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That sharp or aching pain on the inside of your ankle is a classic sign of an overuse injury. When you get inner ankle pain from running, it’s your body telling you that some of the key support structures—like tendons or ligaments—are taking on too much stress from repeated impact.
Think of your inner ankle as a central hub for stability. With every stride, a whole system of tendons, ligaments, and nerves works together to support your foot’s arch and push you forward. When you run, the forces shooting through this area are massively amplified.
This constant, high-impact stress can easily lead to strain, particularly if your running form isn't quite right or your shoes aren't doing their job. It’s rarely a single bad step that causes the problem; it’s the cumulative effect of thousands of them.
To figure out what’s really going on, you need to know the main players. The inner ankle relies on a few critical components, and when one gets overworked, pain is the first thing you’ll notice.
Knowing these structures is the first step to understanding your discomfort. The type of pain you're feeling is often the biggest clue as to which part of this intricate system is crying out for help.
Ultimately, that pain is your body’s alarm system signalling that something is out of balance. It could be your biomechanics, a sudden increase in training, or simply the wrong footwear. Pinpointing the cause is the key to effective treatment. Recognising the signs of common musculoskeletal pain is a vital skill for any runner who wants to stay on the road and out of the physio’s office.
To get back on the road, you first need a clear map of what’s actually causing the pain. Inner ankle pain when running isn't just one thing; it's a symptom that can point to several different underlying issues.
Each of these problems has its own unique signature. Learning to read the signs is the first real step toward getting the right treatment and making a proper recovery. Let's move beyond a vague "sore ankle" and pinpoint what's really going on.
To help you start narrowing down the possibilities, this table breaks down the key differences between the most common culprits runners face. Pay close attention to how and where you feel the pain – these clues are vital for an accurate diagnosis.
As you can see, what might feel like a similar ache in the same general area can stem from very different root causes. Understanding these distinctions is crucial for guiding your recovery.
Think of the tibialis posterior tendon as the main support cable holding up your foot's arch. Every time you run, this tendon works hard. When it gets overworked from the constant, repetitive impact of running, it can get inflamed and start to break down. This condition, known as tendinopathy, is one of the most frequent sources of inner ankle pain we see in runners.
The pain is usually a nagging, dull ache right behind that main bony bump on the inside of your ankle (the medial malleolus). It tends to get worse during a run, especially as you push off the ground, and you might also notice some weakness or even feel like your arch is starting to flatten. In the UK, this type of tendon overuse is a very common diagnosis for runners complaining of inner ankle pain.
Key Takeaway: If your pain feels deep, sits just behind the inner ankle bone, and flares up during or after a run, tibialis posterior tendinopathy is a likely suspect.
You can learn more about the specific symptoms and treatments for tendonitis in our detailed guide.
This chart helps visualise the different pain locations and triggers for the most common inner ankle issues.
Notice how the infographic highlights a major clue: whether the pain came on gradually from overuse or happened suddenly after a specific twist.
While most people are familiar with rolling their ankle outwards (an inversion sprain), you can also injure the deltoid ligament on the inside of the ankle. This usually happens from a sudden, sharp eversion sprain, where your foot rolls awkwardly outwards, stretching or tearing the ligaments that keep the joint stable. The pain is typically sharp, immediate, and quickly followed by swelling and bruising.
But tendons and ligaments aren't the only potential sources of your inner ankle pain from running.
Getting the diagnosis right is absolutely critical. A tendon injury might respond well to targeted rest and strengthening exercises, but a stress fracture demands a complete stop to all high-impact activities. Knowing the difference empowers you to get the right help and stops you from making the problem much worse.
So, your inner ankle is flaring up after a run. The first thing you need to do is get that inflammation under control and take the edge off the pain. Good at-home care is more than just kicking your feet up—it's about using the right tactics at the right time to get your recovery off to a strong start.
Most runners have heard of the RICE method (Rest, Ice, Compression, Elevation), but its real power is in the details. Just going through the motions won’t cut it. We need to apply these principles thoughtfully to the delicate tissues of the inner ankle.
Think of these steps as your go-to response in the first 48-72 hours. Nailing this initial phase can make a huge difference in how quickly you start to feel better and sets a solid foundation for proper healing.
Rest (But Make It Active): Complete rest isn’t always the answer; it can actually lead to stiffness. Instead, try active rest. This means no running or high-impact activities, but you should introduce gentle, pain-free movements. Things like ankle circles or pointing and flexing your foot keep the blood flowing without putting any real strain on the injury.
Ice (Precision Matters): Icing is a fantastic way to dial down inflammation, but you have to get the timing right. Grab an ice pack, wrap it in a thin towel, and apply it to the sore spot for 15-20 minutes every 2-3 hours. Never put ice directly on your skin or leave it on for too long—you could end up doing more harm than good.
Compression (Supportive, Not Suffocating): A compression bandage can provide gentle support and help keep swelling in check. The key is to wrap it so it feels snug but not tight. If you feel any numbness or the pain gets worse, it’s definitely on too tight.
Elevation (Gravity Is Your Friend): This one’s easy. Whenever you’re sitting or lying down, prop your ankle up on a few pillows until it’s higher than your heart. This simple trick helps gravity drain excess fluid away from the joint, which is a major win for reducing swelling.
While you’re giving your ankle a break from the pounding of the pavement, you don’t want it to seize up. Gentle mobility exercises are perfect for keeping things moving.
Give these a try while you’re seated:
Taking control of your diet can also play a supportive role. You can learn more about how certain foods can help manage inflammation in our guide to anti-inflammatory foods to fight chronic disease.
