Ask the Personal Trainer: Ankle Pain

How can I prevent ankle pain while walking?
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In our weekly fitness Q&A series, William Sukala, MS, CSCS, answers questions about fitness, from whether to eat before exercising to how to treat sore muscles.

Q: When I walk very fast, the front of my ankles begin to hurt. This happens more on the treadmill than when I walk on my own. Any idea what's wrong, and how I can make the problem go away?

A: What kind of pain are you experiencing? Is it the "ouch, that hurts!" kind of pain or simply muscular fatigue associated with exercise? Assuming there's no underlying injury, there are a couple of possibilities. Perhaps you increased your treadmill speed too quickly. Did you make small, incremental changes in your progression?

Q: When I walk fast on a treadmill, the front of my ankles hurt. What's causing this, and how can I prevent it? It doesn't happen so often when I walk outdoors.

A: If you're walking with an added incline component (percent grade) along with these fast speeds, then you may be overtaxing the dorsiflexor muscles — muscles on the front of the shin that insert onto the front of the ankle. If you're doing too much speed and grade, you may want to reduce them a bit to get below your pain threshold, then add a bit more time. From there, gradually increase your speed and incline so that your body adapts slowly. In addition, you may find it beneficial to stretch your calf muscles since they resist the dorsiflexion movement.

Your pain could also result from overuse within a certain movement pattern. That is, the surface of the treadmill never changes. So your muscles get worked over and over through exactly the same movement patterns with little, if any, variation.

You mentioned that this pain occurs less frequently when you walk outdoors. This would make sense given that each step is a bit different than the last. The varied terrain forces your brain to recruit those muscles a tiny bit differently each time. For example, if you're out walking in the woods, you may have to walk up and down slopes or on slanted ground, so this automatically prevents you from repeating the same movement pattern each time. The variation keeps your muscles from getting "stale" and prevents repetitive overuse.

What about your walking shoes? Is your current pair worn out or lacking proper arch support for your feet? I suggest visiting a specialty running-shoe store with trained staff that can address your concerns and help you find a proper-fitting pair.

If none of these suggestions helps relieve your ankle pain, then I urge you to see your physician for a proper diagnosis and referral.

In this Q&A series, William Sukala, MS, CSCS, answers questions about fitness and exercise. Read more articles from our personal trainer.