Ankle and foot pain from running is a common complaint heard at REP Physio in Edmonton. Wether you are a marathon runner or a beginner looking to increase your physical activity, foot and ankle pain is not something to run away from. Sharp pain shooting up into your calf and up the front of the lower leg, a dull pain within the joints of the ankle and feet, reduced range of motion, swelling, difficulty to weight bear, and overall general soreness in the area are common.
Though there are many reasons as to why your ankle could be hindering your running, most of these common complaints can be easily resolved from a visit to REP Physio.
Understanding the main causes of ankle pain in runners
Overuse injuries are by far the most common reason why runners come to REP Physio in Edmonton. Rapidly increasing your mileage or speed, or running too frequently can overstress your body and result in not only decreased performance, but also foot or ankle pain during or after running. Simply put, the most common running injuries resulting in pain around the ankle and foot are due to poor load management.
The other main cause of injury while running (but fortunately less freauent) are those traumatic events that are unfortunatley unavoidable. Rolling your ankle in an unseen dip on the terrain, tripping off a curb, slipping on an icy surface etc. can all lead to a lot pain in the muscles around the ankle, as well as the tendons ligaments and bones. Fortunately, foot and ankle pain caused by running does not mean you have to stop running entirely. With the help of REP Physio, and our client centered treatments for ankle pain and foot injuries, we can get you back to running as soon as possible.
Lastly, other factors that may cause ankle pain while running include your footwear (sometimes) , the surfaces you run on (maybe), and your gait pattern (possibly). However, again as mentioned above the overwhelming factor for risk of ankle pain is the amount of running you are doing. Once running volumes are addressed for foot and ankle pain, these other factors can be addressed.
Ankle sprain? Ankle strain? Get a clear diagnosis of foot or ankle pain
An appropriate diagnosis is critical for a timely recovery. At REP Physio, our assessment of ankle and foot pain in runners typically includes the following:
- An understanding of your treatment goals and lifestyle (client centered care)
An understanding of your expectations for recovery
- An understanding of your general health and social factors (sleep quality, stress, past medical history etc.)
- Ruling out medical red flags
An examination of your strength, range of motion and balance
- An assessment of your foot biomechanics and function
A running assessment (stride length, cadence, symmetry)
- Foot wear considerations
Strength testing, stability testing, special orthopedic testing
- A client centered, personalized rehab plan the fits your gols and needs
5 Reasons your ankles hurt
- Tendinitis/Tendinosis: Tendons are responsible for transmitting the force generated by your muscle to a joint to enact movement. If tendons are overworked, they can become inflammed. This is known as tendinitis. Initially, this presents as tenderness to touch and pain with activity. With tendinitis, there are no structural tears to the tendon. It is quite simply overworked. With relative rest/offloading the pain can resolve in a matter of weeks. However, if the tendon is not adequatley rested, the tissue quality of the tendon can change, resulting in tendinosis. Think of healty tendon like uncooked spaghetti (uniform, homegenous). Think of tendinosis like cooked spaghetti (non uniform, heterogenous). The development of tendinosis can take many weeeks/months. It is different from tendinitis as there is typically an absence of inflammatory markers. Rather, the tendon can appear visibly thickened, there may be some persistent swelling. The capacity of the tendon can be quite limited and you can experience pain with general activities of daily living. Recovery from tendinosis can take months. A progressive load management program combined with other interventions (shockwave, pharmalogical management etc.) is typically recommended. Tendinosis/tendinitis can occur in any of the tendons around the foot and ankle, however the achilles and tibialis posterior are often most affected.
- Ankle sprain/ankle strain:
Ankle sprains and strains "twist your ankle" are typically due to a traumatic event. Rolling your ankle when running by stepping off of a curb, landing weird, slipping and falling etc. are the ususal causes. Sprains describe an overstretching or tearinf of the liagments and joints capsule, whereas strains refer to the same mechanims affecting the muscles or tendons. In severe cases, the ligament can tear completely ( 3rd degree tear). Less severe strains are described as 2nd degree or 1st degree. Minor sprains and strains can take days to weeks to heal, while more complicated injuries (2nd and 3rd degree) can take months. Rehabilitation includes a progressive re-introduction of range of motion activities followed by general strengthening and sport specific retraining to improve ankle instability (if present) and to ensure pain in your ankle during and ankle pain after running is minized. In the case of severe sprains, you may wear a walking boot or need crutches for a few weeks. Surgery for these types of injuries is extremely rare. - Fractures:
Most fractures are due to traumatic events. Often in the presence of an acute ankle sprain strain, you may experience significant pain, swelling and bruising, combined with a difficulty to weight bear. If the foot looks quite visibly deformed, chances are you may be dealing with a fracture and go get it checked out asap. However, sometimes the damage, despite the significant pain and swelling is only soft tissue related. At REP Physio, we use the Ottawa Ankle Rules to determine if an X-ray is approriate. Fortunately fractures do heal, but it takes a minimum of 6-12 weeks on average. Another type of fracture is a stress fracture. This is due to overtraining, causing the bone to break down and a small crack to form. Often these are tricky to find on X-ray, and despite pain in the ankle, your ankle may not show visible signs of a stress fracture especially if it is quite small. A careful clinical history and possible referral for a bone scan are the best methods to identify a stress fracture. Women, especially those with poor nutrition and a previous history of stress fracture are at higher risk. As with traumatic fractures, stress fractures can cause a lot of pain and healing timelines are typically 8-12 weeks. - Osteochondral lesion:
Fortunately this type of injury is less common. An osteochndral injury/lesion is injury to a bone's cartilage. Cartilage acts as the primary load bearing surface of a bone. (If you've ever eaten a chicken wing and seen the white stuff at the tips, that's the cartilage). Cartilage is quite slippery and quite durable. Unfortunately, sometimes the cartilage can thin and or crack secondary to overuse and or trauma. With an osteochondral injury, it it is most common to experience ankle joint pain when running at the front and top of the ankle joint (aka the talocurual joint) This pain can be made worse by repetitive jumping or increased dorsiflexion (for example, running up an incline on a treadmill). Typically an osteochondral lesion is diagnosed by clinical exam and MRI - Plantar fasciitis, plantar fasciosis (PF):
One of the most common causes of heel pain, PF refers to overuse and or decreased tissue quality to the fascial layer in the bottom of the foot. The purpose of the plantar fascia is to provide support for the arch of the foot. Typically PF pain is on one side only, and is worse in the mornings. For more information on heel pain, check out our heel pain blog
Your ankles don't need to hurt when running
At REP Physio in Edmonton, we empower our clients to take control of foot and ankle injuries and maximize their recovery. We have over 75 years of clinical expereince to help treat ankle pain and help prevent ankle pain in the future. Our one on one initial assessment typically takes at least one hour (you're worth it) and will provide you with a thorough understanding of your injury and what to expect on your recovery care pathway. While many of us will experience ankle pain, collectively, ankle injuries should not have to cause you to forever stop doing what you love. Remember, the key to prevent ankle injury is be mindful of load management. Don't fall into the trap of doing too much, too soon. Wear running shoes that are comfortable. Your running form should feel natural to you.
If you’re dealing with ankle pain from running book an assessment with us today.
