Why Is the Inside of My Ankle Sore

Why is there pain on the inside of my ankle?

Does the inside of your ankle hurt? Does the pain or discomfort ease after a warm-up or the start of exercise?

If the answer to those questions is yes, you may* have an injured your Tibialis Posterior! 

The Tibialis Posterior is a muscle in your lower leg and has a tendon which wraps around underneath the medial side of your ankle and attaches onto one of the bones at the bottom of your midfoot.

The muscle is responsible for stabilizing the medial longitudinal arch and prevents excessive pronation of your foot when walking or running. Tibialis Posterior also assists in plantarflexing and inverting the foot too.

Most pain associated with Tibialis Posterior is due to the tendon itself, whereby the stresses or loads placed onto the muscle and tendon have outweighed the muscle and tendon’s capacity to be able to tolerate those stresses and loads. There may be some wear and tear of the tendon which is responsible for the pain, or they may be some inflammation of the sheath that looks to protect and cover the tendon itself. 

Common causes of Tibialis Posterior Tendinopathy: 

  • Sudden changes to activity loads without gradual increases to allow for bodily adaptations
  • Changes to training surfaces (e.g from bitumen to uneven surfaces like grass or sand)
  • Running uphills excessively 
  • Repeated toe walking (e.g wearing heels).
  • Pes planus foot posture (flat foot)
  • Excessive pronation when walking or running 
  • Choices in footwear (e.g wearing very flexible shoes)

What can I do to ease the pain?

  • If there is any inflammation in the area the use of ice to reduce the inflammation can in reducing pain throughout the tendon.
  • Anti-inflammatory medications can also be used to address acute pain (ensure to read instructions of medication before self-medicating)
  • Modifying activity loads. Consulting one of our very experienced podiatrists to ensure your daily or weekly exercise routines will not aggravate the tendon and make the pain worse can be very beneficial. This may be a drastic short-term reduction in loads however gradual increases will be made to allow the muscle and tendon enough time to recover.
  • Changing exercises. If you mainly find yourself walking or running to keep fit, it may be worth looking at other forms of exercise such as cycling or swimming that are not weightbearing. 

How can podiatry help?

Here at TFC Podiatry we take pride in being able to get our patients back to doing what they love doing most, whether that’s going out for leisurely strolls or getting out running again. 

As mentioned before, podiatrists are well versed in load management and exercise planning. We are able to prescribe specific exercises which look to strengthen the Tibialis Posterior muscle and tendon and look to increase the tissue’s capacity to withstand more day-to-day exercise.

Podiatrists can also employ other interventions such as taping or custom foot orthotics to support the muscle and offload those external pressures onto other tissues and structures that will be able to tolerate those added stresses.