle may indicate poor running form as a result of striking the inner ankle with the opposite foot. Ankle bruising may also result from cumulative stress on the bones of the foot or ankle over time, especially from long distance running, resulting in injuries such as stress fractures or bone bruises. Certain risk factors can increase your risk of bleeding and therefore susceptibility to bruising as well, such as blood thinner medications, low platelets or blood clotting disorders.
When you notice bruising during or after running, stop and rest your ankle. Minor bruises can be treated at home with the PRICE protocol, which stands for protect, rest, ice, compress and elevate. Medications such as acetaminophen or ibuprofen may be taken to relieve pain, but be aware that nonsteroidal anti-inflammatories also increase the risk of bleeding.
When to Contact Your Doctor
Notify your doctor if you have bruising as a result of an injury, bruises that are very painful or large, an obvious deformity of the ankle, ankle swelling, severe ankle pain, difficulty walking, a history of bruising easily, bleeding from other areas of the body such as the gums or nose or if you bruise easily without any obvious injury. Frequent nosebleeds or bleeding of the gums are an indication of a blood clotting disorder such as hemophilia or Von Willebrand disease. If you are taking a blood thinning medication such as Coumadin or aspirin, your doctor may need to adjust the dosage of your medication.
Although not all causes of ankle bruising are preventable, there are several things you can do to reduce your risk of bruising in the future. Whether you are an experienced runner training for a race or a beginner just getting into running, always increase the intensity, frequency and duration of your workouts very slowly. Increasing your mileage too quickly, especially if you are new to running, can put a large amount of stress on your legs and lead to injury or bruises. Also make sure that your shoes fit properly and your feet are well cushioned. Shoes should be replaced about every 300 to 500 miles or every three to six months to maintain adequate cushioning.