The term and the phenomenon deserve some sensitivity: A doctor of podiatry cautions when swollen ankles can signal underlying health concerns.
Cankles: A Cleveland Clinic Expert Discusses Possible Causes and Treatments
Published on Mar. 24, 2025
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Swollen or thick ankles, non-medically referred to as “cankles,” are a concern that may increase with age. Research published in the peer-reviewed journal PLOS One found that between 2000 and 2016, approximately 19% to 20% of older U.S. adults experienced peripheral edema, a condition that causes fluid retention and swelling in the lower limbs, sometimes leading to the appearance of cankles.
For some, cankles are simply a natural part of their body structure and require no medical intervention. However, when swelling is the primary cause, it may signal an underlying health issue, such as poor circulation, lymphedema, kidney or heart conditions, or fluid retention related to diet and lifestyle. Recognizing the difference between genetic traits and medical concerns can help determine whether treatment or lifestyle adjustments are necessary.
Ahead, we explore everything you need to know about cankles, including their most common causes. Plus, we share insights from Cleveland Clinic podiatrist Georgeanne Botek, DPM, on effective strategies for treating and preventing swelling.
What are cankles?
Cankles is a non-medical term that describes ankles that lack a distinct taper between the calf and foot, creating a thicker, more uniform appearance. While some people naturally have this lower leg shape, cankles can also result from factors like fluid retention, weight distribution, or medical conditions that affect circulation and lymphatic drainage.
What cankles can reveal about your health
In some cases, cankles are simply a natural variation in body shape and pose no health risks. However, when swelling causes the ankles to appear thicker, it may signal an underlying medical issue.
According to the Cleveland Clinic, persistent or sudden swelling can be linked to circulatory problems, lymphatic blockages, or organ-related conditions such as heart, kidney, or liver disease. Medical experts warn that ongoing or worsening ankle swelling may indicate venous insufficiency, in which blood struggles to flow properly through the leg veins, or lymphedema, a condition caused by fluid buildup due to impaired lymphatic drainage.
Also, if cankles are accompanied by pain, redness, or significant swelling, it’s essential to seek medical attention to rule out serious concerns like deep vein thrombosis (DVT) or heart failure.
What causes cankles?
There are several reasons why someone might develop cankles. Here’s a breakdown of the most common causes of cankles (and before trying to address any of them yourself, always speak with a licensed, credentialed doctor).
1. Predisposition
If several members of your family have a similar ankle structure, your lower leg shape may be hereditary. Some individuals naturally have a wider ankle bone structure or more muscle mass in the lower legs, which can create the appearance of cankles. However, it’s important not to assume genetics is the only factor. Be sure to consult your doctor to rule out any underlying health conditions that may contribute to swelling or changes in ankle appearance.
2. Fluid retention (edema)
Excess fluid can accumulate in the lower legs due to prolonged sitting or standing, high salt intake, or hot weather. Temporary swelling often resolves with leg elevation, movement, and hydration. However, persistent edema may signal an underlying health issue like kidney disease, heart failure, or venous insufficiency.
3. Weight and fat distribution
Excess weight can contribute to cankles by increasing fat deposits around the ankles and affecting circulation. People with obesity are at a higher risk of developing fluid retention in the lower legs due to increased pressure on the veins, leading to poor blood flow and swelling.
4. Pregnancy
Hormonal changes and increased blood volume during pregnancy can lead to swollen feet and ankles. The pressure from the growing uterus also slows blood flow from the legs, causing fluid buildup. While mild swelling is normal, sudden or severe swelling should be evaluated by a doctor to rule out preeclampsia.
5. Poor circulation (venous insufficiency)
When leg veins struggle to push blood back toward the heart, fluid can pool in the lower legs, resulting in swelling and the appearance of cankles. This condition, called chronic venous insufficiency, often occurs in people with varicose veins or a history of prolonged standing.
