Swollen ankles from sitting all day: why, and what helps

Swollen ankles after a long day of sitting are usually fluid that has collected in your lower legs. Your calf muscles help push blood back up toward your heart every time you move, and when you sit still for hours they barely work, so gravity wins a little. For most people the swelling is mild, affects both ankles about equally and is gone by morning.

Moving your feet at the desk, getting up about once an hour and putting your feet up in the evening all tend to help. Swelling in one leg only, swelling with pain, warmth or redness, or any swelling with breathlessness or chest pain is different, and needs a doctor straight away.

Why your ankles swell when you sit

Blood travels down to your feet easily. Getting it back up means working against gravity, and your leg veins rely on two things to do it: one-way valves inside the veins, and the muscles around them. Each time your calf muscles tighten, as they do with every step, they squeeze the deep veins and push blood upward. This is often called the calf muscle pump.

When you sit for hours with your feet still, the pump mostly stops. Blood moves back up more slowly, pressure in the small vessels of the lower legs rises, and some fluid seeps out into the tissue around the ankles. That fluid is what you see as puffiness, deep sock marks and shoes that feel tighter at 5 PM than they did at 9 AM.

A few things tend to make it worse:

• A chair that is too high, so your feet don't rest flat and the front edge of the seat presses into the back of your thighs.
• Hot weather, which widens the blood vessels in the skin.
• Long trips, such as a flight or a long drive, on top of a desk day.
• A very salty meal, which makes some people hold on to more water for a day or so.
• Hormonal changes, such as before a period or during pregnancy.
• Some medicines. Some blood pressure medicines, among others, list ankle swelling as a possible side effect. Don't stop or change a medicine on your own. Ask the doctor or pharmacist who knows your prescriptions.

Standing still for hours can do the same thing, which is worth knowing if you have just switched to a standing desk. It is stillness, more than the chair, that lets the fluid gather.

Is it normal for your ankles to swell after sitting?

Mild swelling at the end of a long sit is common and, for most people, harmless. The usual pattern looks like this:

• Both ankles or feet are affected, roughly equally.
• It builds through the day and goes down overnight, or after some time with your feet up.
• There is no real pain, only a feeling of heaviness or tightness.
• It gets better on days when you move more.

If that matches what you see, the steps further down are a sensible place to start. If it doesn't match, or the swelling is still there after a few days of moving more and raising your feet, see a doctor.

When should you see a doctor about swollen ankles?

Some swelling is a sign of something that needs checking. Health services such as the NHS in the UK advise getting medical help in these cases:

• Swelling in one leg only, especially with pain, tenderness, warmth or redness in the calf or thigh. This can be a sign of a blood clot in a deep vein, and long spells without moving raise the risk. Get urgent medical advice the same day.
• Swelling with breathlessness, chest pain or coughing up blood. Call your local emergency number. A clot that travels to the lungs is an emergency.
• Red, hot skin or a fever along with the swelling.
• Swelling with diabetes. Swollen feet are worth getting checked promptly if you have diabetes.
• Swelling that doesn't go down overnight, keeps getting worse or spreads up the legs.
• Sudden swelling during pregnancy, especially in the face or hands, or with a headache or changes in your vision. Contact your midwife or doctor that day.
• A heart, kidney or liver condition you already know about, with new or worse swelling.

None of this is meant to alarm you. Most end-of-day puffiness is just fluid. But for any of the signs above, a quick check is the right call, and it is not something to wait out at your desk.

Ankle exercises you can do at your desk

These are the same movements often suggested for long flights. They work the calf muscles while you stay seated, and you can do them during a call without anyone noticing.

Ankle pumps

1. Sit back with both feet flat on the floor.
2. Lift your toes toward your shins, keeping your heels down.
3. Lower your toes and lift your heels, as if pressing a pedal.
4. Go back and forth slowly, ten to twenty times.

Ankle circles

1. Lift one foot a little off the floor.
2. Draw slow circles with your toes, about ten in each direction.
3. Switch feet.

Seated marching

Lift one knee a few centimeters, put it down, then lift the other, for half a minute or so. It is a small movement, but it gets the whole leg working.

Heel raises

When you stand up, hold the edge of the desk and rise slowly onto your toes, then lower yourself back down. Ten of these work the calves harder than anything you can do sitting.

A round of pumps and circles every half hour or so, and heel raises whenever you are up, keeps the pump going through the day. If any of these hurt, stop and ask a physiotherapist or a doctor.

How to reduce ankle swelling from sitting

Desk exercises help, but nothing works the calf pump like walking. Getting up for a few minutes about once an hour, to refill your water or take the stairs, is the most useful single habit for heavy, puffy ankles, and it helps your back and your energy too. What sitting all day does covers the wider effects of a long sit.

A few more things that help:

• Let your feet reach the floor. Lower the chair until your feet rest flat, or use a footrest, so the seat edge isn't pressing into your thighs.
• Change position often. Uncross your legs, stretch them out under the desk, shift your weight.
• Raise your feet in the evening. Lying down with your feet on a couple of pillows, above the level of your heart, lets the fluid drain back. A footrest at the desk is good for comfort, but it doesn't lift your feet high enough to do the same job.
• Check your socks and shoes. Socks with a tight band at the top, or shoes that pinch by the afternoon, can make it worse. Wide, comfortable shoes are kinder.
• Ask before trying compression socks. They help some people, but they are not safe for everyone, including some people with poor circulation in the arteries of the legs. A doctor or pharmacist can tell you whether they suit you, and which kind.

If you are moving more, raising your feet and the swelling still hangs around for more than a few days, that is a reason to see a doctor too.

Remembering to get up

The weak point in all of this is the hour you meant to get up and didn't. In Notchpals, the Movement characters exist to get you out of the chair, and they do it by sliding down from your Mac's notch. Honk, a goose with a plan nobody has been told about, is one of them. When you have been at the keyboard for close to an hour without a real break, Honk comes down from the notch, and is not subtle about it.

HonkUP. Stand. Now. Don't make me come down there. I will. I'm a goose.

Walk a lap or do ten heel raises, then press Done. Press Later and Honk leaves you alone for twenty minutes before one more try. In between, Honk drops by now and then with a stretch, and once each early afternoon with a short walk, around the time heavy legs start to show.

Notchpals can't see your ankles and doesn't know whether you moved. It trusts your Done. What it can do is catch the long sit you would otherwise have missed. For any of the warning signs above, though, skip the goose and call a doctor.