You take off your socks at the end of the day and notice deep marks around your ankles. Your shoes feel tighter than usual, and the area above your feet looks a little puffy.
Swollen ankles can happen after a long day of sitting or standing. But when the swelling keeps returning, gets worse, or affects one leg more than the other, it may be a sign of something that deserves medical attention.
For men over 50, understanding the difference between temporary fluid buildup and a possible health problem is especially important.
Why Do Ankles Swell?
Ankle swelling often happens when extra fluid collects in the tissues beneath the skin. Doctors call this edema.
Gravity can make fluid accumulate around your ankles and feet, especially after spending hours in the same position. The swelling may be more noticeable in the evening and improve overnight.
However, edema can also develop when veins struggle to return blood to the heart, certain medications affect fluid balance, or an underlying condition changes how your body handles fluid.
One of the first questions a doctor considers is whether one ankle or both ankles are swollen. Another is whether the swelling started suddenly or developed gradually.[1]
7 Common Causes of Swollen Ankles in Older Men
1. Sitting or Standing for Long Periods
Spending much of the day at a desk, driving, or standing without moving can contribute to fluid pooling in your lower legs.
Your calf muscles normally help push blood back toward your heart. When those muscles are inactive for long periods, fluid may accumulate around the ankles.
Mild swelling that affects both ankles and improves after moving around or elevating your legs may be related to prolonged inactivity.
Still, swelling that persists or repeatedly returns should not automatically be dismissed as harmless.
2. Chronic Venous Insufficiency
Your leg veins contain valves that help blood travel upward toward the heart.
When those valves do not work properly, blood can collect in the lower legs, increasing pressure in the veins and contributing to swelling.
Chronic venous insufficiency may cause aching, heaviness, varicose veins, or skin discoloration near the ankles.
The swelling often becomes more noticeable after standing and may improve when the legs are elevated.
Over time, more advanced venous disease can cause skin irritation or wounds around the lower legs.[1]
3. Medication Side Effects
Some commonly prescribed medications can contribute to ankle swelling.
Examples include certain blood pressure medications, particularly calcium channel blockers such as amlodipine, as well as some anti-inflammatory drugs, steroids, and medications used for nerve pain.
Swelling may begin after starting a new medication or changing the dose.
Do not stop a prescribed medication on your own. Instead, ask your healthcare professional whether it could be contributing to the problem.
4. Heart Failure
Heart failure occurs when the heart cannot pump or fill effectively enough to meet the body's needs.
Fluid may build up in the legs, ankles, and feet, sometimes along with shortness of breath, fatigue, or rapid weight gain from fluid retention.
Some people also notice difficulty breathing when lying flat or waking up short of breath at night.
Swollen ankles alone do not mean you have heart failure. But swelling accompanied by breathing problems or reduced exercise tolerance needs medical evaluation.[2]
5. Kidney or Liver Problems
Your kidneys help regulate fluid and salt balance. When kidney function is impaired, fluid may accumulate in different parts of the body.
Some kidney conditions also cause protein loss through urine, which can contribute to edema.
Advanced liver disease may cause swelling by affecting fluid regulation and blood protein levels.
These conditions may produce other symptoms, but ankle swelling can sometimes be one of the noticeable changes.
6. Injury or Infection
A sprained ankle, muscle injury, or local inflammation can cause swelling, often on one side.
Infection may also produce redness, warmth, tenderness, and sometimes fever.
Swelling that is severe, painful, or accompanied by warmth and redness should be assessed promptly rather than treated as ordinary fluid retention.
7. Deep Vein Thrombosis (DVT)
Deep vein thrombosis is a blood clot that forms in a deep vein, usually in the leg.
It can cause new swelling, pain, tenderness, warmth, or skin color changes, commonly affecting one leg.
Risk factors include recent surgery, prolonged immobility, hospitalization, cancer, and a previous blood clot.
DVT is important to recognize because part of a clot can travel to the lungs and cause a pulmonary embolism, a potentially life-threatening condition.
