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Inner Ankle Pain Running

James McCormack
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Inner ankle pain running is a common area of complaint. It’s common not only in runners but also in footballers and dancers. This is an area where different tendons, bones, nerves, and ligaments can become sensitive due to an acute injury or simply because of an overload.

What are the most common reasons for inner ankle pain running?

The majority of injuries that cause inner ankle pain are a result of an overload, such as an excessive amount of running or walking. The most common diagnoses that you can expect are:

  • Posterior Tibial Tendinopathy: this tendon attaches to the inner part of your foot and passes right behind the inner bone of your ankle. It is an important tendon for providing support and stability to the inner arch of your foot. Pain often results from excessive foot pronation moments, so careful consideration should be given to your running and walking biomechanics. Video analysis can be useful for this, as can the appropriate type of running shoes.
  • Flexor Hallucis Longus Tendinopathy is the tendon responsible for the flexion of your big toe. It can become sensitive in dancers, where the common “en-point” position may lead to overuse and pain. It has also been described in runners who wear excessively big shoes, which lead them to “grip” their toes and ultimately lead to an overuse injury.

As with every tendinopathy, conservative treatment is usually the norm, focusing on off-loading the painful area: this is generally done by a combination of strengthening exercises, taping, manual therapy techniques, step-count reduction, and orthotics if needed. After a period of off-loading, the priority moves onto strengthening and tendon loading.

What else could cause inner ankle pain?

If the pain in your inner ankle is also associated with numbness and tingling around your foot, the problem could be Tarsal Tunnel Syndrome. This is caused by the entrapment of a nerve within the ankle joint. Also, in this case, a period of off-loading and taping can lead to positive results.

Another issue to be aware of is Stress Fractures. These are generally rare but can involve the medial malleolus (i.e. inner ankle bone), the navicular, and the calcaneus. They are generally common in people with persistent symptoms aggravated by activity. There is usually tenderness over a bony part, aggravated by jumping and running. If suspected, an MRI should be performed to confirm the diagnosis. If confirmed, a 5 to 6 weeks period of non-weight-bearing is required, followed by a progressive resumption of activity over another 6 weeks.

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We are specialists in treating ankle conditions, and you can see one of our Foot and Ankle Specialists in our clinic in Fulham, South West London. 

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