What to know about ‘cankles’

Factors that can cause or contribute to a lack of definition between the lower calf and ankle include:

• genetics
• an underlying health condition
• other factors that may cause the ankles to swell

Genetics

As with other physical traits, genetics may influence the size and shape of the calves and ankles. Some people have naturally larger bones, muscles, or tendons in the ankles, all of which may contribute to the appearance of cankles.

Health conditions

The following health conditions can cause swelling in the calves or ankles, which may give the appearance of cankles:

• Obesity: Carrying excess weight can put a strain on the ankles and other weight-bearing joints, causing them to swell.
• Diabetes: This condition can affect circulation, causing fluid to pool in the feet and ankles.
• Infections: An infection in the lower legs, ankles, or feet can cause swelling in these areas. People with diabetes are at increased risk of developing infections in the lower extremities.
• Cellulitis: A common bacterial skin infection that can occur when there is an open wound in the skin. The infection may cause swelling, redness, and pain in the affected area.
• Venous insufficiency: A condition in which the valves inside the veins do not send blood back to the heart effectively. The blood “leaks” in the opposite direction to blood flow, pooling in the lower legs and ankles.
• Congestive heart failure (CHF): This condition affects the heart’s ability to pump blood effectively, which may cause blood to pool in the lower legs, ankles and feet.
• Deep vein thrombosis (DVT): This condition involves a blood clot within a deep vein, typically in the leg. It can develop quickly, is accompanied by pain and redness, and requires rapid medical attention.
• Lipedema: A chronic disease that leads to abnormal fat distribution, particularly below the waist.
• Lymphedema: A condition in which the lymphatic system becomes damaged or blocked, causing lymph fluid to accumulate in the body’s tissues. It often occurs due to cancer or cancer treatment.
• Hypothyroidism: An underactive thyroid can cause fluid retention and associated swelling in various parts of the body, including the ankles.
• Cushing’s syndrome: A potentially serious condition involving an excess of the hormone cortisol in the body. It may cause fluid retention and swelling.
• Kidney problems: The kidneys help remove waste products from the blood and balance sodium and potassium levels. Poor kidney function can lead to sodium retention, which may cause swelling in the ankles.
• Liver disease: Issues with the liver, such as cirrhosis, can cause fluid retention in the legs, ankles, and feet.

Other causes

Other factors that can cause swelling of the lower legs and ankles include:

• pregnancy
• medications, such as
  • birth control pills
  • hormone therapy drugs
  • steroids
  • antidepressants
• insect bites or stings
• injuries, such as:
  • bruising or hematoma
  • strains or sprains
• consuming excess salt in the diet
• sitting or standing too long in one position
• warm weather

The treatment for cankles depends on the cause.

People who have naturally larger ankles due to genetics will not require medical treatment. However, those with swollen ankles may require treatment, depending on the cause of the swelling.

Treatments for underlying medical causes

Below are some medical conditions that can cause swollen ankles, along with their associated treatments:

• Diabetes: Medications to control blood sugar levels, such as metformin or insulin.
• Venous insufficiency: Compression stockings to help promote blood flow back to the heart, or radiofrequency vein ablation, which involves sealing off the damaged veins.
• Congestive heart failure: Diuretics to reduce fluid retention, along with vasodilators, which help relax the blood vessels and promote circulation.
• DVT: Anticoagulant medications to help prevent the formation of new blood clots.
• Lipedema: A healthy diet and plenty of exercise, possibly in combination with liposuction to remove excess fat.
• Lymphedema: Decongestive lymphatic therapy, which entails draining excess lymphatic fluid. This may involve exercises, compression bandages, and specific massage techniques.
• Cellulitis: Antibiotics to help combat the underlying bacterial infection.
• Hypothyroidism: The medication levothyroxine, which helps replace the hormones that the thyroid is not making.

Self-care

If cankles are not the result of a serious health concern, the following self-care tips may help ease swelling and discomfort:

• exercising to promote blood circulation
• elevating the feet as often as possible
• avoiding tight-fitting footwear, socks, and clothing
• preventing infection by keeping the feet and ankles clean, dry, and moisturized
• soaking the feet and ankles in Epsom salt
• wearing compression socks

Routine adjustments

The following routine adjustments may help to reduce swelling of the lower calves and ankles:

• maintaining a moderate weight through diet and regular exercise
• consuming a heart-healthy diet
• limiting salt intake
• stopping smoking

Strive for a positive body image

Many people consider cankles to be a derogatory term, typically directed toward females. Using the word cankles to describe a person’s leg shape can cause or contribute to issues with body image.

According to the Office on Women’s Health (OWH), a person with a negative body image can have an increased risk of mental health conditions, such as depression and eating disorders. OWH notes that many women in the United States feel pressured to match up to the narrow and unrealistic beauty standards in society, particularly the media.

Ankles that are naturally larger due to genetic factors may be a cosmetic concern for some people. A person who experiences such concerns may benefit from practicing methods that improve their overall body image. Examples include:

• shifting attention away from areas of the body that cause concern and focusing instead on areas that the person is happy with
• working toward accepting rather than changing perceived flaws in appearance
• being mindful of how the body functions as opposed to how it looks
• being mindful that physical appearance is only part of what makes a person who they are

A person who notices a change in the size or appearance of their ankles should consult a doctor to determine the cause. Signs that a person should seek medical attention include:

• severe, painful swelling that develops suddenly
• swelling that persists or worsens
• inflammation and heat at the site of the swelling
• swelling accompanied by a fever, chest pain, or shortness of breath

A person with diabetes who notices swollen ankles should contact their healthcare team as this could signal kidney disease or early heart failure.

Below are some answers to common questions about cankles.

What causes cankles?

Many different factors can cause cankles. These include:

• genetics
• situational factors, such as sitting or standing for long periods, warm weather, and taking certain medications
• health conditions, such as having obesity, circulatory conditions, and problems with liver or kidney function

Can a person treat cankles?

The treatment for cankles depends on the cause. For example, a person who notices that their ankles are more swollen than usual should make an appointment with their doctor to rule out any underlying health conditions. Likewise, if a person develops swollen ankles after taking a certain medication, they should notify their doctor, who may adjust the dosage or switch the person to a different medication.

A person who has larger ankles due to genetics will not require medical treatment. However, larger ankles may be a cosmetic concern for some people. If this is the case, a person can try exploring body positivity. Anyone who has persistent or worsening concerns over their body image should address these concerns with a doctor or therapist.

Are cankles fat or muscle?

A lack of definition between the calves and ankles can occur due to excess body tissues or fluid in the ankles.

In some cases, a person’s genetics can cause them to develop naturally larger bones, muscles, and tendons around the ankles. In other cases, having overweight or obesity can cause an excess of fat around the ankles.

Cankles can also occur as a result of fluid retention due to an underlying health condition or situational factors, such as medication use, warm weather, and prolonged standing or sitting.

Cankles is a slang term to describe a lack of definition between the lower calf and ankle. This may occur due to genetics, whereby a person has naturally larger bones, muscles, or tendons in the ankle. Alternatively, it may indicate swelling due to an underlying medical condition or factors such as warm weather and prolonged sitting or standing.

The treatment depends on the underlying cause. Certain medical causes require prompt treatment to prevent complications. As such, anyone who experiences sudden or unusual swelling in their ankles should notify their doctor.

Medical treatment will not be necessary for people with naturally larger ankles due to genetics. If a person has concerns over the appearance of their ankles, they can try methods to help improve their body image. Anyone who experiences continued concerns should talk with a doctor or therapist. Without treatment, a negative body image can cause mental health issues, such as eating disorders and depression.