Why do my socks leave indentations on my legs?

The 5 Signs You are Holding Water and 3 Fast Solutions Anyone Can Follow

Water Water Everywhere! 10 Causes of Water Retention

I have had several messages specifically regarding Water Retention. So I will try to explain what the main causes are and what you can do about it. Firstly I must state that I am a personal trainer not a doctor, so I will give you this based on my understanding, and lots of help from the internet!

Well known causes of water retention include heart or kidney problems, the heart and kidneys struggle to work properly and can cause swelling in the legs and ankles. If you are suffering from water retention you need to see your doctor, to rule out anything sinister. You should always contact your doctor if your skin stays swelled for a long period of time or if you poke yourself with your finger and it leaves an indentation mark.

5 Signs that You Are Retaining Water

1. If your socks leave a ring around your leg.
2. When you can not remove your rings because your fingers are swollen.
3. When you have a problem getting your trousers to zip up and down all of a sudden.
4. When you gain several pounds in just a day or so.
5. You have “smoothed out” or lost your definition – for lean people only

10 Causes of Water Retention

1. Inactivity
Weak circulation in the leg veins is probably the most common cause of water retention in legs and ankles.
People who spend a lot of time immobile, e.g. those in hospital beds, wheelchairs, or on long-haul flights, even “couch potatoes” can develop water retention because without regular movement, it is difficult for your lymphatic system to drain excess fluid out of your tissues. Exercise help to boost this process.

2. Pregnancy
Water retention occurs in pregnancy and causes swelling.

3. Older people
In older people this problem may also result in varicose veins.

4. Ladies Week 😉
Premenstrual water retention is also common, and is caused by the hormonal changes of the menstrual cycle.

5. Salt
One of the main causes of water retention is eating too much salty food. The main component of salt is sodium, which the body dilutes with water if too much of it is present. Salt makes you thirsty, and your body will hold on to this water. Reducing the amount of salt in your diet will help you to release a little water retention but not usually more than about 2 lbs in weight.

Even a relatively salty diet, although it can be harmful in many ways, will not normally cause excessive water retention.

Lesser-known Causes

6. Hormones and Medicines
High levels of certain hormones can also make your body hold on to water. These include insulin, which is needed to process sugar; cortisone, which is produced when you are under stress; and the female hormones estrogen and progesterone. The water-retaining effect is caused by the effects which these hormones have on sodium levels in your body, and on the hormones which govern how your kidneys work. Certain prescribed medicines such as the contraceptive pill and some painkillers can affect levels of these hormones. Water retention which is caused by hormones can be spread around the body but often affects your tummy most of all. Women can also get water retention in the breasts, which causes tenderness and swelling.

7. Wastes and Toxins
Cellulite, which mostly affects women’s thighs, is a form of fat combined with retained water. Sometimes it holds so much water that it is swollen and painful to the touch. Metabolic wastes and toxins such as pesticides which the body cannot easily release tend to be stored in this fat. It is thought the causes of the water retention in cellulite are either irritation or swelling due to these toxins, or results from the body’s attempt to dilute them.

8. Low-Calorie Diets
If you have water retention you are very likely to be overweight. But overweight people tend to go on a low-calorie diet. A low-calorie diet will unfortunately not get rid of water retention – it can actually make it worse, especially if you eat less than 1,200 Calories a day for months or years. This is because you may not have enough protein in your blood to draw excess water out of your tissues. This type of water retention can cause generalised puffiness but if severe can give you a swollen tummy.

9. Histamine
Histamine causes water retention leading to bloating and tummy swelling. If you have ever been stung by an insect or developed an itchy red lump after a mosquito bite, you will be familiar with the effects of histamine. Histamine widens the joins between the cells which line your smallest blood vessels, known as your capillaries. This makes them leak both water and protein into your “tissue spaces” – the area surrounding the cells of tissues such as flesh, organs and intestines. If the protein cannot be removed from your tissue spaces, it will stay there, attracting water.