6. Lymphedema
Lymphedema occurs when the lymphatic system fails to properly drain fluid, causing swelling in the ankles and feet. It can be caused by genetic conditions, infections, surgery, or cancer treatments that damage lymph nodes.
7. Medications
Certain medications, including blood pressure drugs (calcium channel blockers), steroids, and hormonal treatments, can lead to water retention and swelling in the lower extremities.
8. Heart, kidney, or liver conditions
Organ-related diseases can cause fluid buildup in the body, leading to ankle swelling. Congestive heart failure, kidney disease, and liver cirrhosis can all contribute to chronic cankles, particularly when accompanied by other symptoms like fatigue or shortness of breath.
How to treat cankles
The best approach to treating cankles depends on their underlying cause. “When it comes to swelling, it’s about management and getting through the day,” Dr. Botek says in the Clinic’s Health Essentials blog. “There’s nothing that’s necessarily curative, but you can take steps to ease pain and discomfort.”
With that in mind, here are some doctor-approved strategies to help reduce swelling:
Exercise
Regular physical activity can improve circulation and prevent fluid buildup in the lower legs. Cardio exercises like walking, cycling, and swimming help keep blood flowing, while strength training exercises such as calf raises can tone and define the lower legs. It’s also important to avoid prolonged sitting or standing—taking movement breaks throughout the day can prevent swelling and discomfort.
Dietary changes
Adjusting your diet can play a key role in reducing swelling and fluid retention. Cutting back on salt can help prevent bloating, as excess sodium causes the body to retain water.
Dr. Botek explains that when the body senses dehydration, it compensates by holding onto fluids, which can lead to swelling. Drinking more water helps signal to the body that hydration levels are sufficient, allowing it to naturally flush out excess sodium and waste.
Magnesium deficiency may also contribute to water retention, so ensuring adequate intake of this essential mineral could help. Magnesium-rich foods to incorporate into your diet include leafy greens like spinach and kale; nuts and seeds such as almonds, pumpkin seeds, and cashews; whole grains; avocados; and bananas.
Compression therapy
Wearing compression socks can improve circulation and reduce swelling by applying gentle pressure to the lower legs. These socks are widely available at pharmacies, shoe retailers, and online stores, and they come in different levels of compression. Dr. Botek recommends starting with a lightweight option and ensuring the fit isn’t too tight for comfort. Putting them on in the morning and wearing them throughout the day can be particularly effective. Additionally, elevating the legs while resting can help drain excess fluid and further reduce swelling.
Medical interventions
For chronic swelling that doesn’t improve with lifestyle changes, doctors may prescribe diuretics, also known as water pills, to help the body eliminate excess fluid. In cases where poor circulation is contributing to the problem, treatments such as sclerotherapy or laser therapy may help by addressing vein-related issues and improving blood flow.
How to prevent cankles
To reduce your risk of developing cankles, consider these strategies:
- Maintain a healthy weight to avoid excess fat accumulation in the lower legs.
- Stay active with regular exercise to promote circulation and reduce fluid retention.
- Limit salt intake and eat a balanced diet to prevent bloating and swelling.
- Avoid prolonged sitting or standing by taking breaks to move around.
- Use compression socks if you experience frequent swelling.
- Drink plenty of water to help your body regulate fluid balance.
Dr. Botek recommends combining multiple strategies for the best results. For example, if walking is part of your exercise routine, consider wearing compression socks as well and elevating your feet later in the day to maximize the benefits.
When to see a doctor
It’s important to seek medical attention for swelling in your feet and ankles if you experience any of the following:
- Sudden or severe swelling, especially in one leg (which could indicate a blood clot).
- Swelling accompanied by pain, redness, or warmth in the ankle or calf.
- Persistent swelling that doesn’t improve with elevation or lifestyle changes.
- Swelling along with shortness of breath, chest pain, or rapid weight gain, which may indicate heart or kidney problems.
- Pregnancy-related swelling that appears suddenly or is accompanied by high blood pressure (a sign of preeclampsia).
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