Bodyworks: Ankle Pain

How to recognise it, how to overcome it


Posted: 5 June 2000
by Patrick Milroy

Many is the runner who has finished training or a race with a pain somewhere in the ankle. You don’t remember injuring it, but it certainly hurts when you position it a certain way or put weight on it at a particular angle.

Symptoms
As well as the pain, you may feel the ankle is a little swollen and becomes progressively more uncomfortable as you point your toes, or turn them in, out or upwards. Sometimes you can pinpoint the exact spot; sometimes it’s more evasive.

Signs
A doctor or physio may find swelling in front of your Achilles tendon or an indication that there’s fluid within your ankle joint. However, there may also be other tender areas where soft tissues have been over-stretched or pulled. A specialist will look for signs of inflammation, such as redness or heat – and not only within the ankle, but throughout your body. There are many diseases which can affect the joints of your whole body, but which may have shown up in your ankle alone, simply because it’s an over-used area.

Medical investigations
These are needed to eliminate other causes. If you’re old or have already suffered injury from contact sports, early osteo-arthritis may show up on an x-ray. Additionally, blood tests can reveal generalised diseases such as ankylosing spondylitis or rheumatoid arthritis, and these will need to be treated and monitored.

What else could it be?
As well as the diseases just mentioned, various infections may target the joint. You could even be suffering from psoriasis, a skin disease.

Self-treatment
Simple first aid using RICE and aspirin-based medicines will ease inflammation, while you can mobilise the joint to stretch over-used ligaments and muscles. If these treatments don’t help, seek professional guidance.

Medical treatment
Much depends on the diagnosis. Any generalised disease of the body will need anti-inflammatory drugs, antibiotics in an infection, and sometimes secondary line drugs. If the diagnosis is simply one of overuse or wear and tear, physiotherapy should resolve the symptoms.

Can you run through it?
You may be able to follow a reduced training programme, but to run on an inflamed or infected joint is asking for long-term damage. Your programme will depend solely on the length and severity of the disease and how effective treatment is.

Recovery time
Anything from a week to three months, providing you work on it.


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Hi I was wondering if anyone has had a similar problem to this............

I've been running about a year, I do four runs a week on tarmac/concrete averaging around 15 miles per week. Using a pair of GT-2070’s that are about 3 months old.

Up until the end of September I have had no injuries at all. Then my right ankle started to ache, there was no swelling or pain when touched, just that in the mornings it was uncomfortable to place any weight on it but this disappeared after an hour or so. I thought it was just a general ache so continued running. The ache stayed. After a month of this I rested for 2 weeks hoping this would resolve the problem, on resuming jogging it was still there.

I then went to the doctor who ruled out all standard running injuries he knew of. Had an x-ray, no joy there. Rested for a further 6 weeks still the same problem. Now I’m off for a MRI scan and a meeting with a sports injury consultant.

I’m still running, with no pain when I actually exercise, but throughout the day the ache comes back for short periods at a time

Sorry for the length of this post. Has anyone had similar problems or heard of something similar??

Cheers

Richard
Posted: 31/12/2002 at 12:11

MRI will be definitive answer as to any major structural probs in the ankle.
Have you had yuor gait and running style analysed ? could be wrong shoes- over or underpronating/etc,,,
When is the MRI due to be done ? Must cost a lot if private !
See what expert says first and then reassess.
Posted: 31/12/2002 at 13:06

Where abouts on your ankle is the pain?
Posted: 31/12/2002 at 14:48

I haven't had my gait analysed, where'd you get that done? I live on Jersey so facilities are a tad restricted. Good thoughts on the shoes, looks like i might try buying another pair and see if that helps, just found out the MRI is not until march!!

The ache runs around the outside of the ankle over the top of my foot and sometimes from the ankle up my calf.

Thanks for the responses
Posted: 04/01/2003 at 18:51

The short answer is yes - I had a similar problem with 2070s, and so did a club mate. Outside of the left ankle in my case, not sure why it wasn't the right ankle too. I never really found out the reason!