Poor digestion and taking antibiotics can cause changes in your intestines which lead to a lot of histamine being produced in this area. Sometimes eating yoghurt and probiotics can help to reduce this problem, but if it has been going on for some time these measures may not be effective on their own.

10. Interesting Point….which you need to know!
Drinking less fluid will not cure water retention. One of the causes of water retention is dehydration due to not drinking enough water.

3 Quick Solutions
Rid yourself of water retention by eliminating your bad habits. Become more active, reduce your salt intake and drink more water are the most basic steps anyone can take.

Many types of water retention will respond to dietary measures. The Waterfall Diet has been designed by British nutritionist Linda Lazarides to help release excess water weight as quickly as possible. It can also help to treat health problems associated with water retention, such as swollen legs, arthritis, high blood pressure and PMS.

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Edema related to circulation (vascular), heart or liver problems

A variety of diseases can cause edema. Most of the time, the edema is not a serious illness, but it may be a sign for one. Here are some examples:

Venous insufficiency can cause edema in the feet and ankles, because the veins are having trouble transporting enough blood all the way to the feet and back to the heart. This means that it gathers in the legs, and fluid is forced out of the blood vessels into the surrounding tissue. Edema can also be caused by varicose veins.

Congestive heart failure can cause both peripheral edema and abdominal edema (ascites). This is because the heart is too weak to pump blood around the body properly, so the blood gathers in front of the heart. Because of this, and due to the increased blood pressure in the veins, fluid seeps out into the surrounding tissue. This may cause swelling in the legs or a build-up of fluid in the abdomen. If the person spends a lot of time lying down, the edema might show up on his or her back (called sacral edema). Congestive heart failure can also cause edema in the lungs (pulmonary edema). This is not common, but the condition is life-threatening. It means the lungs are filling with fluid because the left side of the heart is not strong enough to pump the blood returning from the lungs. The blood gathers in the blood vessels of the lung, and fluid seeps out into the lung tissue. The signs are shortness of breath and rapid, shallow breathing or coughing.

Kidney disease could cause edema in the legs and around the eyes, because when the kidneys do not remove enough sodium and water from the body, the pressure in the blood vessels starts building up, which can lead to edema.

Low protein levels in the blood: If there is a lack of the protein albumin in the blood, fluid can leak out of blood vessels more easily. Low protein in the blood can be caused by extreme malnutrition, as well as kidney and liver diseases which mean that the body loses too much or produces too little protein.

Liver diseases: Scarring of liver tissue (liver cirrhosis) due to, for instance, long-term alcohol abuse or a liver inflammation, can cause edema in the abdomen (called ascites). This is because cirrhosis causes a lack of proteins and congestion in the liver, which can lead to increased pressure in the blood vessels. As a result, fluid seeps out into the abdomen.

Severe lung conditions like emphysema can also cause edema in the legs and feet if the pressure in the lungs and heart gets very high.

Concerns about swollen legs

Ask the doctor

Updated: January 29, 2020Published: February, 2018

Q. I have noticed my legs are getting more swollen lately. Is this anything to worry about? My mother also had this problem and was diagnosed with heart failure.

A. Leg swelling is very common, especially as people get older. Heart failure, which means the heart can’t function well enough to meet the body’s needs, is certainly on the list of serious causes. However, people usually experience other symptoms such as shortness of breath and fatigue by the time the heart failure becomes serious enough to cause leg swelling.

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What is

Heart Failure?

Definition

Heart failure, also known as congestive heart failure, occurs when your heart isn’t pumping enough blood to meet your body’s needs. As a result, fluid may build up in the legs, lungs, and in other tissues throughout the body.

Causes

Heart failure can occur for several reasons. Common causes of heart failure include:

  • Coronary artery disease
  • Previous heart attack (myocardial infarction)
  • High blood pressure (hypertension)
  • Valve disease
  • Congenital heart disease (condition you are born with)
  • Cardiomyopathy (enlarged heart)
  • Endocarditis
  • Myocarditis (infection of the heart)
  • Diabetes

Symptoms

Heart failure symptoms aren’t always obvious. Some people in the very early stages of heart failure may have no symptoms at all. Others may dismiss symptoms like fatigue or shortness of breath as signs of growing older.