These initial steps are all about managing the immediate, acute symptoms. But getting past the pain is just the beginning. For a deeper dive into a complete recovery plan, it's worth exploring these top strategies for quick healing and recovery. By taking these foundational steps, you’re creating the best possible environment for your body to heal, paving the way for a safe and strong return to running.
Moving beyond immediate pain relief is where the real work begins. The goal isn't just to heal the current injury but to build a resilient foundation that prevents inner ankle pain from coming back. This means shifting your focus from short-term fixes to long-term strength and stability.
Think of your body as a connected chain. A weak link in your hips or calves can force your ankles to absorb way too much strain, eventually leading to injury. A proactive strengthening programme is your insurance policy against recurring pain, turning a vulnerable ankle into a source of power.
Building a robust support system for your ankles involves more than just isolated ankle movements. True prevention requires strengthening the entire kinetic chain, from your feet all the way up to your core.
Start with these key exercises, focusing on slow, controlled movements.
Ankle sprains are a major cause of ankle pain for runners, and it's not always the outer ligaments. In the UK, these injuries result in over 300,000 A&E visits annually. While most are lateral sprains, medial ligament injuries can cause significant inner ankle pain and are often overlooked. These incidents account for about 5% of all emergency visits, and for around 25% of people, recovery is delayed by at least a week.
Once you've mastered the basics, it's time to add resistance and more dynamic challenges. This progression is essential for preparing your ankles for the specific demands of running.
You can introduce resistance bands to target the muscles supporting your arch and inner ankle.
Key Insight: Consistency is more important than intensity. Aim to perform these exercises three to four times a week. This regular stimulus is what encourages your muscles and tendons to adapt and grow stronger over time.
For a broader perspective on safeguarding your running journey, consider exploring a comprehensive guide on how to prevent running injuries. While these exercises build a strong local foundation, a holistic approach is always best.
If you find that progress stalls or you're unsure how to advance safely, seeking expert guidance can be incredibly valuable. Professional physiotherapy offers personalised plans to address specific weaknesses and ensure your return to running is both safe and sustainable.
Self-care strategies are a fantastic first line of defence, but it’s vital to recognise when your inner ankle pain needs an expert eye. Pushing through certain symptoms can easily turn a manageable issue into a long-term problem.
Knowing when to switch from self-treatment to professional guidance isn’t a sign of failure; it’s a smart decision that prioritises your long-term running health. Certain symptoms are your body’s way of saying it needs more help than just rest and ice can provide.
If you experience any of the following, it’s time to stop guessing and book an appointment with a doctor or physiotherapist. These are not "wait-and-see" situations.
A professional evaluation is the quickest and most reliable path to an accurate diagnosis. An expert can differentiate between a tendon issue, a ligament sprain, or a potential stress fracture, ensuring you get the correct recovery plan from day one.
In the UK, ankle injuries are a major issue for runners. Research shows the ankle is the most common injury site for ultramarathoners, with an incidence of 34.5%. Specific conditions causing inner ankle pain running, like certain tendinopathies, have a recorded incidence of 19.4% in this group, showing just how overuse can lead to significant problems. You can read the full research about these running injury findings.
Understanding the roles of different specialists can also guide your next steps. A GP can provide an initial assessment and referrals, while a physiotherapist can offer a detailed biomechanical analysis and create a tailored rehabilitation programme.
For more complex cases, exploring options in sports and exercise medicine can provide access to advanced diagnostics and specialised treatment plans designed to get you back to running safely.
When you're sidelined with a nagging inner ankle, the questions start piling up. Getting straight, practical answers is the first step to taking control of your recovery and getting back to running without fear.
Let’s tackle some of the most common things runners ask when that all-too-familiar ache appears.
Yes, absolutely. Your running shoes are often the first place to look. If they're either worn out or just wrong for your foot type, they can throw your mechanics out of whack, putting a huge amount of stress on the tendons and ligaments around your inner ankle.
This is especially true if you overpronate—where your foot rolls too far inward after it lands. The strain gets magnified with every step. Stability shoes are built to help with this, but they aren't a magic bullet for everyone. The best move is to get a proper gait analysis at a specialist running shop to find a shoe that actually supports your stride.
It’s also worth remembering that even the best shoes have a shelf life, usually around 300-500 miles. Running on 'dead' shoes with flattened cushioning is a fast track to injury because they’ve lost the support your ankles depend on.
Patience is everything here. Rushing back is the single biggest mistake you can make. The rule of thumb is to be completely pain-free during normal daily life first—walking, climbing stairs, standing for a while.
A great benchmark is being able to do 10 single-leg heel raises on your sore side without any pain at all. Once you can do that, you can think about a gentle return.
Don't just jump back into your old routine. Start with a walk-run plan:
This one is all about timing. In the first 48-72 hours after the pain flares up (the acute phase), ice is your friend. An ice pack for 15 minutes at a time will help calm down swelling and inflammation, which is key for managing that initial pain.
Once you're past that initial stage, or if you're dealing with a chronic, dull ache with no major swelling, heat is fantastic. A warm soak or a heating pad boosts blood flow to the area, helping to relax tight tissues and speed up the healing process. It feels great before a gentle stretch, but never put heat on a fresh, swollen injury—it'll just make the inflammation worse.
If your pain persists or you're unsure about the next steps in your recovery, the expert team at The Vesey is here to provide a clear diagnosis and a personalised treatment plan to get you back to running safely. Learn more about our specialist services.