I got some new shoes last week and had a long chat with the staff in Run and Become - apparently they've had quite a few people have problems with 2070s. Basically they've made the midfoot bit stiffer than on previous versions. The shop said that people had had various problems with calfs etc as this meant the forefoot had to do more flexing. I can't vouch for the science behind this (or indeed whether it was the cause of my sore ankle), just reporting what happened to me (and my club mate Tim) and what I was told. Tim opted to get a different pair of shoes. The 2080s are apparently similar - I opted for the 1080s which don't have such a stiff middle bit.

Having said that, the ankle pain goes off after a mile or too, and I've done plenty of good miles in the 2070s!
Posted: 04/01/2003 at 19:29

This is a bit spooky!
I have started to have a problem with the inside of my right ankle to calf muscle/tendon. I have been using my 2070s for approx 3.5 months and have recently started to get this pain. I was looking for any guidance when I came across this forum!
I don't have any pains at all when I am not running or wearing my old 2060s as casual trainers.
Any ideas on what this may be or is it a problem with the ASICS shoes?
Posted: 04/01/2003 at 21:16

I have a similar problem but seems to be more in the joint as I can pinpoint the exact location.

Notice it more when horizontal and hang the foot off the end of the bed on certain angles

Have created a bit of a 'click' in the ankle too.

any ideas?
Posted: 09/07/2003 at 10:04

I bought a pair of Asics 2080 recently and have since have developed a severe inflammation of one of the upper tendons in my left ankle (peroneus brevis tenosynovitis). No symptoms in the right foot.
Posted: 09/07/2003 at 10:47

me to!!

I'm currently seeing a physio re: my left ankle. In a nutshell i felt a sudden pain whilst trail running (in barefeet -nothing to do with asics shoes) and that was back in march. There was no swelling and the pain quickly subsided. But now my ankle aches on the front mainly, and there's alot of clicking going on. I'm unable to run barefoot as i get the pain coming back(feels like the ankle is about to give way, causing me to limp) and if i walk for long enough i start to feel the pain coming on. However i'm not too bad when i wear my orthotics but have not tried to run far yet! My phyiso thinks that the problem is due to excessive over-pronation -this would explain why wearing orthotics helps. He has given me some exercises to strenghten my ankle e.g. rising up one leg.
But i remain unconvinced that this will help and i feel that i've caused some damage which requires surgery? I'm seeing my GP next week hoping to be put down for a MRI scan (lets just hope i catch him on a good day). But may end up paying it myself (think they cost around £500).

Grateful for some reassurance. I just feel that its not getting better.



Posted: 09/07/2003 at 13:26

Have recently had a similar sounding problem. My right ankle is fine running but is sore afterwards, especially on the outside above my anklebone. When I put weight on it it feels 'weak'. There is no pain when I press it. I decided to rest it and went swimming and found it was painful when doing front crawl (i.e. foot pointed with force of water creating tenderness in the achilles). I was wondering whether I need new shoes? current pair over a year old although my average mileage is only ~5-10 miles/week. Any suggestions?
Posted: 09/07/2003 at 17:05

I'm still experiencing the same problem!! But I've had my MRI results should be the end of the month. MRI got pushed back till start of june :(
Posted: 09/07/2003 at 18:47

weird...i run in the asics 1070gel and have had similar ankle problems! ive been for all the check ups including an MRI scan which didnt reveal anything major(this costs around £650!). so i m about to invest in a new pair of trainers i think and will probably avoid asics, though apart form the ankle and its strange clicking they have been fine...
Posted: 10/07/2003 at 10:47

Funnily enough, guess what - me too!!! I assumed I'd twisted my ankle earlier this year (beginning of May), despite no recollection of actually having the injury I had constant ankle pain on the inside of my right ankle. I was wearing a pair of 2080's that were approx 3 months old. I've since had to have physio and now have to wear orthotics. Perhaps next time I'll try some different trainers!!
Posted: 10/07/2003 at 16:06

