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Feb
03

Causes and treatments for Ankle Swelling

Dr. Mackarey's Health & Exercise Forum

Ankle swelling is a common symptom that occurs when your body retains fluid in the lower legs, ankles and feet. Most people have experienced it at some point in their lives and it often resolves on its own with elevation and muscle movement. While it is usually benign and occurs on both sides of the body, in some instances immediate medical attention is required. The most common causes of ankle swelling are:

Prolonged Positions – you have probably noticed swelling in your ankles and feet after a long trip by plane or car. Some may also experience symptoms after a long day at work sitting or standing in one position for an extended period of time. It may be the most common cause of lower leg swelling and easiest to resolve. 

Diet– excessive salt in your diet is associated with swelling in the lower legs, especially when associated with other risk factors for swelling such as organ function or obesity.

Varicose Veins – when the valves in the blood vessels which carry blood from the legs back to the heart are damaged, blood and fluid can collect in the lower legs. Prolonged standing or sitting without intermittent movement will worsen the condition. 

Pregnancy – during pregnancy, the body retains more fluids than usual and most women experience some form of swelling in the lower legs, ankles and feet. 

Medications – certain drugs can cause fluid retention in the lower legs such as: anti-inflammatory medications, steroids, diabetes medications, antidepressants and cardiac medications.

Blood Clots – blockages in the blood vessels of the lower leg can limit the movement of fluid from the legs back to the heart. It is often present in only one leg and associated with warmth, pain, and cramping. It is a serious condition and requires immediate medical attention. 

Trauma/Infection – after a trauma or injury such as an ankle sprain, bruise or fracture, the damaged tissue leaks fluid surrounding the affected area. Also, when a specific area of the lower leg becomes infected, as in the case of a cut or splinter in the ankle or foot that has not healed properly, swelling occurs in the surrounding tissues. These situations are often associated with warmth, pain and limited to the side of the injury. Treatment to injured tissues and the infection is required. 

Lymphedema – swelling in the lower leg can occur when there is a blockage in the lymphatic system or when lymph nodes are removed in surgery for cancer. Medications, massage, compression garments, and elevation, can address the symptoms.

Diseases – such as those of the kidney, heart, and liver are associated with swelling in the lower legs.

Obesity – swelling in the tissues of the legs, ankles and feet occurs due to excessive weight placed on these tissues and adipose tissue in the abdomen compressing blood vessels which enter the lower body. Obesity is one of the most common causes of lower leg swelling and it complicates all of the aforementioned conditions associated with swelling in the legs. 

Tips to Control Swelling in the Ankles and Feet

Change Positions – on a long plane ride or sitting all day at school or work – get up and walk around every 30-45 minutes. Set a timer on your phone to remind you.

Exercise – regular exercise keeps the muscles and blood vessels in your lower extremities healthier. Also, intermittent movement of the leg muscles throughout the day, even when sitting, serve to prevent swelling. Try ankle pumps and toe curls.

Elevation – when sitting or lying down, try elevating your ankles and feet on a pillow to allow gravity to assist fluid movement in your legs.

Low-Sodium Diet – read the labels on your food and you will be shocked by how much sodium is in most foods, especially canned soups and vegetables. But, there are low-sodium options and don’t add more salt to your food.

Weight Loss – maintaining a healthy BMI is the single best thing you can do, not only for lower leg swelling, but for your overall health and wellness.

Compression Socks – for most people, over-the-counter compression socks will adequately prevent fluid retention in the lower legs. For comfort, begin with the lightest compression possible. 12-15 or 15-20 mm of mercury is a good start and put them on as soon as you get up in the morning, before swelling begins.

When to See Your Physician about Lower Leg Swelling –

  • If you have a history of kidney, liver or heart disease and notice an increase in leg swelling
  • If the swelling in your leg or legs are associated with warmth, redness and pain
  • If you are have increased swelling in your lower legs and are running a temperature
  • If you are pregnant and have sudden or severe onset of swelling
  • If you tried conservative management (elevation, frequent positional changes) without success
  • If the swelling in your lower legs continues to get worse 
  • If you have lower leg swelling and notice shortness of breath

Sources: WebMD and Cleveland Clinic

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This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine.