What You Need To Know About the Causes and Management of Cankles

Medically reviewed by Jane Kim, MDMedically reviewed by Jane Kim, MD

Cankles refers to thicker ankles that appear to blend into the lower calf. This non-medical term comes from combining "calves" and "ankles." Cankles are often a normal physical variation in people who are genetically predisposed to have larger ankles.

However, you may develop cankles from swelling if you have a health condition that affects fluid retention. People who are overweight, have certain dietary habits, or stand on their feet for long periods can also be at higher risk for swollen ankles.

What Do Cankles Look Like?

Typically, the leg narrows at the ankles because the ankles do not contain the same bulkier calf muscles further up the leg. If you have cankles, your leg doesn't narrow at your ankle. Instead, it looks like your calf and ankle are one body part. A larger ankle may be due to more body fat accumulating on the ankles and lower body. 

If you have cankles due to swelling, you may also have swollen feet and legs that are filled with fluid. Your ankles and lower legs may also look red and feel warm. Sometimes, your ankle may feel sore or difficult to walk on. 

What Causes Cankles?

Cankles are often the result of edema—or swelling caused by fluid buildup in the feet and legs. You may be more prone to developing edema due to genetics, injury, medications, lifestyle, or underlying health conditions. Other people may have cankles due to their genetics or abnormal fat deposits in the lower body.

Lifestyle

Ankle swelling can result from daily activities and habits. Eating diets high in salt can contribute to fluid retention and increase the risk of edema. In addition, people who are overweight are more likely to experience edema.

Standing or walking for long periods, especially in warm weather, can also cause the feet and lower legs to swell. If you spend a lot of time outdoors, getting a sunburn or a bug bite on your legs may lead to swelling and cankles.

Injuries

Injuring your leg, ankle, or foot can cause the area to start swelling, creating the appearance of a cankle. Swelling is common if you sprain or strain the ankle. Injury to the ankle bone (the talus) can specifically lead to osteochondral defects (OCD). These injuries can cause cartilage layers to blister or fracture. You can also develop cyst-like lesions in the bone. As a result, you may experience ankle pain, swelling, and instability.

People who have pelvic surgery, typically for cancer, are also more likely to deal with lymph fluid buildup that leads to edema and swollen ankles. 

Pregnancy or Pregnancy Complications

Many people experience some swelling of the lower legs during pregnancy as blood volume increases and their body begins to retain more fluid. However, severe swelling of the ankles and feet can be a sign of preeclampsia.Preeclampsia is a high blood pressure condition that affects pregnant people, typically after the 20th week. If left untreated, this serious condition can lead to pregnancy complications, including fetal and maternal death. 

Medications

Your lower legs and ankles may begin to retain fluid and swell from taking medications like:

• Antidepressants, like monoamine oxide inhibitors (MAOIs) and tricyclics
• Calcium channel blockers used to treat high blood pressure  
• Birth control pills and hormone replacement therapy containing estrogen (in females)
• Testosterone replacement hormones (in males)
• Steroids

Health Conditions

Ankles that appear swollen or enlarged can also indicate an underlying health condition that causes ankle, foot, or leg swelling, including:

• Venous insufficiency: If your veins can't transport blood efficiently to the feet and back to the heart, your body forces fluid from the blood vessels into the surrounding tissue. This is more common in people with varicose veins (swollen veins you can see under the skin). 
• Blood clot: A blood clot in the leg can cause swelling, pain, red skin, and warmth in the lower ankle and leg. 
• Kidney disease: Kidneys that don't properly remove water and sodium can cause leg swelling.
• Congestive heart failure: A heart that can't pump blood properly can slow blood flow to the legs and cause blood to build up in the leg veins and fluid to build up in the leg tissue. 
• Liver disease: Liver failure and scarring (cirrhosis) can cause fluid to build up in the abdomen, feet, and ankles. 
• Emphysema: This severe lung disease can cause fluid retention in the legs and feet as pressure increases in the lungs, causing blood to build up in the heart and veins. 
• Lymphedema: Lymph fluid can build up in the legs or arms if lymph nodes become blocked or damaged. This is common during cancer surgery that removes lymph nodes.
• Lipedema: This condition is more common in females and causes abnormal fat tissue accumulating on the lower body, including the legs and ankles.  