I am having problems with a pair of 2080's. I have worn Asics for most of my running since 97 with no problems. But for no apparent reason inside and back of ankle hurts, ran on it, but it seemed to improve as i ran, until next day when it swelled up, rested for 12 days and took anti inflammatories. The problem is still there, went to sports injury clinic thinking it might be achilles tendonnitis, however, they think I may be fortunate enough for it to just be a swollen bursar (i think I have spelt that right) they still recommend resting from running but cycling is ok. But the Asics 2080's have been nothing but trouble and I will think very carefully before buying another pair. I run with orthotics and these did not suit them at all. Anyone got any recommendations in this area, I have not got a clue where to start looking for different shoe???
Posted: 12/07/2003 at 14:09

Hi,i have ran in my 2080s for six months and have now got a pain in my left ankle as well as the bridge of my left foot,I think this is my last pair of 2080s.
Posted: 19/07/2003 at 11:58

I have a constant pain on the inside of my left ankle. After loads of xrays and blood tests I've been told that I under pronate and that I will need supports inside my shoes because I'm stretching the tendons continuously. the trouble is the supports cost £220. Does anyone know if I can get them on the nhs?
Posted: 07/09/2003 at 13:10

HOW INCREDIBLY STRANGE! I too had a problem with my ankle area about 3 years ago, and funnily enough i had a pair of asics 2070's or 2060's or sommink! anyway it did put me out of action. Curious i went to see a sports therapist who advised me that i had strained the (ere we go!) Soleus or soloid! ligament the one that goes from the ankle up to the knee and back down the other side! excuse my technical know how! Anyway to cut a short story long... never had a problem since ditching the asics. Touch wood! ...
Posted: 19/09/2003 at 17:02

Rt ankle pain but no swelling nor tender to touch. Pain comes and goes. Previous soreness in rt achilles (last +/- 4 months) Was wearing Asics but switched to Saucony 3 months ago.

Have been doing a lot of stretching which has definitely helped BUT major advance came from getting deep massage on my rt calf.

I pulled my rt calf a year ago and rested but did not rehabilitate the injury. As a result there is a lot of residual scar tissue and the flexibility of the calf had been compromised. The stiffness of the calf then put greater strain on my ankle - hence the pain.

This is a long-winded way of saying "perhaps it is not the shoes but referred pain from higher up"

Just a thought.
Posted: 24/09/2003 at 16:39

I too have Asics 2080 and three months down the line have a pain on the inside of my left ankle. Has anybody contacted the makers of Asics cos it makes me mad to think I have to buy new trainers after spending £70 only 3 months

Posted: 02/10/2003 at 10:19

Im having ankle problems outside left and inside right with Asics 1080 Gel.

Problems being going on for two months now and rest works but as soon as I start running the problem manifests its self again.

pretty peeved as i only bought them three months ago had footscan etc @ sweatshop
Posted: 26/11/2003 at 21:41

I have changed to Brooks and have run about 300 miles with no problems in the ankle. Asics have been dumped.
Posted: 27/11/2003 at 08:54

i don't have the trainers you mention, i am new to running doing about 20 miles a week but have pain and swelling in my left ankle.i'm in training for my first ever race great north run so i don't want to stop my training plan if i can help it can anyone give me any tips on what i should do to keep me running pain free. problem only just started a couple of days ago
Posted: 23/07/2004 at 19:36

Richard - I had a similar pain on the outside of my ankle and up the outside of my lower leg. It felt stiff in the mornings and sometimes after a run. Physio on the muscle didn't seem to help at all and I wasn't able to stretch it. It turned out it was the nerve that was injured (sciatic nerve runs along here and along the outside of the foot), stretching and physio for this has made a big difference.

