There are several types of lymphedema, and all are serious health problems. But many people don’t know that. Instead, they might think they just have cankles. Now, for those of you who aren’t aware, cankles is a term used to describe wide or swollen ankles–the swelling eliminates a distinction between your calves and ankles (hence the name.) Keep in mind, “cankles” is a slang — it isn’t a term you’ll hear doctors using. But it could be describing several medical conditions, so it’s worth paying attention to your cankles.
Of course, sometimes, cankles could just be a sign that your calf muscles aren’t well-defined. It may even be the result of extra fat tissue in the are. But often, cankles develop because you have fluid build up in your lower leg.
Sometimes, people will also complain about elephant legs. This is another sign of lymphedema, but it just means the swelling extends beyond your ankle. (It’s also a sign that you’ve entered the last, and most dangerous, stage of lymphedema.) While many women, and some men, complain about the way their cankles or legs look, it turns out that they could both be a sign of more serious health issues.
What Causes My Ankles to Swell? Types of Lymphedema
There are two main types of lymphedema: primary and secondary. With primary lymphedema we don’t always know the cause. (But we’ll review some common ones in a moment.) Now, with secondary lymphedema, your swelling usually develops after a surgery or infection, because those triggers damaged your lymphatic pathways’ ability to drain.
When it comes to primary lymphedema, there can be several triggers we’ve identified. Many pregnant women develop swollen ankles. Usually, this cankle cause clears up once you deliver your baby, so you may not need to seek treatment. Individuals with liver or kidney disease may also develop ankle swelling. So, if you have a family history of either disease, mention your swollen ankles right away to your doctor.
Additionally, cankles could be a sign of excess fat in your ankles, and not of swelling. If you are a woman and you’re seeing excess ankle fat, you might have lipedema. This hormonal condition, affecting up to 11% of women, causes extra fat to build up beneath the skin on your legs. It can be painful and serious, and you should review your symptoms with your doctor.
You should discuss the possibility of any of these conditions with your doctor. But, today, we’re going to talk about circulation and cankles. Because swollen, puffy ankles are symptoms of several potentially serious vein conditions. For that reason, you should see your doctor at the first signs of lymphedema. That’s the only way to prevent serious complications.
Venous disease/insufficiency
When your veins struggle to send blood back from your extremities to your heart, it’s known as venous insufficiency. In this condition, the blood that doesn’t flow properly can pool in your leg veins. Varicose veins or deep vein thrombosis (DVT, a blood clot that forms in the deep veins of your legs) are also warning signs of Venous Insufficiency.
Symptoms of VI include:
- Swelling of the legs or ankles
- Painful, heavy legs
- Thicker skin on the legs and ankles
- Color changes in the skin around your ankles
Edema
Swelling in the legs (edema) can occur when fluid becomes trapped in the soft tissues of the leg, typically because of malfunctioning valves in your veins. When the valves in your leg veins begin to weaken, or fail, the blood can no longer be pumped out of the legs properly. This causes fluid and blood to become trapped there and, as the fluid begins to build up, the leg may begin to swell. The term for the buildup of fluid which leads to swelling in the body is edema.
Lymphedema vs Lipedema
Lymphedema is a form of chronic edema that occurs when the body’s lymphatic system does not function properly. It is not the same as edema caused by vein disease, although vein disease can eventually progress into a combined venous/lymphatic disorder. As with swelling in the lower legs, lymphedema requires the attention of a healthcare professional as soon as possible.
Other signs of lymphedema include progressive symptoms. In the later stages of disease, you may also not some “pillow” swelling in your foot. If it’s caused by Lymphedema, it won’t go away after sleeping. Another sign is called Stemmer’s symptom. This is when you can’t fold the skin on the back of your second toe. Also, your skin will likely appear pale. And the swelling will reach the middle of your lower leg, but won’t hit your thigh. (This is when we start to hear about 
elephant legs.) Finally, you may develop fibrosis, when the skin on your leg becomes thicker and hardens.
Now, lipedema is a different condition that also may increase your ankle size, but this is due to fat buildup, not fluid retention. Plus, if lipedema is your concern, you’ll likely have fat deposits in areas other than your ankles. In fact, lipedema usually strikes your calves, thighs and buttocks. And, unlike lymphedema, this condition typically impacts women, not men.
Recognizing Lipedema
With this condition, excess fat builds up on the lower half of your body, but there’s no obvious cause for this build-up. While many women with lipedema are overweight, obesity doesn’t seem to cause this fat build up. Instead, the condition seems linked to hormones, since most women develop symptoms at times of major hormonal shifts. (Think puberty, pregnancy and/or menopause.)
Lipedema Types
This condition comes in several different forms. With Type I lipedema, most of your fat covers your buttocks and pelvis, staying concentrated between your navel and hips. With Type II, those buildups develop between your pelvis and knees.
Do you have fat concentrations that run from your pelvis to your ankles? That’s a sign of Type III, especially if you notice a distinct fat cut-off right at your ankles. Now, with Type IV, the deposits are distributed on your upper body, from your shoulders to your wrists. But with Type V, most of your buildups hang out on your calves.
Now, it’s difficult to treat lipidemia. So many women, including body positivity role model Heather Johnson, choose to embrace their larger lower bodies. Still, lipidema can cause pain, and the build-up of lymphatic fluid. (That condition is called secondary lymphedema.) And if that happens, treatment may be necessary.
How and When to Treat Your Cankles 
While some forms of cankles are just the result of fatty buildups in your bodies, when they are a sign of a vein problem, treating the underlying issue may also improve the look of your lower legs. When it comes to purely cosmetic treatments, that is a personal choice, but when treating your cankles could actually save your veins from further damage, it is always a good idea!
Noticed swelling in your ankles? Don’t wait to see if it goes away on it’s own, or your symptoms may progress! Instead, schedule an appointment with your Houston vein specialists right away. We can diagnose the cause of your cankles. And get you on the path to proper healing.
Sources: Lymphatic Network