Quick answer: Inner Ankle Pain Running And Walking has multiple potential causes including mechanical, neurological, vascular, and inflammatory. The patterns we see most often are overuse, poorly-fitted shoes, and biomechanical imbalance. Red flags requiring urgent evaluation: warmth/redness (infection), inability to bear weight (fracture), and unilateral swelling without injury (DVT). Call (810) 206-1402.
β Medically Reviewed by Dr. Tom Biernacki, DPM
Board-certified podiatric physician & surgeon | Balance Foot & Ankle | Updated April 2026
The most important clinical decision with Inner Ankle Pain Running And Walking isn’t which treatment to start with — it’s identifying the correct subtype. That changes everything. Call (810) 206-1402.
Pain in Inner Ankle: 6 Causes (Podiatrist 2026)
Pain in inner ankle is most often caused by: (1) posterior tibial tendon dysfunction (PTTD) — #1 cause in adults over 40, (2) tarsal tunnel syndrome (pinched tibial nerve causing burning + tingling), (3) medial ankle sprain (deltoid ligament), (4) flexor hallucis longus tendinopathy (“dancer’s tendinitis”), (5) medial malleolus stress fracture, or (6) saphenous nerve entrapment.
In my Michigan podiatry clinic, ~50% of inner ankle pain in adults is PTTD. Treatment: medial-post orthotic + Aircast AirLift PTTD brace + eccentric heel raises + 6 weeks of activity modification — about 70-80% of stage 1-2 patients avoid surgery if started within 6 months. Red flag: arch visibly collapsed, can’t perform single-leg heel raise, or burning down the bottom of the foot — that’s stage 2-3 PTTD or tarsal tunnel and needs a podiatrist within 2 weeks before tendon ruptures.
Medically reviewed by Dr. Tom Biernacki, DPM Β· Board-Certified Podiatric Surgeon Β· Last reviewed: April 2026 Β· Editorial Policy
Quick Answer
Inner Ankle Pain Running & Walking 2026: Causes & relates to foot pain β typically caused by overuse, footwear, or biomechanics. Most patients improve in 6-12 weeks with conservative care. Same-week appointments in Howell + Bloomfield Township: (810) 206-1402.
β Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatrist Β· Last updated April 6, 2026
How to Treat Inner Ankle Pain When Running or Walking?
Do you have inner ankle pain and swelling when walking or running? This may be posterior tibial tendonitis! Sharp pain in the inner bone?
Inner Ankle Pain When Walking or Running Video:
https://youtu.be/bkiRUlAfnZoInner Ankle Pain after Running & Walking Video Summary:
π¦Ά Do you have Inside of the Ankle Pain, Inside of the Arch Pain, or Inside of the Foot Pain? Try the BEST Posterior Tibial Tendonitis Home Treatment!π¦Ά
Do you have posterior tibial tendonitis pain? Inner Ankle Pain when walking? Inner ankle pain when running? This guide will help!
0:00 Posterior Tibial Tendonitis Treatment
0:42 Posterior Tibial Tendonitis Causes
1:07 Posterior Tibial Tendonitis Symptoms
1:38 Posterior Tibial Tendonitis Podiatrist Treatment
2:02 Posterior Tibial Tendon Tear
2:20 Posterior Tibial Tendonitis Surgery
2:45 Posterior Tibial Tendon Injection
3:05 Posterior Tibial Tendonitis Medication
3:32 Posterior Tibial Tendonitis Home Remedies
3:59 Posterior Tibial Tendonitis Ice vs. Heat
4:38 Posterior Tibial Tendonitis Massage
5:58 Posterior Tibial Tendonitis Biomechanics
6:44 Posterior Tibial Tendonitis Stretches
7:26 Posterior Tibial Tendonitis Cast
7:54 Posterior Tibial Tendonitis Boot
8:50 Posterior Tibial Tendonitis Cross-Training
9:48 Posterior Tibial Tendonitis Braces
10:26 Posterior Tibial Tendonitis Best Orthotics
11:35 Posterior Tibial Tendonitis Best Shoes
12:39 Posterior Tibial Tendonitis Rehabilitation
13:25 Posterior Tibial Tendonitis Physical Therapy
13:52 Posterior Tibial Tendonitis Warm-up
14:20 Posterior Tibial Tendonitis Massage
14:38 Posterior Tibial Tendonitis Stretching
15:00 Products
Inner Ankle Pain Symptoms?
Sharp pains in your arch or inner ankle? Popping sensations? Sore to the touch? These are all signs you might have posterior tibial tendonitis!
Posterior tibial tendonitis is a common runner’s injury that can stop you in your tracks and make you wonder if you will ever run pain-free again. Never fear, though. We can help you can back on track, literally!
