Ankle Swelling

Plenty of patients have come to us complaining of ankle swelling at the end of the day. This is usually normal and not a cause for concern. But if you have pain, OR if you’ve recently had a ‘clumsy moment’, it’s highly likely you have a torn ligament and delayed swelling.

At DeLoor Podiatry, we can quickly assess what’s causing your ankle inflammation and treat it to prevent further damage down the line.

Your feet ballooning at the end of the day is normal. This is why magazines advice you to buy shoes in the afternoon or evening, so that your new shoes would fit you at 6pm, not just at 7am.

You’re on your feet all day, or you’re sitting all day at your desk. Either way, liquid can accumulate around your legs.

In older people, painless swelling of the ankles is normal, as is circulatory slows down. If you’re pregnant, swollen ankles are part of pregnancy, although you and your doctor would keep a watchful eye out for signs of preeclampsia. Your OB-GYNE would advise you not to be on your feet for long periods.

You might have severely injured your foot without realizing it.

If you’ve been on a long flight, the elevation and having your feet dangling from your chair can also cause swelling.

Other possible causes of swollen ankles are:


You might have severely injured your foot without realizing it. It’s a possibly a fractured bone or torn ligament/tendon. Or if the injury happened some time ago and it had healed, you might be having trouble with scar tissue that has built up over time.


When ankle swelling at the end of the day needs attention

Dr. Jose Loor says, “You should go to a doctor when the swelling is so bad you have to take off your shoes and you can’t get them back on. One foot is swollen, the other is not. That means one foot is badly affected. If you have pain along with the swelling, if you notice bruising on your ankle area, something bad has happened and it needs attention before it gets worse.”

Signs you need to bring your swollen ankle to the specialists at DeLoor Podiatry:

You might have severely injured your foot without realizing it. It’s a possibly a fractured bone or torn ligament/tendon. Or if the injury happened some time ago and it had healed, you might be having trouble with scar tissue that has built up over time.

Delayed Swelling of the Ankle

After an injury, like a sprain you thought didn’t do any damage, your ankle joint produces excess synovial fluid to protect itself from further damage, and to start healing. This increase in synovial fluid causes the very gradual swelling in and around the ankle.

At DeLoor Podiatry, the specialists led by Dr. Jose Loor would diagnose and evaluate your ankle injury for the best treatment match.


An ankle injury neglected and left by itself could and would degenerate into osteoarthritis — bone deterioration — over time. This is a whole new level of pain and disability you’d best avoid.


The importance of your ligament and ankle

Ankles are weight-bearing joints. They support you when you stand, and enable the up and down flexion of each foot so you could get up, walk/run and climb up and down.

Ligaments are tough tissue made of collagen, functioning like duct tape in flexibly holding bones together. Ligaments connect your leg bones (the tibia and fibula) to your foot bone (the talus). And you have ligaments on the sides of your foot, the lateral ankle ligaments.

The tibiofibular ligaments move your foot up and down: dorsiflexion and plantarflexion, respectively. This is the movement of walking and climbing. The lateral ligaments support your legs whenever you are on your feet, and when you move your feet left and right.

The most injured ligaments are the ones located in the ankles. When you twist your ankle, you sprain the front and middle bands of your lateral ligament.

A torn ligament doesn’t pick athletes and women in high heels. Bad sprains happen to anyone, young and old.

Damaged ligaments lead to bad joint alignment and movement, which causes pain and damaged cartilage. Cartilage is another tough tissue that acts like a cushion and impact-absorber between joints. Without this cushion, bones rub together, grow roughage, and cause extreme pain and bone damage.

It’s critical that you always consult a doctor like the specialists at DeLoor Podiatry for ligament injuries and repair. During ligament tearing, some pieces of bone or chipped cartilage may also come off. These pieces would float between the joints and irritate the cartilage and soft tissue in your ankle. Inflammation (swelling) and pain would result.

Both ligament and cartilage have little to no blood supply. This makes it difficult for them to heal when injured. DeLoor Podiatry provides and would recommend the best procedures to remove any floating bone or cartilage causing joint pain and damage, and coax torn ligaments into healing and to speed up your recovery.

Torn ligaments, under improper rehabilitation without doctor supervision, can heal badly and lead to chronic ankle instability. See our articles about this.

An ankle injury neglected and left by itself could and would degenerate into osteoarthritis — bone deterioration — over time. This is a whole new level of pain and disability you’d best avoid.

Symptoms of a torn ligament and scar tissue

For the degrees of sprains, see our article on Ankle Instability.

When a ligament, tendon or muscle is damaged, scar tissue forms to act as a glue to heal the damage. But scar tissue has none of the flexibility, elasticity and function of the ligament.

You are dealing with a badly healed ligament tear when you experience ankle instability, pain and swelling. The scar tissue takes up space as it grows, causing the swelling, and medical research has found nociceptors– pain nerve endings– in scar tissue. The scar tissue itself is painful.

Even if your injury happened months or a year ago, the scar tissue would keep paining you.

Dr. Loor says, “There are physiotherapy and massage meant to improve and even reduce scar tissue, but the best option is ligament repair.”

Ligament Repair in New York City (10010, Gramercy)

Advances in science has made it possible to repair torn ligaments and restore as much of the flexibility as possible. Foot and ankle surgery is proven effective in changing and improving the healing process of ligaments.

Arthroscopic Radiofrequency Ablation

In radiofrequency ablation (RFA), heat is applied to the damaged ligaments to strengthen and heal the collagen. This is an outpatient procedure completed in minutes. Dr. Jose Loor and his team uses arthroscopy to identify and refine the heat application. For more details, see our article on Ankle Instability.

Ankle ligament reconstruction

While not as successful as the first two procedures in restoring ligament function, ankle ligament reconstruction can still also help, especially in cases of extensive damage to the ligament.

Under general anesthetic, a nerve block and sedatives, Dr. Loor or one of the other specialists at DeLoor Podiatry makes an incision in the ankle over the torn ligament, which would be identified, stitched, reattached to the fibula (when the damage needs it) and tightened to strengthen the repair.

While it sounds drastic and complicated, it is not. You can go home on the same day, or as soon as you’re comfortable to do so.

Your ankle would be in a cast, and you can’t bear your weight on that foot at all. DeLoor Podiatry would keep in touch with you for pain management. You may need painkillers, and anti-inflammatories during the first 6 weeks post-surgery.

Some blood is expected, but contact DeLoor Podiatry if you’re concerned. At 2-4 weeks, you can partially bear your weight again, but you would be given a boot to immobilize your foot.

Weeks 8-12 are for physiotherapy to start the rehab on your ankle, with appointments with your doctors to keep track of your progress.

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