Introduction: Running is a widely accessible and popular means of exercise that confers many health benefits. There has been an increase of acute running related injuries (RRI) because most runners increased the volume and intensity of their running workouts during the pandemic. The purpose of this systematic review was to determine the causative factors for three distinct running related injuries to the ankle- Achilles tendinopathy, peroneal tendonitis, and ankle sprains and their implications in pediatric, adult, and elderly populations. Additionally, we sought to propose recommendations on how to prevent, treat, and rehabilitate these injuries to optimize return to play and running. Methods: A systematic literature review was performed using PubMed, CINAHL and EMBASE in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies that evaluated running related ankle injuries were selected and were included if they were randomized control trials (RCT’s), which discussed prevention or management of Achilles tendinopathy, peroneal tendinitis, or ankle sprains in a pediatric, adult or elderly population.

Results: A total of 189 studies were identified and 12 met inclusion criteria. Six of the 12 (50%) studies found foot core strengthening exercises to not only prevent ankle instability issues, but also assist in the rehabilitation process following injury. Four of the 12 (33%) studies discussed the causes of Achilles tendinopathy and different methods to manage the injury either by changes in training volume, intensity, shoe type or range of motion of the ankle joint. Two of 12 (17%) studies discussed rehabilitation of the ankle-foot complex following lateral and medial ankle sprains. All twelve (100%) of the studies researched an adult population, with 1 study (8%) discussing ankle instability implications in the elderly and 2 studies (17%) discussing running related ankle injury in a pediatric population. Conclusion: Conservative management using devices such as rocker shoes and orthoses can help alleviate symptoms associated with Achilles and peroneal tendonitis. However, progressively training and strengthening the ankle-foot complex using the reviewed methods will result in a joint that will be less prone to injury and more compliant with training demands.