Sometimes, however, heart failure symptoms are more obvious. Because of the heart’s inability to efficiently pump blood and supply your organs (such as the kidneys and the brain), you may experience a number of symptoms, including:

  • Shortness of breath
  • Swelling of the feet and legs
  • Lack of energy, feeling tired
  • Difficulty sleeping at night due to breathing problems
  • Swollen or tender abdomen, loss of appetite
  • Cough with “frothy” mucus or phlegm
  • Increased urination at night
  • Confusion
  • Impaired memory

Risk Factors

Some people are more likely than others to develop heart failure. No one can predict for certain who will develop it. Being aware of the risk factors and seeing a doctor for early treatment are good strategies for managing heart failure. Heart failure risk factors include:

  • High blood pressure (hypertension)
  • Heart attack (myocardial infarction)
  • Abnormal heart valves
  • Enlargement of the heart (cardiomyopathy)
  • Family history of heart disease
  • Diabetes

Diagnosis

Only your doctor can tell if you have heart failure and how far the condition has progressed. Your doctor will review your medical history, including past and present illnesses, family history, and lifestyle. As part of your physical examination, your doctor will check your heart, lungs, abdomen, and legs to see if signs of heart failure are present.

To rule out or confirm the diagnosis of heart failure, your doctor may order one or several of these diagnostic tests:

  • Echocardiogram
  • Electrocardiogram (ECG)
  • Chest x-ray
  • Exercise test (stress test)
  • Cardiac catheterization

If you have heart failure, your doctor may also track your ejection fraction over time. Ejection fraction is the percentage of blood that is pumped out of the heart during each beat. It’s a key indicator of your heart’s health and doctors frequently use it to determine how well your heart is functioning as a pump.

Managing Swelling Caused by Heart Failure

By

Elizabeth Hanes, RN Was this helpful? (24)

Your heart is a magnificent organ. Though it’s only about the size of your fist, it manages to pump blood all the way to your toes—at least, it does when it’s healthy.

Unfortunately, the heart can become weakened and gradually fail to pump as well as it should. When this happens, doctors call it “heart failure.” One of the more noticeable features of heart failure is swelling. This is known as heart failure edema and often involves swollen feet and ankles. It can also cause swelling of your hands. Learn more about what causes this swelling—and how to manage it.

Why does heart failure cause swollen feet and ankles?

At Your Appointment

Heart Failure Appointment Guide

One of the key functions of your circulatory system is the transport of substances—excess fluid, nutrients, waste products—to other places in the body for use or excretion. When you have heart failure, your circulation slows down and becomes less efficient. Fluid that normally would be picked up by the blood and swept away to the kidneys for elimination instead remains behind in places like the lower extremities.

With heart failure, your kidneys also become less able to remove sodium from the blood. You may know that sodium helps your tissues use and retain fluid. However, when excess sodium can’t be cleared by the kidneys, then abnormal swelling can occur. Heart failure edema may be most noticeable with swollen feet and ankles, but it also can occur in the abdomen. Edema is why people with heart failure should weigh themselves daily. Weight gain can be a sign of fluid retention, even if you can’t see it.

Heart failure edema treatment starts by throwing away your salt shaker.

Sodium (salt) is possibly the biggest dietary culprit in causing fluid retention. The first thing anyone with heart failure should do to improve their overall health is throw away their salt shaker.

In general, you should consume less than 2,000 mg of sodium a day if you have heart failure. Because sodium lurks in most pre-packaged foods, you should read food labels carefully to get a real understanding of how much salt you’re taking in.

Take all your medications as prescribed.

If you have heart failure, chances are your doctor prescribed you a diuretic medication (sometimes referred to as a “water pill”). This medication is a swelling treatment because it helps your body get rid of excess fluid. It’s important you take it exactly as prescribed.

