So your ankles are sore, and you have a race coming up? It can be stressful figuring out the safest path forward to stay fit heading into race day—especially when you can’t get an appointment with a physiotherapist right away. While medical care should always be your first stop for injury answers, here are some common causes and symptoms to keep in mind when your ankles start to ache.
Common causes
“Overuse” is a buzzword for injuries caused by repetitive stress on muscles, bones or tendons when you run beyond your body’s limits or use inefficient movement patterns. It’s so commonly used because many running injuries develop gradually, rather than from a single incident. At the extreme end, this can contribute to conditions such as sprains and stress fractures. At the milder end, runners may experience soreness or irritation that may subside with appropriate rest and training adjustments.
Overuse often comes from doing too much too quickly. That’s why running coaches recommend slowly increasing mileage slowly (e.g., the 10 per cent rule), rather than making sudden jumps in training volume. Be careful how you approach training and building mileage, because it’s easy to increase your injury risk when you ramp up too quickly.
Improper mechanics can also contribute to ankle pain. Overstriding, for example, is when your foot lands too far in front of you. Generally, you want your foot to land close to your centre of mass, so landing too far in front increases the braking forces your body has to absorb.
Another potential factor is a lack of strength in the ankle muscles. Strength training can help runners build capacity in their feet and ankles, particularly when they are taking up running or increasing their mileage. Although it can seem tedious, incorporating exercises that strengthen the ankles and feet (e.g., banded ankle extension and pendulum balance) can be a useful part of a well-rounded training routine.
And don’t forget about your shoes. If you are running in footwear with worn soles or cushioning, it may be time for a new pair. No single type of shoe is right for every runner, but comfortable, stable shoes can help you feel supported throughout training.
Pain or an injury doesn’t necessarily mean you have to lose all your fitness. If the injury is not serious, runners may be able to modify their training instead of stopping altogether.
How serious is it?
Knowing when to be concerned about the pain is a good place to start. We all have different pain tolerances, but mild soreness that improves with rest and doesn’t affect your running mechanics may be less concerning than pain that persists or worsens. Instead of pushing through the pain, pay attention to how your symptoms respond to activity and whether they are changing your stride. It isn’t about “toughing it out”; it’s about what’s smart for your body. We aren’t all attempting to run like Ethiopia’s Tigst Assefa on pace to break a world record. Make sure your goals match your fitness level.
Some signs you need to rest and make physiotherapy a priority again are: the injured area is swollen, the pain is sharp or worsens with use, you feel unstable, it hurts when you walk or it causes a limp. If you are experiencing any of these symptoms, don’t rely on rest alone. A physiotherapist or other medical professional can help determine the cause of the pain and the best path to recovery.
These running injury stats should change how you train
If it’s not too bad
If you are being honest with yourself and the pain is mild, doesn’t worsen with activity and is improving over time, there may be a path back to healthy running without losing much fitness. The key is to reduce the impact and stress on your body while you determine what your ankle can tolerate.
Cross-training can be particularly useful for runners who need to reduce running impact while maintaining aerobic fitness. Many experienced runners incorporate cycling, swimming or elliptical workouts into their programs, even when they are healthy. An ankle-strengthening routine can also improve strength and function.
When it comes to actually running, keep it easy. That means no speed workouts while you are figuring out how your ankle is responding. If you can run without increasing your pain, changing your stride or having trouble balancing, you may be able to continue with easy running. Instead of running hills or pushing yourself on a track, stick to easy routes and wear stable, comfortable shoes that support you.
You know your body best, so be honest about how you’re feeling. You can delay chasing that Boston qualifying time for another year if you need to; runners who prioritize longevity know when to stop, rest and make recovery a priority.