What Causes Puffy Ankles?

One question I am often asked is about an area on the outer side of the front of the ankle that often appears puffy in many people. Sometimes this can be referred to as “cankles”. Many people are concerned about this and often ask me for an explanation of what it is, so this article will explain exactly what this lump or this mass usually is and what sometimes it can be that might actually pose a problem.

The area that I’m talking about is on the outer side of the ankle. I usually see this in women and not so much in men, although it can be present in men, where the side of this ankle will appear a bit puffier than the rest of the surrounding tissue. This is different than if you have swelling of the entirety of the ankle or swelling of the foot and the legs. This is actually something that is sort of a mound that rises over this area.

Why are my ankles puffy?

What usually causes puffy ankles is simply an enlargement of fat tissue or a greater level of fat deposition across the front of the ankle. Sometimes this is placed by the body simply for protective purposes and sometimes it just simply forms there. On very rare occasions this can actually represent a tumor of fat tissue, which the actual fat tissue itself is too enlarged. The vast majority of the time this is simply a benign process, although on occasion there can be cancerous tumors of fat tissue itself, although this is usually quite rare.

Another explanation for this is that some people just happen to have more fluid retention on that side of the ankle than the rest of their ankle or in the foot or lower leg itself. Sometimes it’s just simply depositing of extra fluid, edema is what we call that, which actually just forms on that side. That’s generally harmless, unless it becomes very expansive and starts to harm the overlying skin. Usually we don’t see that where it’s just limited to the ankle area. Usually, it’s the whole leg that’s swollen.

One final explanation is this part of the foot itself has a muscle belly that kind of lies over the top of it. On occasion, this muscle belly can actually become too enlarged. The muscle fibers themselves will enlarge, or something we call hypertrophy. When that muscle is too big you can feel it underneath the skin. Normally that’s a little bit further away from the ankle joint itself. It’s a little bit more on top of the foot. But sometimes, given all the other tissue that lies over there, it can feel like it’s closer back towards the ankle itself.

This muscle itself has tendons which attach to the lesser toes, which allow the toes to kind of raise upward. That’s the function of that muscle. On occasion, this muscle can become enlarged, and that’s another explanation for why there’s this puffy area in front of the ankle. Once again, this generally is a benign process, as muscle tumors are extremely rare. However, if you do have this area and it’s either causing pain or making shoe wearing difficulty, please see your podiatrist because we can make a decent diagnosis, figure out if there’s anything that is serious or whether it’s simply a matter of it just being a benign condition that may just need a little more accommodation in the shoes.

Of course, if it is a mass, whether it’s benign or malignant, surgery can be possible. Certainly for malignant lesions it has to be taken care of surgically, but if it’s just simply a benign mass and you have no other way of being able to comfortably fit on shoes the mass can simply be removed.

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