Why Does My Ankle Hurt When Running? 6 Possible Causes
Running injury guide
Ankle pain during a run can come from several different tissues. A previous sprain, an irritated tendon, the Achilles, the ankle joint or a bone stress injury can all cause pain in roughly the same area. Where it hurts and how it started are useful clues, but they cannot confirm a diagnosis on their own.
Quick answer: Pain on the outside of the ankle can follow a lateral ankle sprain or involve the peroneal tendons. Pain on the inside can involve the posterior tibial tendon. Pain at the back often involves the Achilles. Pain at the front may come from the ankle joint or surrounding tissues. Stop running and arrange an assessment if the pain is sharp and focused over a bone, you cannot walk normally, swelling is marked, the ankle feels unstable or symptoms keep worsening.
Important: This guide is educational and cannot diagnose an injury. Pain location overlaps between conditions, and a clinician may need to examine your ankle or order imaging.
Start with the exact location
Use one finger to point to the most painful spot. Then think about whether the pain began after a twist or fall, appeared gradually over several runs, or followed a change in hills, speed, distance, surface or shoes.
The table below is a starting point, not a self-diagnosis. More than one condition can hurt in the same place.
| Where it hurts | Possible source | Other clues |
|---|---|---|
| Outside of the ankle | Lateral ankle sprain or peroneal tendon irritation | Previous ankle roll, swelling or bruising, pain on uneven ground, or a giving-way feeling |
| Inside of the ankle or toward the arch | Posterior tibial tendon irritation | Pain with walking or running, inside swelling, arch discomfort, or weakness during a calf raise |
| Back of the ankle or above the heel | Achilles tendinopathy | Gradual pain, stiffness after rest, or soreness during the first steps in the morning |
| Front of the ankle | Joint or surrounding soft-tissue irritation | Stiffness or pinching with stairs, downhill running, or moving the knee forward over the foot |
| One sharply tender spot over a bone | Bone stress injury or fracture | Pain with weight-bearing that builds with activity, local swelling, or pain that begins to affect walking |
Six possible causes of ankle pain while running
These are common possibilities, but symptoms can overlap. The way the pain started, the exact tender area, swelling, strength and ankle stability all matter during an assessment.
Possible cause 1
A previous lateral ankle sprain
An ankle can feel better before its strength, balance and confidence have fully returned. That can leave it sore or unsteady on trails, corners and uneven ground.
Common clues: The original injury involved rolling the ankle, the pain is mostly outside, or the ankle repeatedly feels as though it may give way.
Possible cause 2
Peroneal tendon irritation
The peroneal tendons run behind the outside ankle bone and help control the foot. They may become painful after a training increase, uneven running or an ankle sprain.
Common clues: Pain follows the outside of the ankle rather than sitting directly on one bone. Activity tends to make it worse, and some runners notice swelling or snapping.
Possible cause 3
Posterior tibial tendon irritation
This tendon travels behind the inside ankle bone and helps support the foot. Pain may be felt inside the ankle and sometimes continues toward the arch.
Common clues: Weight-bearing activity hurts, the inside of the ankle is swollen or tender, or a single-leg calf raise feels weak or painful.
Possible cause 4
Achilles tendinopathy
Achilles pain often builds gradually after changes in running load. Hills, faster sessions and a return after time off can all increase demand on the tendon.
Common clues: Pain and stiffness at the back of the heel or lower calf, especially after rest or during the first steps of the morning.
Possible cause 5
Bone stress injury
Stress injuries can develop when repetitive load outpaces the bone’s ability to recover. The pain is often gradual, focused in a small area and worse during weight-bearing activity.
Common clues: A clearly tender spot over a bone, local swelling, pain that builds during a run, or pain that has begun to affect walking. Stop impact exercise and arrange an assessment rather than testing it with more running or hopping.
Possible cause 6
Front ankle or joint irritation
Pain at the front can involve the ankle joint or nearby soft tissues. It sometimes follows a sprain and may feel pinched or blocked during deeper ankle movement.
Common clues: Pain with downhill running, stairs or bending the knee forward over the foot. Persistent catching, locking or restricted movement should be assessed.
Can you keep running with ankle pain?
There is no safe yes-or-no answer without knowing the cause. Do not run through pain after a significant twist or fall, sharp pain over a bone, marked swelling, instability or an altered stride.
Back off and monitor
- The pain is mild and began gradually.
- You can walk normally and the ankle is not giving way.
- There is no focused bone tenderness or marked swelling.
- Symptoms settle when the aggravating activity stops.
Stop running and get assessed
- The pain is sharp, worsening or focused over a bone.
- You are limping or changing your stride.
- The ankle is swollen, bruised, numb or unstable.
- Walking hurts or normal daily activity is becoming difficult.
If you try an easy run after mild, gradual soreness, stop if the pain increases, changes your stride or is worse later that day or the next morning. When the cause is unclear, an assessment is safer than repeatedly testing it.
What to do next
- Reduce the aggravating load. Pause speed, hills and long runs. Cross-training is useful only if it does not hurt the ankle.
- For a recent twist or sprain, protect the area. Compression, elevation and ice may help with short-term pain or swelling. Avoid aggressive stretching or exercise immediately after a more significant injury.
