Swollen ankles improve with a combination of elevation, movement, compression, and dietary changes. Most cases involve fluid pooling in the lower legs due to gravity, prolonged sitting or standing, or excess sodium intake. The strategies below work for everyday swelling, but sudden swelling in one leg, especially with pain or warmth, needs immediate medical attention.
Why Ankles Swell in the First Place
Swelling happens when fluid leaks out of small blood vessels and collects in the surrounding tissue. Normally, your body maintains a tight balance between the pressure inside blood vessels and the pressure in surrounding tissue. When that balance tips, whether from too much salt, standing all day, weakened veins, or an underlying health condition, fluid accumulates in the lowest point gravity can pull it: your feet and ankles.
Your calf muscles act as a pump, squeezing veins to push blood back up toward the heart. When you sit or stand still for hours, that pump barely activates, and fluid backs up. This is why ankle swelling tends to worsen throughout the day and improve overnight while you’re lying flat.
Elevate Your Legs (Even a Little Helps)
Elevation is the fastest way to get temporary relief. Lying down and propping your feet on a pillow is enough. Research on post-surgical ankle patients found that low elevation (about 10 cm, or roughly 4 inches, on a standard pillow) reduced swelling just as effectively as high elevation, and was significantly more comfortable. You don’t need to stack pillows to your ceiling.
The catch is that the effect fades quickly. One study found that after returning legs to a normal position, the swelling-reduction benefit disappeared within about five minutes. That means elevation works best as a habit you return to throughout the day, not a one-time fix. Try 15 to 20 minutes with your feet up several times daily, especially after long stretches of sitting or standing.
Use Ankle Pumps to Activate Your Calf Muscles
Ankle pumps are simple movements that turn your calf muscles into a circulation booster. Sit or lie down with your legs out in front of you, then point your toes toward your knees as far as you can, followed by pointing them away from you. Repeat this back-and-forth motion for two to three minutes, and aim to do it two to three times every hour when you’re sedentary.
Walking is even better if you’re able. Any movement that contracts your calf muscles helps push fluid out of your ankles and back into circulation. If you work at a desk, setting a timer to stand and walk for a few minutes each hour can make a noticeable difference by the end of the day.
Cut Back on Sodium
Sodium causes your kidneys to retain water, and that extra fluid has to go somewhere. The World Health Organization recommends staying under 2,000 mg of sodium per day (just under a teaspoon of salt) to prevent fluid retention. Most people consume well over that amount, largely from processed and restaurant foods rather than the salt shaker.
Packaged soups, deli meats, frozen meals, sauces, and bread are some of the biggest hidden sodium sources. Swapping these for whole foods, fresh vegetables, and fruits can reduce fluid retention within days. Increasing your potassium intake through bananas, leafy greens, and potatoes also helps your kidneys excrete excess sodium more efficiently.
Drink More Water, Not Less
It sounds counterintuitive, but not drinking enough water makes swelling worse. When you’re dehydrated, your kidneys respond by holding onto more sodium and water, which increases fluid buildup in your tissues. Drinking 1.5 to 2 liters of water per day helps your kidneys flush excess sodium and keeps fluid moving through your system rather than pooling in your ankles. Fruits and vegetables with high water content count toward that total.
Compression Stockings and How to Choose Them
Compression stockings apply graduated pressure to your lower legs, squeezing tightest at the ankle and gradually loosening toward the knee. This helps push fluid upward and prevents it from settling. They come in different pressure levels, measured in millimeters of mercury (mmHg):
- 15 to 20 mmHg (mild): Good for mild, occasional swelling, long flights, or days when you’ll be on your feet. Available over the counter without a prescription.
- 20 to 30 mmHg (moderate): The most commonly prescribed level for persistent swelling and mild to moderate venous insufficiency.
- 30 to 40 mmHg (firm): Used for more significant swelling that doesn’t respond to lighter compression, or for chronic venous conditions.
Put them on first thing in the morning before swelling starts, since they’re much harder to pull on over already-swollen ankles. Avoid compression stockings if you have significant peripheral artery disease, active skin infections, suspected blood clots, or severe nerve damage in your legs. If you’re unsure which level you need, start with 15 to 20 mmHg and work with a provider if that isn’t enough.
When Swelling Is Only on One Side
Swelling in both ankles is usually related to fluid retention, prolonged sitting, or a chronic condition. Swelling in just one leg is a different situation. It can signal a deep vein thrombosis (DVT), a blood clot in a deep vein that can become dangerous if it travels to the lungs.
DVT symptoms include sudden swelling in one leg, pain or tenderness (often worse when walking or standing), warmth over the swollen area, and skin that looks red or discolored. Some people also notice that surface veins appear larger than usual. A clot that breaks loose and reaches the lungs causes chest pain, shortness of breath, coughing up blood, or lightheadedness. This is a medical emergency.
If your swelling is one-sided, came on suddenly, or is accompanied by pain and warmth, get it evaluated the same day. DVT is diagnosed with an ultrasound and is treatable, but waiting can lead to serious complications.
How Doctors Assess Swelling Severity
If you visit a provider, they’ll likely press a finger into your ankle for a few seconds and watch what happens. This is called a pitting edema test. When the finger leaves an indentation that slowly fills back in, it confirms fluid in the tissue. The depth of the pit and how long it takes to rebound determine the grade:
- Grade 1: A shallow 2 mm pit that rebounds immediately. Mild swelling.
- Grade 2: A 3 to 4 mm pit that fills back in within 15 seconds.
- Grade 3: A 5 to 6 mm pit that takes up to 60 seconds to rebound.
- Grade 4: An 8 mm pit that persists for two to three minutes. This indicates significant fluid retention.
Grades 1 and 2 often respond well to the lifestyle strategies above. Grades 3 and 4 typically point toward an underlying cause that needs treatment, such as heart failure, kidney disease, liver problems, or chronic venous insufficiency.
When Medications Are Part of the Solution
If lifestyle changes aren’t enough, your provider may prescribe a diuretic, commonly called a water pill. These medications work by signaling your kidneys to release more sodium and water into your urine, reducing the overall fluid volume in your body. The type prescribed depends on the underlying cause. Some are gentler and preserve potassium levels, while others are more potent and used when kidney function is reduced.
Diuretics treat the symptom, not the root cause. If your swelling is from venous insufficiency, heart failure, or a medication side effect (calcium channel blockers and some anti-inflammatory drugs are common culprits), addressing that underlying issue is what provides lasting improvement. Persistent or worsening swelling that doesn’t respond to elevation, compression, and sodium reduction is worth investigating further.