Inner Ankle Pain
Pain or aching along the inside of the ankle or arch, often worse with running, walking, or long periods on your feet.
Inside of the ankle, sometimes extending into the arch of the foot
Posterior Tibial Tendinopathy
Sometimes, if symptoms stay mild and the tendon is not worsening afterwards
Usually 4 to 12 weeks, depending on irritation levels and tendon strength
Often linked to increased running load, poor foot control, or repeated strain through the inside of the ankle
Can I Keep Running?
Some runners can continue modified running if symptoms stay manageable and the tendon is not significantly worse the next day. If the inside of the ankle becomes increasingly painful, swollen, or fatigued during or after running, it usually means the tendon is not coping with the current load.
Typical Recovery Timeline
Milder cases often improve within 4 to 8 weeks, while more stubborn tendon irritation can take several months to fully settle and rebuild. Like many tendon injuries, symptoms may improve before the tendon is fully ready for normal training again.
What's Actually Going On?
Posterior Tibial Tendinopathy is irritation of the posterior tibial tendon, which helps support the arch and control foot movement during walking and running.
In runners, this tendon can become overloaded when the foot and ankle are repeatedly asked to control more force and stability than they are ready for.
Over time, the tendon becomes irritated, reactive, and less tolerant of repeated loading.
Common Symptoms
Can You Still Run With It?
Sometimes, yes, but only if symptoms stay controlled and the tendon is not becoming progressively more irritated.
Easy flat running is usually tolerated better than hills, longer runs, or uneven terrain.
If the ankle and arch become increasingly sore, fatigued, or painful during daily activity, it usually means the tendon needs a clearer reduction in load and more focused strengthening.
Things That Often Need Adjusting:
Does This Sound Like You?
- The inside of your ankle feels sore after running
- The arch of your foot feels tired or achy
- Longer runs or hills make symptoms worse
- The tendon feels tender behind the inner ankle bone
- The ankle feels less supportive or stable
- Symptoms build gradually over time rather than starting suddenly
Why Do Runners Get This?
This usually happens when the tendon on the inside of the ankle is repeatedly overloaded.
Often the tendon is trying to stabilise and support the foot more than it is capable of handling at that point.
Worth Getting Assessed If:
- •the pain keeps returning
- •walking or standing is becoming uncomfortable
- •the arch feels increasingly fatigued
- •symptoms are not improving with reduced load
- •you are struggling to return to normal running
Get Help Sooner If You Have:
- significant swelling
- increasing weakness through the foot
- worsening arch pain
- difficulty walking normally
- symptoms that are progressively getting worse
- Tendons on the inside of the ankle often stay irritated if strength and foot control are not rebuilt properly.
A Note From Liesel
“A lot of runners keep trying to stretch or massage this area without realising the tendon is often struggling because it is overloaded and underprepared. The runners who usually recover best are the ones who rebuild strength and control properly instead of only chasing short term relief.”
Stop Guessing. Start Moving Forward.
Get a clear clinical diagnosis and a personalised return-to-running plan with Liesel (In-person in Pretoria East or Online via Google Meet).
Book a Consultation