For the Runner With a “Bad Ankle”: Here’s What I’d Actually Do

This is for the runner who has a “bad ankle”

Every time they run, their ankle hurts and gets swollen for a couple days after. They may have chronic ankle instability or recurring ankle sprains — maybe even a couple of injuries years ago — so they've just accepted that "this is the way it's going to be."

If that's you, here's what I need you to know:

The swelling, the pain, the repeated injuries — those are signals. Helpful, important signals.

That's your ankle telling you that it can't keep up with what you're asking of it.

THE GOOD NEWS: that can be solved. It doesn't have to be this way forever.

You don't have a permanently bad ankle.

You can actually solve this — and it might be simpler than you think.

If You Walked Into My Office Today: 3 Things I'd Assess

Obviously, how I assess things will differ person to person. My whole assessment depends on everything you've told me so far — how long has this been going on, what your pain feels like, whether there's a certain distance or pace that triggers it, your injury history, your current training plan.

There's a reason our assessments are 90 minutes.

But at a minimum, here are three things I know I'm looking at:

1. How Your Ankle Responds to Impact

Running is basically thousands of single leg jumps, one after the other, in a row.

So the first thing I want to do is watch you jump.

Every runner needs an ankle that can handle the impact of running — preferably two of them.

If you can't do a double leg pogo without pain, that tells me a LOT about where your ankle baseline is compared to the demands of running. If that's super easy for you, I'll test something more challenging — like a single leg pogo or a depth drop.

Unless you're in a lot of acute pain, I'd also want to watch you run. I'm not overhauling your gait — I'm looking for major red flags side to side. Most of the time, the way we run is a result. In my assessment, I'm prioritizing finding the causes.

2. Ankle Stability and Strength

Running puts a lot of stress through our feet and ankles. Every time we land, we have to absorb that force — then immediately release it as we take off from that foot.

It's also a single leg sport. You're only ever on one foot at a time.

So I'd want to see if you can balance on one foot, whether one ankle is significantly shakier than the other, and what your ankle strength looks like side to side.

A single leg calf raise can tell me a LOT here.

3. Single Leg Strength Up and Down the Chain

Running is like a group project — your ankle doesn't work in isolation. Every muscle needs to do its job when you run.

I'd want to look at your quad, glute, and hamstring strength to see if there's any weakness up the chain that might be showing up in your ankle.

I'm not going to overwhelm you with everything I'd look at — but those three things alone tell me a LOT about where to start.

3 Things I'd Probably Have You Start Working On

The HOW will look different person to person.

I'm looking to challenge your ankle without it swelling up the next day. It's all about finding the right amount of challenge for where you're currently at — that's why the assessment matters so much.

1. Plyometric Exercise

In our assessment, we'll find the most challenging version of jumping that you can do without pain or swelling the next day.

That might look like a band-assisted double leg pogo for 30 seconds — and then we'd progress to single leg from there.

2. Single Leg Stability and Strength

If you've had multiple ankle sprains, chances are your single leg stability is not great.

I love a single leg RDL, single leg KB pass, or a single leg squat to a box to start training your ankle to handle load on one leg and build more single leg strength.

3. Calf Raises

An absolute non-negotiable for runners.

On day one, a lot of people can't do a single leg calf raise without pain. That doesn't mean we skip it — it means we modify.

A common starting point: go up on two feet, come down on one. Build the strength your ankle can tolerate, then progress from there.

My goal is always: find the most challenging version we can recover from, with the least amount of pain. The same goes for your mileage.

One More Thing About Your Running

If your current mileage is flaring you up, we may need to take it down a notch for now so we can actually solve this issue.

While this is an incredibly common problem — and can 100% be solved — it won't fix itself. The longer you push through it, the harder it gets.

Taking a few weeks to solve it NOW means it won't hold you back LATER.

If you want someone to actually look at your ankle and tell you exactly where to start, that's what we're here for.

- Hannah