From Ankle Pain to Marathon Success: One Runner's Journey

When pain started on the inside of Al’s ankle during a half marathon, this experienced runner hoped it was just a minor niggle that would settle with a bit of rest.

It didn't.

Instead, the pain gradually worsened, making longer runs increasingly uncomfortable and putting marathon training in doubt.

The Problem

The pain started after an awkward landing while avoiding an obstacle during a half marathon. Although he finished the race, the discomfort never really went away.

Over the following weeks he noticed:

·      Pain on the inside of the ankle, just behind the ankle bone.

·      Pain during runs, followed by a dull ache afterwards.

·      Symptoms that became worse on longer runs.

·      Temporary relief after warming up or taking a few days off.

As the miles became harder to manage, it was clear the problem wasn't going to disappear on its own.

Finding the Cause

A physiotherapy assessment identified the problem as tibialis posterior tendinopathy.

The tibialis posterior tendon helps support the arch of the foot and controls movement with every step. When it's overloaded, it can become painful and make running increasingly difficult.

The Recovery Plan

The goal was simple: reduce pain, rebuild strength and gradually get the tendon ready for running again.

The rehabilitation programme combined several approaches to help Al recover and get back to training. It included guidance on managing training load to avoid overloading the tendon, hands-on treatment for the calf and foot, and a progressive strengthening programme to rebuild the tendon's capacity. Exercises to improve foot stability, balance and hip strength were also introduced, along with advice on choosing supportive footwear. During the early stages of rehabilitation, kinesiology taping was used to help reduce symptoms while the tendon settled.

After discussing the available treatment options, Al also agreed to have four weekly sessions of radial shockwave therapy (rESWT) as part of his rehabilitation.

Back on the Road

After the first shockwave treatment, Al noticed His ankle was already feeling more comfortable. Over the following weeks, pain continued to settle while strength steadily improved.

Running distances were increased gradually, with each stage of rehabilitation building confidence as well as fitness.

By the end of the programme, he had returned to full marathon training and successfully completed a marathon.  {insert Al’s finisher photo}

Don't Let Ankle Pain Stop Your Running

Persistent ankle pain doesn't have to mean the end of your running goals.

Getting the right diagnosis early allows you to start the right treatment and rehabilitation before the problem becomes more difficult to manage.

If ankle pain is limiting your running, a physiotherapy assessment can identify the cause and help you get back to doing what you enjoy with a rehabilitation programme that's tailored to you.

Case Example by Emma Frost-Marchant, Chartered Physiotherapist.