- For gradual soreness, track the pattern. Note the exact location, when it starts, how it feels the next morning and what changed in training.
- Do not guess with sharp bone pain. Stop impact activity and arrange an assessment.
- Get help if it is not improving. Recurring pain, ongoing instability or pain that limits normal activity deserves a sports medicine or physiotherapy assessment.
For a wider look at common running problems, see our guide to common injuries from running.
Strength and balance exercises can be useful during rehabilitation, but the right starting point depends on the injury.
When an ankle brace may help
A brace can provide short-term support after some ankle sprains and may be part of a return-to-running plan for an ankle that feels unstable. It does not diagnose the problem, heal a stress fracture or replace rehabilitation.
If a clinician has said a brace is appropriate, compare options in our guide to the best ankle braces for running. Our guide on how to choose an ankle brace explains the difference between compression sleeves, lace-up braces and more structured supports.
| Situation | Where a brace may fit | What still matters |
|---|---|---|
| Recovering from a diagnosed lateral ankle sprain | Short-term support during progressive weight-bearing or return to sport | Strength, balance, movement and a gradual return plan |
| Repeated giving way after previous sprains | Extra support during higher-risk activity if advised | An assessment for chronic instability and targeted rehabilitation |
| Unexplained tendon, joint or bone pain | Not a reason to self-treat and continue running | Find the cause first, especially with bone tenderness, swelling or worsening pain |
When to seek urgent medical care
Seek urgent care after an injury if the ankle or foot looks deformed, you heard a snap or pop and cannot walk normally, pain is severe, the foot becomes numb or changes colour, or swelling and bruising are substantial.
- A pop near the Achilles followed by weakness, difficulty walking or an inability to rise onto the toes can indicate a rupture.
- After a sudden ankle injury, inability to bear weight and focused tenderness over certain ankle or midfoot bones can indicate that an X-ray is needed.
- Sharp, local bone pain that worsens with weight-bearing can be a stress injury even without one dramatic accident.
About the Ottawa Ankle Rules: Clinicians use this screening rule after an acute ankle or midfoot injury to help decide whether an X-ray is appropriate. It includes the ability to take four steps and tenderness at specific bone landmarks. It is not designed to diagnose every running injury or rule out a stress fracture at home.
How to reduce the chance of another flare
- Build training gradually. Large jumps in distance, speed, hills or trail time can overload tissues that are not ready for the change.
- Finish the rehabilitation. After a sprain, strength and balance work can help reduce ongoing instability and repeat injury.
- Change one thing at a time. New shoes, a different surface and a mileage increase in the same week make it harder to identify what caused the problem.
- Pay attention to recurring symptoms. An ankle that repeatedly gives way or hurts in the same spot needs more than another rest week.
Our strength training guide for runners covers simple ways to support your running. If you are reviewing your shoes, use the Running Shoe Finder as a shopping tool, not as a way to diagnose ankle pain.
A brace can support some diagnosed ankle problems, but it should not be used to hide worsening pain.
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Frequently asked questions
Why does my ankle hurt when I run but not when I walk?
Running places more repeated load on the ankle than walking. A tendon, healing sprain, joint problem or early bone stress injury may hurt during running before it affects everyday walking. Stop and get assessed if the pain is sharp, focused over a bone or worsening.
Can I keep running with mild ankle pain?
Only consider an easy test if the pain began gradually, remains mild, does not change your stride and there is no swelling, instability or focused bone tenderness. Stop if symptoms increase during the run or are worse later that day or the next morning.
What can pain on the outside of the ankle mean?
Outside ankle pain can follow a lateral ankle sprain or involve the peroneal tendons. Pain over the outer ankle bone or base of the fifth metatarsal after an injury also needs fracture screening. Location alone cannot confirm the cause.
What can pain on the inside of the ankle mean?
Inside ankle pain can involve the posterior tibial tendon, particularly when there is tenderness or swelling behind the inner ankle bone and discomfort toward the arch. A medial ankle sprain and other conditions can hurt there too.
When should ankle pain be checked?
Arrange an assessment if you cannot walk normally, pain is focused over a bone, swelling or bruising is marked, the ankle feels unstable, you heard a snap or pop, or symptoms are worsening or repeatedly returning. Seek urgent care for severe pain, deformity, numbness, colour change or suspected Achilles rupture.
Do ankle braces help runners?
A brace can provide short-term support after some diagnosed ankle sprains or for recurring instability. It works best as one part of a rehabilitation and return-to-running plan. It should not be used to keep running through unexplained bone, tendon or joint pain.
Medical sources checked
- American Academy of Orthopaedic Surgeons: Sprained Ankle
- American Academy of Orthopaedic Surgeons: Stress Fractures of the Foot and Ankle
- American Academy of Orthopaedic Surgeons: Achilles Tendon Rupture
- American College of Radiology: Acute Trauma to the Ankle
- Journal of Orthopaedic & Sports Physical Therapy: Lateral Ankle Sprain Clinical Practice Guideline
- NHS: Ankle Pain
Sources reviewed September 2026. This article has not been individually reviewed by a physician and should not replace personal medical care.