Causes:
The posterior tibial tendon is one of the most important tendons of the leg. This tendon attaches the calf muscle to the bones of the inside foot. The main function is to hold up the arch and support the foot while walking. An acute injury like a fall can tear the tendon or cause it to become inflamed. Once the tendon becomes damaged, the arch will slowly fall over time. This can cause pain along the inside of the foot or ankle, pain that worsens with activity, and pain outside the ankle due to compensation.
Inner Ankle Pain Home Treatment
- Resting your foot as much as possible to reduce pressure on the arch is a good strategy.
- Staying off your foot as much as possible and switching to swimming or bicycling to reduce foot pressure is also a good strategy.
- Icing your foot – you can use a freezer gel pack or a plastic bag with some ice wrapped in a cloth. Place it on your foot around your arch. You may need to use medical tape or tie a cloth around the ice pack to keep it in position on the foot.
- Anti-inflammatory medications include topical analgesic gel, Motrin, Advil, or Aleve by mouth to reduce swelling and pain.
- Once pain allows, do calf stretching and perform strengthening exercises for the tendon, such as a seated theraband with light resistance-type exercise.
Isn’t Home treatment working? We have several in-office ways to help you
Podiatrist Diagnosis:
I will do a physical examination to look for several signs of this condition, such as swelling, a change in the foot’s shape, toe layout, flexibility, and range of motion. X-ray, ultrasound, MRI, and CT scans may also be used to further evaluate the tendon and rule out a posterior tibial tendon tear.
Schedule an appointment with us in Michigan if you are not getting better!
“If you are inside of the ankle pain, inner ankle pain while running an inner ankle pain while walking is not can better after a month or 2, you need to see a podiatrist excavation point,” Says Michigan podiatrist Dr. Tom Biernacki DPM.
In Office Treatment
- Physical therapy is something I can write a prescription for if home stretches are not enough. Physical therapists offer rehabilitation exercises or other modalities to help the foot heal.
- I can also give steroid injections or prescribe stronger anti-inflammatory medication.
- Podiatry recommended orthotics – insoles for posterior tibial tendon problems should support the medial longitudinal arch.
- I may prescribe bracing or a CAM boot to keep the foot immobilized. A lace-up ankle brace may help mild to moderate flatfoot by supporting the joints of the back of the foot and taking tension off the tendon. A custom-molded leather brace is needed for the severe flat foot that is stiff or arthritic. The brace can help some patients avoid surgery.
- Additional treatment options, including surgery, may even be discussed
When can I return to running after inner ankle pain?
Posterior Tibial Tendonitis can cause permanent damage if not properly taken care of, so returning to running should be very gradual. If you think you may be experiencing symptoms of posterior tibial tendonitis, please schedule an appointment for an evaluation.
Possible Causes of Inner Ankle Pain When Walking or Running:
Overuse/chronic medial ankle pain: The following injuries are common causes of pain on the inside of the ankle, occurring gradually over time. They are often the result of overuse:
Tibialis posterior tendinopathy & tendonitis:
Tibialis posterior tendonitis – medial ankle pain
Tibialis posterior tendinopathy causes pain inside the ankle, under the medial malleolus (bony bit inside the ankle).
Symptoms include:
- Gradual onset pain is located under and behind the medial malleolus, on the inside of your ankle.
- Pain may also radiate under the arch of your foot.
- More on Tibialis posterior tendinopathy
- Flexor hallucis longus tendinopathy
- Flexor hallucis longus
- Flexor hallucis longus tendinopathy or flexor tendonitis is inflammation or degeneration of the flexor tendons in the foot. Symptoms include:
Flexor hallucis longus tendonitis:
- Pain on the inside of the ankle: Specifically, pain along the length of the tendon as it passes around the back of the medial malleolus and into the foot’s arch.
More of the Flexor hallucis longus tendon injury:
Medial calaneal nerve entrapment:
This is also known as Baxter’s nerve:
- Medial calcaneal nerve entrapment has similar symptoms to that of tarsal tunnel syndrome.
- You will feel a burning pain below the medial malleolus (bony bit on the inside of your ankle).
- Pain may radiate under the sole into the arch of your foot.
- Running usually aggravates the condition.
- You may also have tenderness over the medial malleolus.
More on medial calcaneal nerve entrapment
Tarsal Tunnel Syndrome:
Tarsal tunnel syndrome medial ankle pain
- Tarsal tunnel syndrome is caused by pressure on the posterior tibial nerve as it passes on the inside of the ankle. Symptoms consist of:
- Burning pain in your heel can radiate into your foot’s arch.
- The sole of your foot may feel numb, or you may experience pins and needles.
