Why does my ankle keep swelling up?

A previously sprained ankle may swell after activity because healing tissues remain sensitive or the joint is not yet moving and loading normally. Other possibilities include ankle osteoarthritis, gout, a missed bone injury, tendon irritation or fluid collecting because of circulation or a medical condition.

Swelling that follows long walks and settles with rest differs from swelling that appears overnight with intense warmth and pain. A one-sided problem often directs attention to the ankle, leg or local circulation; swelling in both ankles can prompt review of medicines and heart, kidney, liver or vein-related causes.

The timing after an old injury is useful too. An ankle sprain commonly presents with swelling, bruising and tenderness, while an ankle fracture can present with marked pain, swelling and inability to bear weight. Symptoms alone cannot reliably distinguish every injury.

Keep a simple record of which ankle swells, the time of day, recent activity, footwear, pain, warmth and how quickly it settles. Photographs taken from the same angle can help show change. Temporarily scale back aggravating exercise, elevate the leg when resting and use comfortable, supportive shoes.

If an old injury is involved, a physiotherapy assessment can check ankle movement, calf strength, balance and walking mechanics. Avoid repeatedly treating the puffiness without investigating why it returns, especially when episodes are becoming more frequent or severe.

Arrange prompt assessment for a red, hot, severely painful ankle, fever, an open wound, or rapidly increasing swelling. After trauma, seek urgent care for deformity, inability to take steps, severe focal bone tenderness, or a foot that is numb, weak, unusually pale or cold.

Call emergency services for chest pain, faintness or sudden breathlessness with leg swelling. New swelling mainly in one calf or leg, particularly with warmth or calf pain, warrants urgent medical review.

Ask whether the source seems joint-related, tendon-related or circulatory; whether your medicines could contribute; and whether imaging or blood tests would change management. Bring your symptom record and mention prior ankle injuries, recent travel or immobility, other swollen joints and any general illness.