The ankle, knee and hip provide almost all the propulsive forces during running. Clearly, a healthy and functional ankle joint is important for running, but the ankle is a common site of running-related pain and injury. Some of the most common causes of ankle pain from running include inversion sprains, Achilles tendinitis and blisters due to excessive friction.
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A sprained or twisted ankle is a common cause of ankle pain, and the most common ankle sprain is an inversion sprain. An inversion sprain, which frequently occurs in runners, especially trail runners, involves a rapid and forceful inward roll of the ankle that damages ligaments on the outside edge of the ankle. The ligament most commonly injured with inversion sprains is the anterior talofibular ligament, which connects the talus or ankle bone with the fibula. Like all sprains, inversion sprains are assigned a grade -- from grade one to grade three -- to indicate its severity. Grade three sprains are the most severe, and involve a complete tear or rupture of the ligament. Inversion sprains may also involve damage of the nearby tendons, bones and other joint tissues, which is why a person who experiences an inversion sprain should seek treatment from a qualified professional. A health care specialist focusing on sports medicine will be able to effectively diagnose and treat inversion sprains.
According to the American Association of Orthopaedic Surgeons (AAOS), runners frequently experience Achilles tendinitis. The Achilles tendon is a fibrous tissue that connects the calcaneus bone with calf muscles. Although the Achilles tendon is the thickest and strongest tendon in your body, it's vulnerable to injury from overuse, misalignment, improper footwear, medication side effects and accidents. Often, multiple causes may contribute to Achilles tendinitis in runners. Runners may notice posterior ankle pain building slowly over time, along with a corresponding increase in Achilles tendon thickness and skin that becomes red and swollen. Treatment for Achilles tendinitis involves activity modification, including rest or cross training activities such as swimming. Stretching exercises and manual therapies such as instrument-assisted soft tissue mobilization can be helpful. Running in shoes that are flat, wide and flexible may help alleviate the pain associated with Achilles tendinitis.
Blisters are caused by friction from shoes or clothing that repeatedly rubs against the skin. As the outer layer of skin separates from the inner layers, lymph fluid begins filling the empty space between the two. Blisters frequently occur in runners wearing new shoes and in athletes participating in long distance events such as marathons, ultramarathons and adventure races. Blisters, although typically small, can be debilitating and force the discontinuation of an athletic endeavor. Fortunately, blisters can be prevented by taking appropriate precautions prior to and during activity. To prevent blisters, you should ensure that your shoes fit properly, apply tape or second skin products to potentially problematic areas around the heel and ankle, keep your feet as dry as possible -- using powder, if necessary -- and change socks regularly during activity.