More on Tarsal Tunnel Syndrome
Talar stress fracture:
- The talus bone is the bone at the top of the ankle, where the tibia or shin bone sits. A stress fracture of the talus is a hairline crack in the bone caused by overuse.
- Symptoms are more likely to include gradual onset pain outside the ankle but may also be felt on the inside.
- Exercise will worsen symptoms, particularly running, and ease with rest.
Medial malleolar stress fracture:
- The medial malleolus is the bony bit on the inside of the ankle. A stress fracture of the medial malleolus can occur but is very rare2.
- It causes pain on the inside of the ankle, which is exacerbated by activity, especially running and jumping.
- You will have specific point tenderness over the medial malleolus where the fracture is located.
- You may also be swelling, but not in all cases.
- If the stress fracture is in the early stages, it may not show up on an X-ray, but a bone scan, CT scan, or MRI can confirm the diagnosis.
More on Medial malleolar stress fracture.
Posterior ankle impingement:
Ankle impingement is when a bony growth at either the front or back of the ankle bone restricts normal ankle range of motion. Impingement means tissues have become trapped between bones.
Pain is usually felt at the back of the ankle but can radiate or manifest on the inside of the ankle.
There will be tenderness behind the bottom tip of the fibula bone.
Pain will most likely be worse at the end of the movement when the foot is pointed down into plantarflexion with the foot pointing downwards.
Going up onto tiptoes may be painful. An X-ray can show up any bony spurs on the talus (heel bone) and end of the tibia (shin bone).
Referred pain:
Pain on the inside of the ankle may be referred from injuries or conditions elsewhere in the body. For example, sciatic pain from the lower back can radiate down into the leg. Trapped nerves in the foot may also cause medial ankle pain.
More on referred pain and nerve pain.
Eversion ankle sprain:
Eversion ankle sprain
An eversion ankle sprain occurs when your ankle rolls inwards. It is much rarer than a normal ankle strain and is often accompanied by a fracture of the fibula bone.
More on Eversion ankle sprains
Ankle sprain
Sprained ankle
A conventional ankle sprain will likely cause most pain outside the ankle. However, bruising of the bone on the inside of the ankle can also occur from compression.
Navicular stress fracture:
Symptoms of a navicular stress fracture include a poorly localized ache in the midfoot, which worsens with exercise.
Pain may radiate along the inside arch of the foot and goes away quickly with rest, only to return as training resumes.
Tenderness may be felt when the thumb is pressed into the top of the foot over the navicular bone, called the N spot.
Read more on Navicular stress fracture.
References & further reading
Rolf C, Guntner P, Ekenman I et al. Dislocation of the posterior tibialis tendon: diagnosis and treatment. J Foot Ankle Surg 1997;36(1):63–5.
Brukner P, Bennell K, Matheson G. Stress Fractures. Melbourne: Blackwells Scientific Asia, 1999.
Inner Ankle Pain Stages & Healing Time:
Posterior tibial tendonitis is classified according to the stage of the condition.
Stage 1:
The earliest stage is having pain and swelling along the tendon. The foot may appear completely normal. On the other hand, some people may notice their foot has a mild flatfoot deformity. This may be something they feel they have always had.
Usually, this gets better within a few weeks or months.
Stage 2:
When they stand, the foot appears flat along its inner side. As the condition progresses, the arch of the foot begins to collapse. At this stage, it may be possible to correct the flattened arch.
The healing time can be weeks.
Stage 3:
In stage 3 of the condition, called a rigid flatfoot deformity, a physician cannot easily correct the foot.
The healing time may be weeks or months.
Stage 4:
In stage 4, the foot is involved, and the adjacent ankle joint is also affected by the condition.
The healing time can be numerous months.
Related Treatment Guides
- Sports Foot & Ankle Injury Treatment
- Posterior Tibial Tendon Dysfunction Treatment
- Plantar Fasciitis & Heel Pain Treatment
- Custom 3D Orthotics
Medical References & Sources
- American Podiatric Medical Association — Patient Education
- American Orthopaedic Foot & Ankle Society — Foot Conditions
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Howell, MI 48843
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When to See a Podiatrist
Athletic injuries heal faster with sport-specific rehab protocols β not generic rest and ice. Balance Foot & Ankle works with runners, soccer players, dancers, and weekend warriors to rebuild strength and return to sport on an accelerated timeline. Don’t let a foot injury keep you sidelined longer than necessary.
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Pros & Cons of Conservative Care for foot care
Advantages
- β Conservative care first
- β Same-week appointments
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Considerations
- β Self-treatment can mask issues
- β See a podiatrist if pain >2 weeks
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About Your Care Team at Balance Foot & Ankle
Dr. Tom Biernacki, DPM Β· Board-Certified Foot & Ankle Surgeon. Specializes in conservative-first care, minimally invasive bunion surgery, and complex reconstruction.