Try keeping your leg straight, pointing your toes and turning your foot inwards, if that stretches the area that hurts it maybe a nerve problem.
Posted: 23/07/2004 at 20:27

Dipsy - thanks for that advice, have been stretching and trying to change the way i place my feet when running, i have put a firm strapping on my ankle and it seems to help a little, now considering going to see a physio, i don't want to stop my traing schedual if i can help it.
Posted: 24/07/2004 at 17:12

Yvonne, did you twist your ankle or did it just start to hurt. If it is swollen then it probably isn't a nerve problem but you should put ice on it to reduce the swelling. Going to see a physio is probably the best way to avoid having to stop running. The best way to treat/avoid injuries is to find out what is causing them and put that right rather than just resting and treating the injury.
Posted: 24/07/2004 at 17:51

i don't recall twisting my ankle at any point but then you never really notice, it just seemed to start bothering me a about a week ago and when i get up in the mornings i feel like an old woman going down stairs and just generally walking about the house its quite uncomfortable. Will book that appointment with the physio and hopefully get the problem sorted, thanks once again. will go and get a bag of peas out of freezer and put it on my ankle.
Posted: 24/07/2004 at 18:30

Yvonne - I agree with Dipsy that you should really see a physio. Your ankle pain may well be the result of an imbalance elsewhere.

I too am like an old invalid when I get up, go downstairs etc however, with proper stretching, I don't actually get pain when I run. My physio says that apart from my tight calves (see earlier) I am also running too late at night for my legs to recover.

There may be many reasons, so best see the physio

Good Luck
Posted: 24/07/2004 at 19:20

thanks timbo until i read about other runners complaints i thought it was only me that was doing something wrong. Having a rest day today thought it for the best. I hope my problem is something simple that can be sorted quickly.
Posted: 25/07/2004 at 16:48

thanks guys i've now been to the physio and had my problem diagnosed i have tenosynouitis and i now have a recovery programm and will be out running again soon. Looking forward to clocking up the miles again
Posted: 29/07/2004 at 19:27

ooooh she's got an 'ouitis!

Good Luck with your recovery.
Posted: 29/07/2004 at 20:30

Sorry to bring this thread back to life, but has anyone got any update on ankle injury and asics trainers?
Reason I ask is I am getting ankle problems and do run in a pair of asics 2090.Have seen both a sports physio and a podiatrist but am sceptical
Posted: 23/01/2005 at 07:35

mmmm... this all sounds very familiar!
I've been running just over 1 year and am on my second pair of Asics 2090 shoes with another pair in the wings.
I was having similar foot problems, more on the top of my foot, which would only occur during the run and disappear within minutes of me finishing the run - and not on every run.
I had put it down to the shoes and after spending 2 hours in specialist running shop with foot scan and running up and down the pavement with different shoes, the recommended shoe was - the GT2090!
I was told that the top of my foot was fairly high and with a wide foot I was shown how to adjust the lacing to 'miss' out that section of my foot.
I also looked closely at my running route and tried to assess what was causing this, if it wasn't the shoe as such.
I have concluded three things:
1. Following good safety advice, I always ran on the right hand side of the road facing the oncoming traffic. The roads were fairly cambered and this was throwing my LEFT foot off all the time. I try wherever possible and where safe, to move about on the road.
2. I make sure my lacing is comfortable.
3. My usual training route would take me along a stretch which involved quite a steep downhill section early in the run. By changing this around I now avoid this (unfortunately I have the steep uphill to content with instead!)

Since changing the above, I have had no further problems and am still in Asics 2090s.

Sorry for the long post, but it is worth checking other factors before blaming the shoes. I would never buy shoes other than from a specialist running shop where they can properly assess your own running style and foot profile.
Hope this helps
RD


Posted: 23/01/2005 at 09:55

strangely enough I bought a pair of Asics Duomax Gel-1090's about a month ago. I did have a problem before this with sore heels and although the gel's helped and was feeling very comfortable to wear the problems have still persisted and got worse. I've done all the stretching things and warm and warm down exercises and even taken anti-flammatory tablets and the glocosamine suppliments but my sore heels are still there when I run. mornings are worse and I get very stiff and takes me half an hour or so to get going to releave the pain a bit. will be very disappointed if I find it's the Asics as when I had my old Reeboks I never had any problems at all and ran for miles both training and in half-marathon events. tried Nike first but couldn't get on with them so ended up going to a running specialist and they recommended these Asics for me. does make me wonder a bit though!??
Posted: 07/06/2005 at 03:53

Very strange. After 6 months of happy chugging in Nikes I got some Ascic Gel VII's from Run & Become in London. They felt very nice despite a slight tendency to blister and I have been wearing them alternately with my Nikes.

