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Ankle Pain Running

Ankle Pain Running: Causes, Treatment, And Prevention

Ankle pain running refers to strain or discomfort experienced in any part of the ankles after a run. Ankle pain can result from a medical condition, such as arthritis, sports injury, or normal wear and tear of the tissue. The ankle sprain is the most common cause of ankle pain, accounting for more than 80% of ankle injuries. This happens when the ligaments in your ankle tear up or get overstretched.

Typically, over-the-counter medications and rest resolve ankle pain. Ankle pain due to arthritis and injuries can be treated without surgery. However, surgical treatment is critical when dealing with ankle injuries caused by a fractured or dislocated ankle.

A man with ankle pain after running

What Are The Common Causes Of Ankle Pain?

It is important to get an idea of the anatomy of the ankle. Your ankle joint comprises three major components: the fibula, tibia, and talus. The lower leg bones (fibula and tibia ) join together to meet your talus (foot bone) to form the ankle joint.

The following listicle highlights some of the most common causes of ankle pain:

1. Sprains: An ankle sprain develops when you roll or twist your ankles in an awkward way, and as a result, ligaments that hold bones together end up with a tear or get overstretched. An abrupt injury like a sprain can drastically injure the cartilage on the heel bone and may even cause fractures. Sprained ankles are associated with the following symptoms:

  • Bruising
  • Swelling
  • Intense ankle pain after running or exercising leading to overuse injury).

Of all common running injuries, ankle sprains and sore ankles are very challenging. This is because they trim down your training regimen and hamper your day-to-day life.

2. Achilles Tendinitis: Ankle pain can also be caused due to Achilles tendinitis, during which the Achilles tendon becomes inflamed after a tendon injury. The Achilles tendon is connected to your calf muscles to the calcaneus (back of the heel bone). The Achilles tendon is often inflamed in athletes because of running for an extended period (tissue overuse) or too fast. It can cause severe ankle pain in runners, followed by acute stiffness around the ankle. Not many runners are able to run pain-free if they don’t take essential steps to avoid aggravating factors of an ankle injury.

Achilles Tendinitis can affect both sorts of people, athletic as well as non-athletic. Though it is often observed in runners who increase their training intensity very quickly or those with very tight calf muscles. You are prone to experience extreme symptoms after a workout. If you are having discomfort with your tibialis anterior tendon, you might also be experiencing shin splints (the first symptom of a bone stress injury).

3. Bursitis: The irritation and inflammation of bursae are known as bursitis that causes dull aching pain and swelling in the ankle. Bursae are fluid-filled sacs that cushion the bones to reduce friction.

4. Fractures: Accidents and injuries can cause fractures in the bones that make up the ankle joint. Ankle pain resulting from common injuries like fractures can be mild or severe in nature and lead to pain and swelling. Stress fractures due to running excessive miles can also cause ankle injuries while running as a result of a broken ankle.

Ankle Pain As A Result Of Disorders:

The following conditions can also cause ankle pain:

1. Ankle Arthritis: Ankle pain and stiffness are the results of multiple types of arthritis, but the most common types are osteoarthritis and rheumatoid arthritis. Arthritis mostly occurs in people aged over 65 years. A less common reason behind ankle pain can be reactive arthritis. Both, osteoarthritis and rheumatoid arthritis can be managed with non-steroidal anti-inflammatory drugs (NSAIDs) and strength exercises that focus on your ankle joint and muscles. ibuprofen, Paracetamol, and pain-relief gels can also help with easing the pain.

2. Gout: Gout, a condition characterized by uric acid buildup in the body, is another major cause of developing ankle pain. Excessive uric acid can deposit as crystals in your joints, resulting in sharp pain of the ankles. Your big toe is typically the most common spot for gout related-pain but it can also include the ankle joint if uric acid crystals get deposited there.

3. Infection: Severe ankle pain can be caused due to numerous types of infections, like cellulitis. A bacterial or fungal infection causes septic arthritis and leads to sharp pain in the ankle bones, along with other joints.

What Are The Symptoms Associated With Ankle Pain?

The following conditions may develop alongside ankle problems :

  • Inability to bear weight on the affected ankle
  • Instability in motion
  • Constant, dull aching pain
  • Swelling or stiffness in the joint
  • Tingling or numbness
  • Sharp pain around the ankle
  • Reduced ability to walk or run.

A lady with ankle pain after running

Ankle Pain During And After Running:

Marathon runners often experience ankle pain. There are numerous reasons for the development of ankle pain during and after running. The ankle joint has complex and delicate biomechanics which makes it highly prone to ankle instability. Tendinitis (soft tissue injury), ankle fracture, sprained ankles, and arthritis are a few of the major reasons. Some possible causes for ankle problems related to running can be:

  • Physical attributes (flat feet, low arches)
  • Running in only one direction (repetition)
  • Equipment (wearing unsuitable shoes)
  • Running too long or too far

How Can Ankle Pain Be Treated At Home?

