Differential Diagnosis and Treatment of Medial Ankle Pain in Long Distance Runners

This course provides an in-depth exploration of medial ankle pain specific to runners and running-related injuries, presented through a practical case study format. Participants will learn how to perform a comprehensive subjective evaluation tailored to runners-covering training routines, footwear, and social or environmental factors that influence healing and injury risk.

Through discussion of patient history and key subjective findings, the audience will learn to identify red flags, recognize training errors, and assess biomechanical and social determinants that contribute to a multifactorial cause of injury. This approach emphasizes understanding the runner’s mindset, enabling clinicians to design treatment plans that align with training goals. Using this approach can enhance better therapeutic alliance and patient engagement.

Given that symptoms in distance runners can be difficult to reproduce in the clinic, this course will instruct participants which questions to ask, and which tests to perform to accurately identify the source of pain.

Differential diagnosis will be reviewed for bone, soft tissue, and neural sources, and discuss how to determine tissue irritability to guide safe treatment and training progression.

The presentation will also explore:

• How to modify training loads while managing injury.
• Evidence-based strategies for gait assessment and retraining in runners.
• The role of musculoskeletal ultrasound in identifying tissue dysfunction to enhance clinical decision- making.
• Treatment approach including appropriate exercise dosage, and effective use of manual therapy techniques.

By the end of the course, the audience will have the tools to confidently assess, diagnose, and treat medial ankle pain in runners, while keeping patients active and engaged in their sport.

Upon completion of this session, the attendee will be able to - 

• Determine the most appropriate specific runner-related history questions and be able to identify key findings from subjective information.
• Use evidence-based practice to differentially diagnose between multiple diagnoses and come up with the most likely diagnosis and understand why.
• Identify key findings from the use of MSKUS that can guide the most appropriate treatment.
• Apply a manual therapy-based treatment approach to treatment of medial ankle pain on a long-distance runner.