Ankle pain is a common problem for runners. Every step you take puts weight and pressure on your ankles. Eventually this could result in injury and pain.

According to a 2008 study published in the American College of Sports Medicine’s Health and Fitness Journal, the average runner takes 1,700 steps per mile when running at a pace of 10 minutes per mile (6 miles per hour).

While your number of steps per mile will vary based on other factors, such as your height and stride, you might place stress on your ankle joints about 1,700 times with every mile you run.

The four primary culprits of ankle pain during and after running are:

A sprain is a stretched or torn ligament (tissue that connects two or more bones). The common symptoms of a sprain include:

A strain is a stretched or torn tendon (tissue that connects muscle to bone). The common symptoms of a strain include:

Tendinitis is the irritation or inflammation of a tendon. For runners, tendinitis is often caused by:

  • overuse (running too far or for too long)
  • equipment (wearing the wrong shoes)
  • repetition (running in only one direction on the track)
  • physical attributes (low arches, flat feet)

Common symptoms of tendinitis include:

  • pain (sometimes described as a dull ache when the ankle is moved)
  • limited swelling
  • tenderness

Stress fractures are tiny cracks in a bone that are typically caused by repetitive force and overuse. Runners may experience stress fractures if they:

  • run excessive miles
  • greatly increase their mileage, such as adding extra running days
  • change running surfaces, such as moving from a treadmill to an outdoor track
  • do not cross-train (by doing forms of exercise that focus on different areas of the body)
  • do not get proper nutrition, such as enough vitamin D and calcium

Common symptoms of a stress fracture include:

  • pain that worsens over time but diminishes during rest
  • limited swelling
  • possible bruising

The first step in treating ankle pain is to reduce the stress on your ankle and allow your body to heal. In other words, take a break from running. This is the first phase of the RICE treatment method:

  • Rest. Avoid putting weight on the ankle for 48 to 72 hours.
  • Ice. Get an ice pack on the injury as soon as possible. For the first 48 hours, or until swelling improves, ice your ankle for 15 to 20 minutes, four to eight times a day.
  • Compress. Wrap your ankle with an elastic bandage or use a compression sleeve designed for ankles.
  • Elevate. When possible, keep the ankle raised above your heart.

RICE is designed to relieve pain, reduce swelling, and speed healing. You might also consider over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) as needed for pain and inflammation.

When experiencing ankle pain, see your doctor if:

  • your pain lasts for more than three days
  • you can’t run after a week of rest
  • you can’t bear weight on your ankle
  • your ankle feels numb or unstable
  • you have symptoms of an infection (your ankle becomes very red or red streaks extend from the injury)
  • your ankle has been previously injured many times

Running puts a lot of stress on the ankles, which can result in tenderness and pain. The discomfort could be caused by, among other things:

  • overuse
  • lack of proper nutrition
  • incorrect footwear
  • a change in running surfaces

Treat a sore ankle with the RICE method (rest, ice, compress, elevate). If the pain persists for a few days, see your doctor for a diagnosis and recommended treatment.