However I have had persistent pain across the top of the forefoot, and this morning it turned into pain on the outside of the ankle, about 3 inches above the ankle bone. I have been prowling the RW injury site trying to find out what it could be. I wonder if it could be the Ascics? I will rest it for a day or two and then try sticking with the Nikes for a couple of weeks to see if it improves.

If anyone else has any updates on this, I would really like to hear from you as I don't want to stop chugging but I also don't want to ignore it and make it worse, whatever it is!
Posted: 11/10/2005 at 11:16

I have had a similar problem with my right ankle. I wear a pair of reeboks, not sure of model.

I have varied my routes as i think i may have had a problem with the camber of the road and running on the same side of the road for a long way, it seems to have helped.

A further question: someone mentioned overpronating, what does this mean???
Posted: 18/10/2005 at 09:10

I've been running for a week in Nikes now and the problem has disappeared, so I fear it may be the Asics....

George, overpronating is when your foot rolls too far inward as you move in your stride from heel to toe. Some inward movement is normal. People who don't roll enough are called under-pronators or supinators, people who roll the right amount are neutral runners. The reason it matters is that different shoes are designed for different gaits, so if you are (say) an overpronator you need shoes designed for overpronators. Running in the wrong shoes can actually cause injury. Have a look at

http://www.runnersworld.co.uk/news/article.asp?UAN=481

where is a simple explanation of this stuff. A good running shop will do a gait analysis for you and tell you what class you fall into---well worth doing, even though it doesn't guarantee particular shoes will always work for you, alas!
Posted: 20/10/2005 at 16:12

I have hopefully just cured this problem of no pain when running,but then my right ankle/heel gradually stiffend up during the hours following a run.

I was running in a pair of neutral shoes (Nike Pegs)with orthotics fitted ,but after having my gait analysed it was found I slightly overpronate,I`ve now bought a pair of motion control shoes (Asics Gel 1110)and so far so good,in fact I`m even running without my orthotics and my feet feel as if they are hitting the ground like they are supposed to do.
So the best advice I`d give anyone is go and get your gait analysed and buy your shoes from a specialised running shop.
Posted: 08/12/2006 at 12:13

Well another story for you. I had the full gait analysis at Pro Feet in Fulham and was also sold the moulded insoles - £200 later walked out with my new trainers. 2 weeks later I suffered a fracture to the ankle, 4 months off, back running again and I find my left ankle is starting to niggle. Turns out I not only had the wrong size trainers but also I was sold a pair of trainers that were not for a natural gait which is what I was diagnosed as! First time in Asics (gel-1110) and the last!
Posted: 13/01/2007 at 22:23

Can anyone help me? I have a pain on the inside of my left ankle joint uppermost part. I do a lot of my training on the threadmill, could this be the problem? I get to a 1.5 miles and have to stop because of the pain. I run in asics too! My training has stopped, but have a 13 mile in 3weeks and the London marathon looming.
Posted: 01/02/2007 at 09:44

I have recently changed to the new Asics Nimbus and have had gait analysis saying the shoes are right for me!

I have always loved Asics but guess what.......

Pain and clicking ankle and into the front of my foot in the centre!!!  I am resting it but am very upset as have a boxing competition on the 10th (lets hope I have stopped in time)

This is really odd is it the Asics!!?

(Or just a group of runners training too hard on uneven badly maintained roads)

Any ideas what my pain is????


Posted: 02/10/2007 at 21:14

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