Swollen Ankles
What causes swollen ankles?
When we are walking around, the muscle pumps in our legs push all the extra fluid back towards our heart, and none gathers around our ankles. However, when we stand or sit for long periods of time, the muscle pumps are not working and fluid begins to build up in the veins in our legs. Sometimes this causes the valves in the veins to leak, and instead of flowing towards the heart, the fluid drains backwards and gathers under the skin of the feet and ankles.
Swollen ankles are much more likely if you suffer with varicose veins, have had a clot in one of the deep veins in the leg, or are pregnant. Older people are also more commonly affected. Women go to see their doctor because of swollen ankles more often than men, but this may be because men can hide their swollen ankles under their trousers and are therefore less bothered by them.
Ankle swelling is very common when flying and many people also have problems when they go on long coach journeys.
Sometimes fluid gathers around the ankles because of an underlying condition, for example if the heart is not pumping properly or the kidneys are not working effectively to get rid of extra fluid. Some people are born with a lack of the normal drainage channels in the legs and they have very swollen legs throughout life.
What will I notice?
You will notice that your feet and ankles are swollen, usually after standing or sitting for a long period. Usually both legs are swollen equally. The swelling may extend up your legs as far as your knees, or even higher if it is severe. Your shoes may be tight, and your calves and ankles will feel tight when you walk. You may notice that you put on weight.
The swelling is usually worse at the end of the day, and better in the morning when you first get out of bed. You may also notice that you have to get up one or more times during the night to pass water, as the excess fluid passes back into your blood and is filtered off by your kidneys.
Occasionally, if your ankles and legs have been very swollen for a long time, the skin may become damaged and develop an ulcer. This can be very hard to heal unless you can reduce the swelling.
What treatment is available?
The most effective treatments rely on gravity or external pressure on your legs to force the fluid back where it belongs. If you have swollen ankles, the most effective treatment is to sit or lie with your feet higher than your heart for 30 to 60 minutes twice a day. Sitting with your feet up on a low stool is not high enough to allow gravity to help drain the fluid away. Either lie on your bed with your feet up on one or more cushions, or lie in a reclining chair tilted fully backwards, or lie on the sofa with your feet on cushions on the armrest. Often the problem can be prevented by getting up and walking around regularly rather than sitting or standing still for long periods of time. Working the calf muscle pumps by rocking backwards and forwards on your feet when standing, or by circling your ankles when sitting, will help to pump the fluid back up.
Support stockings or tights apply external pressure around your feet and ankles to help push the fluid back upwards. They can be used to both prevent and treat swollen ankles. The external pressure provided is highest around the ankles and becomes gradually less further up the legs. This allows the fluid to be massaged upwards when you move around. Support stockings can be prescribed on the NHS, but you will have to buy support tights as these are not available on prescription.
If your ankles are swollen because of an underlying health problem, your doctor will treat that and may prescribe water tablets to help drain off extra fluid. Take these exactly as recommended. If only one ankle or leg is swollen, or you are breathless as well as having swollen ankles, you should see your doctor, as he or she may want to examine you and do some tests.
Help Yourself
- Avoid sitting or standing still for long periods of time. Get up and walk around.
- If you need to sit or stand for long spells, rock backwards and forwards on your feet, or circle your ankles frequently to prevent fluid gathering.
- Consider wearing support stockings or tights if you have to stand for long periods, or when flying.
- If your doctor recommends sitting or lying with your feet up, make sure that they are higher than your heart. Try to find time to do this every day.
- Avoid wearing tight socks or other clothes which cut into the swollen areas.
- Take care not to damage the skin around your ankles. If you do, see your doctor or practice nurse to have it dressed properly.