Reducing the stress on your ankles is the first step in easing ankle pain. Some foot pain conditions can become a chronic condition if left interested. For immediate treatment of ankle pain, many healthcare providers recommend the RICE method.

Rest: Patients with ankle pain should avoid putting extra weight on the ankle for 48 to 72 hours. Walking boots or crutches can help you walk or move without putting weight on the ankle.

Ice: Cold compresses or applying an ice pack on the injured ankle for 15-20 minutes between multiple icing sessions can help reduce swelling on the ankles. Start by icing your ankle four to eight times per day.

Compress: Wrap your ankle with a compression sleeve or elastic bandage to improve swelling and pain of the ankle.

Elevation: If possible, raise your ankle above your heart level by placing a stack of pillows.

Other Treatment Options For Ankle Pain:

The following are some treatment options to manage ankle pain:

1. Over-The-Counter Pain Medication: Doctors usually recommend NSAIDs (Nonsteroidal anti-inflammatory drugs), such as ibuprofen or acetaminophen, to reduce swelling and relieve ankle pain in a non-surgical approach.

2. Physical Therapy: Physical therapy involves different exercises like calf raise, resistance band work, and ankle circles to prevent ankle pain while running by strengthening the muscles around the feet. Clinical studies have demonstrated that certain exercises are highly effective at minimizing the symptoms in Achilles tendonitis, plantar fasciitis, and ankle sprains.

In some locations, it is possible for you to self-refer to an NHS-vetted physiotherapist. On other hand, if that is not something feasible for you, your healthcare providers will request an appointment on their behalf for you.

3. Supportive Footwear: Choosing shoes that provide support to the feet and ankles prevents ankle pain. Sandals and flip-flops can make you vulnerable to injuries and sprains while walking or running. Special braces or inserts can help lessen the stress on the tendons too.

4. Surgery: When ankle pain fails to resolve with NSAIDs, surgery can help repair torn tendons or ligaments, correct flat feet, and relieve arthritis pain. You’ll need to book an appointment with an orthopaedic surgeon.

5. Steroid Injections: Steroid injections, such as cortisone shots, when administered directly into the joint, can reduce pain, inflammation, and swelling of the ankle.

When To Consult A Healthcare Provider?

A patient should see a doctor if:

  • The ankle feels unstable or numb.
  • The ankle has been injured many times.
  • The patient cannot bear weight on the ankle.
  • Ankle pain lasts for more than 3 days.
  • The patient can’t run even after a week of rest.

Prevention:

Whether ankle pain is a result of an injury, infection, or arthritis, the following tips can help prevent the pain:

  • Practising healthy eating habits.
  • Maintaining a healthy body weight, which will reduce stress on the joints.
  • Staying physically active.
  • Using topical pain relievers.
  • Never run before warm ups.
  • Stability running shoes can help runners avoid ankle injuries
  • Stretching to maintain a good range of motion.

Conclusion:

Ankle pain mainly occurs as a result of fractures, sprains, or medical conditions like gout or arthritis. Running a lot is also associated with ankle pain. At-home treatments, such as the RICE method, can ease ankle pain, but surgical management of ankle pain becomes necessary in case of severe pathological pain. You should see a doctor if the pain persists for more than three days. Your doctor may recommend an imaging test such as a CT, X-ray, or MRI scan which will help create images of bones and soft tissues so your healthcare professional can identify the damage.

References:

  1. Chimenti RL, Cychosz CC, Hall MM, Phisitkul P. Current Concepts Review Update: Insertional Achilles Tendinopathy. Foot Ankle Int 2017;38:1160–9. https://doi.org/10.1177/1071100717723127.
  2. Kobashi Y, Munetomo Y, Baba A, Yamazoe S, Mogami T. Ankle and Foot Injuries: MRI Pitfalls BT  – Pitfalls in Musculoskeletal Radiology. In: Peh WCG, editor., Cham: Springer International Publishing; 2017, p. 479–509. https://doi.org/10.1007/978-3-319-53496-1_25.
  3. Stewart S, Dalbeth N, Otter S, Gow P, Kumar S, Rome K. Clinically-evident tophi are associated with reduced muscle force in the foot and ankle in people with gout: a cross-sectional study. J Foot Ankle Res 2017;10:25. https://doi.org/10.1186/s13047-017-0207-4.
  4. Chen ET, McInnis KC, Borg-Stein J. Ankle Sprains Evaluation, Rehabilitation, and Prevention. Curr Sports Med Rep 2019;18.
  5. Arthritis Foundation. Ankle Pain. (http://www.arthritis.org/about-arthritis/where-it-hurts/ankle-pain/) Accessed 11/18/2021.
  6. McKay, G. D.; Goldie, P.; Payne, W. R.; Oakes, B., Ankle injuries in basketball: injury rate and risk factors. British Journal of Sports Medicine 2001, 35 (2), 103-108.
  7. Manusov EG, Lillegard WA, Raspa RF, Epperly TD. Evaluation of pediatric foot problems: Part II. The hindfoot and the ankle. American Family Physician. 1996; 54:1012–1026.

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