Runner’s Ankle & trail run injury
This topic is close to home for me right now.
About four weeks before my first marathon, a root grabbed my foot during a trail run. What started as a single awkward moment turned into progressively worsening symptoms over the following week and, ultimately, the decision to defer my race.
And honestly? That decision was hard.
There’s a reason there is an entire field of psychology dedicated to sports and athletes. When running is a big part of your life, an injury isn’t just a physical event. It can change your routine, your goals, your identity, your social life, and the way you see your own body.
It’s not easy to have something you’ve been working toward for months change in a matter of seconds.
So, in this month’s blog, I wanted to talk about ankle injuries and pain with running because ankle issues have followed me for over a month now during this training block. And when runners start experiencing pain, I often see them go one of two ways:
1. Push through everything.
“If I can technically run, I’m going to keep running.”
2. Stop everything.
“If something hurts, I shouldn’t run at all.”
There is, of course, a third option: work with a physical therapist 😉
And no, I’m not saying every ache or pain requires a trip to your PT. But there is a pretty big middle ground between ignoring your symptoms and putting your entire training plan on pause.
Trail running and ankle injuries
Running already places a significant amount of repetitive force through the lower extremities, including the Achilles tendon and ankle complex. Add uneven terrain, rocks, roots, changes in elevation, and the occasional moment where the trail decides your foot belongs somewhere it absolutely does not, and things get a little more interesting.
Trail running increases the number of environmental variables your body has to respond to. Your foot may land on a rock you didn't see, your ankle may have to quickly adjust to uneven ground, or, in my case, a root may decide to become a temporary ankle trap.
Which, unfortunately, is also part of the joy of trail running. IYKYK.
During a trail run in Breckenridge, CO, I was about 2.5 miles into my run with approximately 600–700 feet of vertical gain when I didn't lift my foot quite high enough.
My foot got lodged in a root while my forward momentum continued.
Not ideal.
I had to make a very weird movement to get my foot free while simultaneously trying not to faceplant into the trail. Once I finally stopped moving, I sat down on a fallen tree for at least five minutes because I genuinely wasn't sure whether my foot was okay.
Thankfully, this injury wasn't as serious as it initially felt.
I was ultimately able to finish my run using what we call the 4 Pain Rules, which we talk about on The Dual Force podcast. These rules are a helpful framework for determining when pain may be something you can continue moving through versus when it's a sign to modify, stop, or seek additional help.
Aches and pains are normal with training
One of the tricky things about being an active person is that some aches and pains are a normal part of training.
Your body is adapting to increased load. Muscles get sore. Your legs can feel heavy. Something might feel a little stiff after a harder workout or a long run.
Pain doesn't automatically mean you've injured yourself.
What becomes more concerning is when pain starts changing the way you move.
For runners, this might look like:
Limping or altering your walking pattern
Changing your running stride to avoid pain
Suddenly avoiding push-off through one foot
Feeling unstable or like the ankle is going to give way
Shortening your stride significantly
Developing pain that progressively worsens during a run
Pain that continues to increase from one training session to the next
Your body is pretty good at giving you information. Sometimes we just aren't particularly interested in listening to it when there's a race on the calendar.
And I get it.
I've been there.
When you've spent months building mileage, following a training plan, and picturing yourself crossing a finish line, the idea of backing off because of an ankle injury can feel completely unacceptable.
But modifying your training isn't the same thing as giving up.
You don't have to choose between "push through"
and "stop everything"
This is where I think physical therapy can be especially helpful for runners.
The goal isn't always to tell you to stop running.
And it isn't always to tell you that you can keep doing exactly what you've been doing.
Sometimes the answer is somewhere in between.
A physical therapist can help you figure out what your body is currently capable of tolerating, what may need to be modified, and what you can work on while you're still training.
That might mean temporarily reducing mileage, changing terrain, adjusting intensity, incorporating strength work, addressing ankle mobility or stability, or finding other ways to maintain your cardiovascular fitness while symptoms settle down.
The goal is not simply to get you to a point where you can run without pain.
The goal is to help you get back to running confidently and doing the things you actually want to do.
Because sometimes persistence doesn't look like pushing harder.
Sometimes persistence looks like changing the plan.
And yes, I'm learning that one firsthand right now.
Interested in how I can help? Book a free discovery call here