Dr. Carl Jay, DPM Β· Accepting new patients. Specializes in sports medicine, athletic injuries, and routine podiatric care.
Dr. Daria Gutkin, DPM, AACFAS Β· Accepting new patients. Specializes in surgical reconstruction and pediatric podiatry.
Locations: 4330 E Grand River Ave, Howell, MI 48843 Β· 43494 Woodward Ave Suite 208, Bloomfield Township, MI 48302
Hours: MonβFri 8:00 AM β 5:00 PM Β· (810) 206-1402
In-Office Treatment at Balance Foot & Ankle
If home treatment isn’t providing relief for your foot and ankle conditions, our podiatry team at Balance Foot & Ankle can help with same-day evaluations and advanced in-office care.
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Shop Doctor Hoy’s →Frequently Asked Questions
When should I see a doctor?
See a podiatrist if pain persists past 2 weeks, prevents normal activity, or is accompanied by red-flag symptoms (warmth, swelling, numbness, inability to bear weight).
Can I treat this at home?
Mild cases respond to RICE protocol (rest, ice, compression, elevation), supportive shoes, and OTC anti-inflammatories. Persistent symptoms need professional evaluation.
How long does it take to heal?
Most soft tissue injuries resolve in 2-6 weeks with appropriate care. Bone injuries take 6-12 weeks. Chronic conditions need longer-term management.
Dr. Tom Biernacki, DPM is a board-certified foot & ankle surgeon (ABFAS & ABPM) at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has made him one of the most-followed foot & ankle educators on YouTube.
More questions patients ask
What causes inner ankle pain when running or walking?
Inner (medial) ankle pain with activity has multiple potential causes: posterior tibial tendonitis (most common β the tendon that supports the arch, runs behind the inner ankle), tarsal tunnel syndrome (posterior tibial nerve compression at the inner ankle causing burning/numbness), stress fracture of the medial malleolus or navicular bone, deltoid ligament sprain (inner ankle ligament injury), flexor hallucis longus tendonitis (the tendon to the big toe), and arthritis of the ankle or subtalar joint. At Balance Foot & Ankle in Howell (4330 E Grand River) and Bloomfield Township (43494 Woodward Ave #208), we pinpoint the exact cause of medial ankle pain β call (810) 206-1402.
What is posterior tibial tendonitis and how is it treated?
Posterior tibial tendonitis (PTT) is inflammation or degeneration of the posterior tibial tendon β the main tendon supporting the arch. It is the most common cause of adult-acquired flatfoot. Symptoms: medial ankle pain (behind and below the inner ankle bone), arch pain, swelling, and progressive flattening of the arch (the 'too many toes' sign when viewed from behind β the heel drifts outward). Treatment: orthotics (critical β arch support to offload the tendon), physical therapy, ankle brace, NSAIDs, and for severe cases, surgical reconstruction. At Balance Foot & Ankle, we specialize in PTT management β call (810) 206-1402.
Is inner ankle pain serious?
Inner ankle pain should always be properly evaluated β some causes are benign and resolve with conservative care, while others (posterior tibial tendon rupture, stress fractures, tarsal coalition) can lead to permanent deformity or disability if neglected. The posterior tibial tendon, in particular, is sometimes called the 'keystone' of the arch β complete rupture leads to progressive flatfoot collapse and ankle arthritis that may ultimately require complex reconstructive surgery. Early treatment produces far better outcomes. At Balance Foot & Ankle in Howell and Bloomfield Township, MI, we provide prompt evaluation of medial ankle pain β call (810) 206-1402.
Can orthotics help medial ankle pain?
Custom orthotics are one of the most effective treatments for medial ankle pain, particularly for posterior tibial tendonitis and flatfoot-related conditions. They support the arch, control excessive pronation (the inward rolling that stresses the medial ankle), redistribute pressure, and reduce the workload on the posterior tibial tendon. Over-the-counter insoles may provide partial relief but custom orthotics β based on a biomechanical examination and casting or scanning of your foot β provide superior support for medically significant conditions. At Balance Foot & Ankle, we fabricate custom orthotics in-office β call (810) 206-1402.
Should I stop running with inner ankle pain?
Whether to continue running with medial ankle pain depends on severity. For mild discomfort that doesn't worsen during or significantly after the run: activity modification (reduce mileage, avoid hills and soft surfaces), better shoes with medial support, and temporary insoles may allow continued running. For pain that worsens during running, limps during running, or is accompanied by swelling β stop running and seek evaluation. Running through significant posterior tibial tendon pain risks complete tendon rupture and permanent flatfoot deformity. At Balance Foot & Ankle, we provide running-specific advice for athletes with medial ankle conditions β call (810) 206-1402.
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