Ankle injuries specific to running or sports involving running are rare, but both soft tissue and bony injuries can occur in running athletes. Many running-related injuries are caused by repetitive impact stress in individuals who are either unprepared for the physical load, or have subtle to significant foot deformities. While the majority of these injuries are minor and often resolve with non-operative management, others can result in chronic pain, deformity and eventual loss of function and ability to partake in sport. Early identification and management are key. Once a running injury has occurred, cessation of the activity for an appropriate period of time is essential for healing and to enable the individual to return to running. It is important for the clinician to carefully assess the foot and ankle for deformity and/or instability;​ identifying the etiology is vital for developing an appropriate treatment pathway. Subtle foot deformities can often be managed by appropriate orthotic and shoe modifications. At times, the only long-term solution for repetitive or persistent running injuries is to permanently modify the exercise routine and/or duration of activity.