Chances are you have heard the human body is 50-60% water by volume, with the majority of that being the intracellular and intercellular fluids, along with blood. This water keeps your cells moist, which is most important for the inner core of your bones, spinal cord and brain. When your body’s fluid systems become unbalanced, gravity will cause a good portion of the water to collect within your feet, ankles and legs, leading to something known as Peripheral Edema.

There are two types of peripheral edema:

1. Pitting Edema: When squeezing the swollen tissue for at least 30 seconds, an indentation remains once you remove pressure and your hand for any length of time.

2. Non-Pitting Edema: As the name implies, no pitting occurs. When you release the skin, it returns to normal.

As you can imagine, pitting edema is worse as it can be a complication of early-to-late organ failure (heart, liver, kidney). Non-pitting edema is more common and usually is the result of lymphatic swelling (blocked lymph nodes) or excess sugar and sugar-like substances in the blood (which settle due to gravity and cause fluid retention due to the concentration gradient).

Most Common Causes of Swollen Ankles

• Water Retention – most commonly from increased table salt and sugar consumption. Water is retained to dilute the excess solids of salt and sugar collecting in your ankles.
• Inflammation – swelling/water retention is the hallmark of inflammation.
• Medications always have side effects. Swelling is common with NSAIDS (Naproxin & Ibuprofen), Insulin, HCTZ/Lisinopril and steroids (cortisol injections included).
• Decreased Protein – albumin is a special blood protein that regulates blood volume. Decreased albumin results in increased leaking across blood membranes.
• Vein Issues – as they are designed to propel fluids from the extremities. Any venous weakness results in stagnation of blood and leaking into the surrounding area. Varicose and Hemorrhoid veins are usually produced in the process.
• Kidney Disorder – due to inability of the kidneys to turn extra fluid into urine.
• Heart Disorder (Congestion) – due to weakness of the heart and difficulty pumping and pulling fluids from the extremities. The heart therefore fills with extra blood, simply due to backup and the veins distend with pressure leading to leakage.
• Lung Disorders – can create additional pressures in the lung, making it difficult for the heart to push blood to the lungs, which leads to a backup of blood in the extremity tissues. This can also lead to pulmonary edema or “fluid on the lungs.”