How To Manage Cankles

If a serious health condition isn't the cause of your cankles, you may be able to minimize their appearance with lifestyle changes, including:

• Getting regular exercise: Moving your body helps improve blood circulation and reduce swelling. Exercise also helps reduce excess fat and increase muscle tone, making your ankles more prominent. 
• Doing more calf exercises: Strengthening your calf muscles can help add muscle mass, giving the illusion of a smaller ankle. 
• Following a low-salt diet: Reducing your salt intake may help prevent excess water retention that travels to your legs and ankles. 
• Avoiding tight-fitting clothing: Wearing tight shoes, socks, or pants may make the appearance of cankles more noticeable. 

How To Prevent Cankles

You can't always prevent cankles with lifestyle habits, especially if a medical condition or genetic predisposition is the cause. However, you may be able to avoid developing swollen ankles by following a lifestyle that reduces your risk of fluid retention, weight gain, and health conditions that lead to swelling.

Limiting salt intake may help reduce ankle swelling if you're prone to fluid retention. To help manage your weight, aim to eat a nutritious diet with whole foods like fruits, vegetables, dairy, whole grains, and proteins. Exercising for 30 minutes five times a week can also help improve blood circulation and reduce excess body fat on the lower body and ankles. 

If you often notice ankle swelling after standing up for long periods of time, try to elevate your feet as soon as you get home to help prevent fluid buildup.

Treatment Options for Cankles

Treatments for cankles will depend on the underlying cause. If your ankle is enlarged as the result of edema or swelling, you can help reduce fluid retention and promote circulation by: 

• Wearing compression socks or stockings
• Getting a lymphatic drainage massage to clear blocked lymph nodes
• Increasing your water intake
• Following a low-salt diet or limiting salty foods
• Taking a diuretic to help reduce water retention (with your healthcare provider's approval)
• Elevating your legs on a pillow when lying down
• Avoiding wearing tight clothing around your thighs and ankles
• Completing leg exercises to help pump fluid in the legs back to the heart
• Avoiding sitting for long periods and moving around often when traveling or working

If your ankles are thicker due to genetics, you typically don't need to treat them. However, you may not like how they look or make you feel. If you find the appearance of your ankles makes you feel depressed or think negatively about your body, talking with a mental health professional may help you learn to manage these feelings. 

In some cases, cosmetic surgeries like liposuction can help remove excess fat from the ankle area that is due to genetics or lipedema. 

If you have an ankle injury, you may need surgery to correct any fractures or lesions causing swelling, pain, and instability. A physical therapist can also provide foot and ankle rehabilitation exercises to help heal and strengthen ankle injuries that cause swelling. 

When To See a Healthcare Provider

If you've suddenly developed a swollen ankle or if the swelling worsens, see your healthcare provider to rule out a health condition or injury that's leading to ankle swelling. Swollen ankles and legs can be a sign of kidney, liver, or heart failure. An infection or blood clot in the leg can also lead to sudden lower leg swelling.

You should also visit a healthcare provider if you develop enlarged ankles along with these other signs or circumstances: 

• You have a history of heart, kidney, or liver disease
• Your foot or leg feels warm and appears red
• You have a fever
• You're pregnant
• The swelling is worse in one leg
• The swelling does not get better after home care

Signs of a Medical Emergency

Call 911 or seek emergency care immediately if you experience shortness of breath or chest pain—especially with pressure or tightness. These symptoms may indicate you have a life-threatening blood clot or heart issue.

A Quick Review

Cankles are thicker ankles that look like they are part of the calf. While not a medical term, cankles are often used to describe ankle swelling caused by inactivity, injuries, pregnancy, certain medications, and underlying health conditions. Some people may also have larger ankles simply due to their genetics.

If a health condition is the cause of your cankles, treatment depends on the specific condition. People with severe or sudden ankle swelling should see a healthcare provider to ensure they don't have a serious medical issue. 

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