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Lateral Ankle Pain… A Hindrance for Runners

HIGHLIGHTS:

  • Peroneal tendonitis, which is caused by inflammation of the tendons in the ankle joint areas over a long period of time, causes reduced ability to control ankle movement and can result in ankle sprain trauma.
  • Changing foot strike is one method of reducing inflammation of the tendons in the lateral ankle area. If you are experiencing ankle pain, transitioning to striking or placing a little more weight on the heel instead of the painful area can help reduce the force to the ankles without having to stop running altogether.

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Lateral ankle pain may not be as common in runners when compared to knee or heel pain, but those who have experienced it know all too well how hard it is to cure. While it may not cause pain to the point of inability to run, it is a stubborn pain that seems to refuse to go away. Additionally, lateral ankle pain may be associated with other more serious injuries that require discontinuation of running in order for the injury to heal, such as ankle sprains.

Research carried out by Pejman Zia collected data from 58 runners who had experienced acute ankle sprain trauma, with pre-existing pain in the lateral ankle region. Clinical assessments revealed that as many as 48 of them had symptoms associated with peroneal tendonitis. When magnetic resonance imaging (MRI) scans were performed, it was found that 55 out of the 58 runners (or 95%) did, in fact, have peroneal tendonitis in the peroneus longus and peroneus brevis (tendons at the ends of the muscles on the outer part of the leg).

These findings indicate that there is indeed a correlation between lateral ankle pain and ankle sprain trauma. While it is not yet clear enough to state conclusively that peroneal tendonitis is the cause of ankle sprains, it is, however, possible that inflammation of the tendons in the ankle joint areas over a long period of time can cause a reduced ability to control ankle movements until, finally, ankle injury can occur.

Because of this, if you are a runner who has been experiencing lateral ankle pain for some time already, I recommend that you seek treatment immediately until it is completely cured in order to reduce long-term inflammation in the tendons in that area. There are several treatment methods, including a reduction of impact to the affected area, as well as strengthening the muscles so that they can better support the impact and force placed upon them while running and also aid in tissue recovery.

Changing your running foot strike is one fairly new and very interesting method that I would like to suggest. This method does not involve changing to forefoot strike or midfoot strike as has been popularized recently, but, in fact, involves even more of a heel strike. This is because with each type of foot strike, while the structures and muscles used to absorb the impact or ground reaction force (GRF) change accordingly, impact and ground reaction force remain either way.

For runners who use heel strike, there is greater force to the knees. For those who run using forefoot strike, there is more impact to the ankles and calves. In cases of ankle pain, a transition to striking or placing a little more weight on the heel instead of the painful area can help reduce the force to the ankles without having to stop running altogether. But be careful not to overstride and come down on your heel when the knee is extended.

In summary, a correlation does exist between lateral ankle pain and ankle sprain trauma. Any runner who starts to experience symptoms should seek treatment and a cure to avoid more intense symptoms and injuries, such as ankle sprains, which are more severe and generally result in runners having to refrain from running for extended periods of time.

References

NCBI – Peroneal tendinosis as a predisposing factor for the acute lateral ankle sprain in runners: http://www.ncbi.nlm.nih.gov/pubmed/25786820.  Accessed on October 29, 2015.

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