A swollen ankle can be the result of a joint injury, but it can also be related to a problem with blood circulation.

A swollen ankle, or ankle edema, results in swelling of the joint, which can be accompanied by pain, a feeling of warmth, and redness.

We can distinguish two main situations, even if there are other possible diagnoses:

• edema linked to an injury to the joint (trauma, sprain or strain, tendonitis, etc.);
• or edema related to a blood circulation disorder.

In the first case, the swelling (swelling) usually follows a shock, a fall, a wrong movement … The ankle is swollen and painful, it can be blue (or red), hot, and the pain can start. Or be continuous.

In the second case, the ankle swells due to poor blood circulation in the feet and legs. This is called venous insufficiency. The swelling is usually not painful, although it can be bothersome. It is accompanied by a feeling of “heaviness” in the legs and sometimes cramps.

Do not delay in seeing a doctor in case of a swollen ankle, because it is not a trivial symptom.

A swollen ankle should lead to a consultation. Make sure after shock or trauma that nothing is broken, or, if there is unexplained swelling, that it is not a potentially serious circulatory, cardiac or kidney disorder.

As we have seen, ankle swelling can follow a trauma: strain, sprain, fracture, etc. In these cases, the swollen ankle is painful and the origin of the pain may be:

• articular;
• bone;
• or related to tendons (rupture of the Achilles tendon for example).

The doctor may order an x-ray and examine the mobility of the ankle, in particular:

• the so-called “tibio-tarsal” joint, which allows flexion and extension movements of the foot;
• the subtalar joint (left-right movements).

The second case is ankle swelling, or edema, due to a blood circulation disorder. The blood flows normally from the feet to the heart thanks to a system of venous valves which prevents it from flowing back, and thanks to the pressure of the calf muscles among others. Many situations can lead to venous insufficiency, which impairs the flow of blood and leads to stagnation of fluids in the legs. Some of these factors include:

• age;
• pregnancy (fluid retention);
• prolonged sitting or standing (travel, office, etc.).

The presence of swelling in the ankles or legs can also indicate heart or kidney failure, that is, serious dysfunction of the heart or kidneys.

Finally, in the ankle, the pain (generally without swelling, however) can also be linked to osteoarthritis, which often appears following repeated injuries (for example in former athletes who have sprained their ankles many times. ). The ankle can also be the site of inflammation, in cases of rheumatoid arthritis or other inflammatory rheumatism. Finally, gout or spondyloarthropathies can also affect the ankle and cause inflammatory pain.

A swollen ankle should lead to a consultation, in order to rule out the diagnosis of heart or kidney failure. In the event of an injury, adequate management is also necessary. The ankle is a fragile joint, which can be easily injured. It is therefore important that the injury heals properly to prevent recurrence.

Treatment obviously depends on the underlying cause.

In the event of a strain or sprain, the application of ice, the elevation of the foot and the taking of anti-inflammatory drugs are generally recommended. A serious sprain or fracture requires the installation of a cast or an orthosis.

As soon as the pain subsides, it is advisable to resume walking quickly by protecting the affected ligament (bandage or semi-rigid orthosis for example) and avoiding pain.

The use of a cane or crutches may be required to enable walking.

Physiotherapy, rehabilitation or physiotherapy sessions can be useful for the joint to regain its mobility and to strengthen muscles weakened by prolonged immobilization.

In the case of venous insufficiency, it may be advisable to wear compression stockings or socks to limit the edema. Some drugs can also be bought in pharmacies, but their effectiveness has not been formally demonstrated.

In the event of cardiac or renal failure, medical monitoring will be instituted. Several treatments exist to reduce the symptoms and preserve the functioning of the organs as much as possible.