Swollen Ankles? How to Take Care for Swollen, Puffy, & Bloated Ankles

As we age, our bodies go through many changes. Some are expected—like needing reading glasses or feeling a bit stiffer in the mornings. But some changes can be surprising and concerning, like swollen ankles, puffy ankles, or bloated ankles.

If you’ve noticed your ankles looking bigger, feeling tight, or even making it hard to get your shoes on, you’re not alone. Many older adults experience swollen ankles and wonder what’s causing them—and more importantly, what can be done about it.

In this guide, we’ll explain why swollen ankles happen, when they could be a sign of something serious, and how physical therapy, exercise, and lifestyle changes can help you feel your best again.

🦶 What Are Swollen, Puffy, and Bloated Ankles?

Swollen ankles, puffy ankles, and bloated ankles describe a common condition called edema. Edema means fluid is building up in the tissues of your body—often in the legs, ankles, and feet.

You might notice:

• Shoes fitting tighter than usual

• Skin that looks stretched or shiny

• Puffiness around the ankle bones

• A feeling of heaviness or tightness

• Small pits left behind when you press your skin

While a little swelling can be harmless after standing too long, ongoing or severe puffy ankles could signal underlying health issues.

🧠 Why Do Older Adults Get Swollen Ankles?

There are several reasons why swollen ankles become more common with age:

1. Poor Circulation

As we get older, blood vessels can become less efficient at returning blood from your feet and ankles back up to your heart. This can cause blood and fluid to “pool” in the lower legs, leading to bloated ankles.

2. Heart, Kidney, or Liver Conditions

Sometimes, puffy ankles can be a sign of heart failure, kidney disease, or liver problems. These conditions cause fluid imbalance in the body, leading to swelling.

3. Medications

Certain medications commonly used by seniors—like blood pressure drugs, diabetes medications, and steroids—can cause swollen ankles as a side effect.

4. Inactivity

Sitting or standing in one place for too long without moving can cause fluid buildup. Staying active helps your circulation and prevents bloated ankles.

5. Injury

A sprained ankle or broken bone can cause local swelling. Even older injuries can lead to lingering puffy ankles if not properly rehabilitated.

🚨 When Should I Worry About Swollen Ankles?

While mild puffy ankles can be normal after a long day, you should seek medical advice if you notice:

• Swelling that is painful, red, or warm to the touch

• Shortness of breath or chest pain with the swelling

• Swelling that comes on suddenly

• One ankle much more swollen than the other

• Swelling that does not improve with rest or elevation

These could be signs of a serious condition like a blood clot or heart failure. Always better to be safe!

🏥 How Physical Therapy Helps Swollen, Puffy, and Bloated Ankles

You might be wondering: “How can a physical therapist help with swollen ankles?”

The answer is: a lot.

At HWY Physical Therapy, we help older adults with swollen ankles, puffy ankles, and bloated ankles by:

✅ Performing a Full Mobility and Circulation Assessment

We check your strength, balance, walking pattern, and circulation. We find out if poor movement habits or weak muscles are making your swelling worse.

✅ Designing Gentle, Effective Exercises

Moving your ankles and legs properly is one of the best ways to prevent and treat puffy ankles. We teach exercises that:

• Improve blood and lymphatic flow

• Strengthen calf muscles (your “circulation pump”)

• Reduce stiffness in the ankle joints

✅ Educating on Elevation and Positioning

We show you the best ways to sit, lie down, and move to encourage swelling to go down naturally.

✅ Advising on Compression Garments

For some people, compression socks or sleeves help manage bloated ankles. We’ll teach you how to use them safely.

✅ Teaching Balance and Fall Prevention

Because swollen or stiff ankles affect your balance, we also work on fall prevention exercises to keep you safe and confident.

🏠 In-Home or Clinic-Based Therapy for Swollen Ankles

Whether you prefer to be seen in the comfort of your own home or visit us at our outpatient clinic, physical therapy for swollen ankles is available in both settings.

• In-home therapy is ideal if you have trouble traveling or if you feel more comfortable working in your own space.

• Clinic-based therapy provides access to specialized equipment for strengthening and balance.

The important thing is to start early—the longer puffy ankles are left untreated, the harder they can be to reverse.

🦵 Top Exercises to Help Swollen, Puffy, and Bloated Ankles

Here are a few simple exercises we often recommend for older adults dealing with swollen ankles:

1. Ankle Pumps

While sitting or lying down, flex your foot up toward your head, then point it away. Repeat 20–30 times.

Benefit: Helps move fluid out of your lower legs.

2. Heel Slides

Lie on your back. Slowly slide your heel toward your bottom, then slide it back out straight. Repeat 10–15 times.

Benefit: Encourages gentle movement of the knee, ankle, and hip.

3. Seated Marching

Sit in a sturdy chair and slowly lift one knee, then the other, like you’re marching.

Benefit: Strengthens the hip and leg muscles, improving circulation.

Important: Always consult your physical therapist before starting any exercise program, especially if you have medical conditions.

🍎 Lifestyle Tips for Managing Swollen, Puffy, and Bloated Ankles

Along with exercise, small daily habits can help reduce and prevent swollen ankles:

• Elevate your feet above heart level several times a day

• Stay hydrated to help flush extra fluid

• Limit salty foods, which cause the body to hold onto water

• Wear supportive shoes—poor footwear can worsen ankle swelling

• Move regularly—avoid sitting or standing still for long periods

👩‍⚕️ When Medications or Compression Help

Sometimes, swollen ankles need more than exercise and home care.

Your healthcare team may recommend:

• Compression stockings to gently squeeze the legs and encourage blood flow

• Medications like diuretics to remove excess fluid if related to heart, kidney, or liver conditions

Physical therapy and medical care work best together for managing more serious cases of puffy ankles or bloated ankles.

🧑‍🤝‍🧑 Support for Caregivers

If you are caring for a loved one with swollen ankles, remember:

• Encourage them to move and elevate their legs regularly

• Watch for changes in swelling, skin color, or pain

• Help them stay active and involved in therapy plans

• Ensure shoes and socks are not too tight

Physical therapists often include family and caregivers in the education process—because teamwork helps everyone succeed!

✅ Final Thoughts: Don’t Ignore Swollen Ankles

Swollen ankles, puffy ankles, and bloated ankles may seem minor at first, but they are your body’s way of telling you something needs attention.

By taking action early—getting a mobility screening, working with a physical therapist, and following a customized plan—you can reduce swelling, regain strength, and continue living the independent, active life you deserve.

Don’t let ankle swelling limit your lifestyle.

You can move easier, feel lighter, and stay safer with the right support.

📞 Ready to Take the First Step?

Schedule a HIPAA Compliant Video Call With Dr. Raj Pusuluri, PT, DPT.

👉 Swollen ankles aren’t just a part of aging. Let’s work together to find relief!