New, unexplained swelling in one leg requires prompt medical assessment, even if the pain is mild or absent.[1]
One Swollen Ankle vs. Both Ankles: Does It Matter?
Yes. The pattern can help narrow down possible causes.
Swelling in both ankles may be related to prolonged sitting, venous insufficiency, medication effects, or conditions affecting the heart, kidneys, or liver.
Swelling in one ankle or leg may be caused by injury, infection, a local venous problem, or a blood clot.
Important distinction: These patterns are clues, not diagnostic rules. A blood clot can sometimes occur without obvious pain, and some systemic conditions may produce uneven swelling.
What Is Pitting Edema?
Sometimes, pressing gently on swollen skin leaves a temporary indentation. This is called pitting edema.
It happens when fluid accumulates in the tissues and can occur with several different conditions, including venous insufficiency and systemic fluid retention.
The presence or absence of a dent does not identify the cause by itself. A clinician may use this finding alongside other examination results.
How Do Doctors Find the Cause?
Your healthcare professional will usually ask when the swelling began, whether it affects one or both legs, and whether it changes throughout the day.
They may also review your medications, recent travel, medical history, and symptoms such as shortness of breath or leg pain.
Depending on the findings, testing may include:
- Blood and urine tests: to assess kidney function, liver function, thyroid function, and other possible causes.
- Venous ultrasound: to investigate a possible blood clot or problems with vein function.
- Heart-related testing: such as BNP blood testing or echocardiography when heart failure is suspected.
- Additional vascular assessment: when arterial disease or other circulation problems are possible.
Not everyone needs every test. The appropriate evaluation depends on your symptoms and medical history.[1]
What Can Help Reduce Mild Ankle Swelling?
If your swelling is mild, affects both ankles, and is not accompanied by concerning symptoms, a few habits may help:
- Take regular walking and movement breaks.
- Elevate your legs comfortably when resting.
- Avoid sitting or standing in one position for long periods.
- Wear comfortable shoes and avoid overly tight socks.
- Discuss sodium intake and cardiovascular risk factors with your healthcare professional.
- Pay attention to changes in swelling, weight, and other symptoms.
Compression stockings can be useful for some people with venous problems, but they are not appropriate for everyone. If peripheral artery disease is suspected, circulation may need to be assessed before compression is recommended.
Do not start water pills, also called diuretics, or change prescription medications without medical guidance. Treatment should address the underlying cause.[1]
When Should You See a Doctor?
Schedule a Medical Appointment
Arrange an appointment if swelling repeatedly returns, does not improve after a few days, gradually worsens, or develops after a medication change.
Persistent swelling deserves evaluation even when it is not painful.
Seek Urgent Medical Assessment
Get same-day medical advice for new, unexplained swelling in one leg or ankle, particularly if it is painful, warm, red, or tender. Seek prompt care for severe swelling, fever, or worsening skin changes. These findings may indicate a blood clot, infection, or another condition requiring timely treatment.
Call 911 for Emergency Symptoms
Swelling accompanied by sudden shortness of breath, chest pain, coughing up blood, fainting, or severe breathing difficulty requires emergency medical care. These symptoms can indicate a pulmonary embolism or another serious cardiopulmonary problem.[3]
The Bottom Line
Swollen ankles in older men are not always a sign of serious disease. Sometimes, fluid buildup is related to long periods of sitting, standing, or medication effects.
But persistent swelling, sudden changes, or swelling accompanied by pain, redness, or breathing problems should not be ignored.
The most useful questions are simple: Did the swelling start suddenly? Is it affecting one ankle or both? And are there other symptoms?
Understanding those details can help you recognize when to seek medical care and identify the right treatment.
Medical References
- Patel H, Skok CJ, DeMarco A. Peripheral Edema: Evaluation and Management in Primary Care. American Family Physician. 2022;106(5):557–564. Read the clinical review.
- National Health Service (NHS). Swollen Ankles, Feet and Legs (Oedema). Reviewed February 2026. Read the clinical guidance.
- National Health Service (NHS). Shortness of Breath. Read the emergency guidance.