Your doctor may have given you other medications, too, including:

  • Beta blockers to slow your heart rate
  • Blood pressure pill
  • Potassium supplement

All of these medications, when taken in combination, treat various symptoms of heart failure, including swelling. You should never stop taking a heart failure medication just because you are not noticing any swelling.

Monitor your fluid intake.

When you have heart failure, you have to be careful about how much fluid you drink because your body can’t process it efficiently. This includes water, coffee and tea, sodas, juices—any fluids at all.

Of course, human beings cannot survive without drinking water. Talk to your doctor for personalized guidelines about how much fluid you should aim to consume daily, and then measure and track your intake to make sure you’re not having too much.

Put your feet up to help combat swollen legs.

When you have heart failure, your heart pumps less forcefully. This means it can’t push blood through distant veins easily. You can give your heart a “gravity assist” by elevating your feet and legs as soon as you notice them starting to swell. By positioning your feet higher than your chest, blood will literally run back through your veins to your heart more easily.

Ask your doctor about wearing support hose.

Sitting for long periods of time promotes swelling in the feet and legs in anyone, but especially in heart failure patients. If you’re planning to travel by plane, train or car for more than a few hours, ask your doctor about whether or not you could benefit from using compression stockings. These garments squeeze your tissue layers together, making it harder for fluid to find a space to accumulate. Some people, such as those with diabetes, perhaps should not wear support stockings, so be sure to consult your doctor before you make this decision.

Heart failure may be incurable, but many people with the condition enjoy a good quality of life. One of the best things you can do to slow the progression of your heart failure is to manage the fluid retention and swelling that may come along with it.

What Does It Mean If You Have Sock Marks on Your Legs?

Most often, peripheral edema is the result of fluid retention rather than an underlying condition. The swelling is usually mild and temporary.

Dependent edema

When you stand or sit for long periods throughout the day, gravity pulls blood into your legs. The increased pressure pushes fluid from the blood vessel into the soft tissue, causing mild swelling.

Swelling related to gravity is called dependent edema. It’s more pronounced at the end of the day, which is why sock marks are typically worse in the evening. They are usually gone by morning.

Salt

Eating lots of salt makes your body retain water. This leads to peripheral edema, which may cause more noticeable sock marks the next evening.

Hormonal changes

Hormone levels change throughout a woman’s menstrual cycle. This can cause water retention and leg swelling the week before menstruation.

Pregnancy

As it enlarges, a pregnant woman’s uterus can push on the blood vessels leading to her legs. This slows the movement of blood from her legs up to her heart, which can lead to peripheral edema.

Most pregnant women get peripheral edema, but it can also be a sign of a serious condition called preeclampsia. Other symptoms are the sudden onset of high blood pressure and protein in your urine (proteinuria). It requires urgent medical attention.

Heat edema

Peripheral edema often occurs in hot weather. Heat causes your blood vessels to open wider, so more blood pools in your legs. If fluid leaks into the tissue, edema develops.

Obesity

Being obese can cause excess fat in your abdomen and pelvis to push on blood vessels, slowing blood flow out of your legs. It accumulates in your leg veins, and the increased pressure pushes fluid into the soft tissue.

Peripheral edema caused by an underlying medical condition is generally more severe and doesn’t go away without treatment.

Venous insufficiency

One-way valves in your veins keep blood from backing up into your legs instead of moving toward your heart.

These valves can get weak and start to fail with age. Blood then backs up in your leg veins and leads to peripheral edema. This condition is called venous insufficiency. It can make your legs cramp or ache.

Congestive heart failure

Congestive heart failure develops because your heart is weak or damaged and can’t pump blood efficiently. Blood and fluid back up into your legs and sometimes your lungs (pulmonary edema).

Other symptoms include rapid weight gain and shortness of breath.

Kidney disease

With kidney failure, your body can’t remove enough fluid, so it builds up in your tissues — especially your legs. Swelling around your eyes (periorbital edema) is also common.

Liver disease

Diseases like hepatitis and alcoholism can scar your liver (cirrhosis), making it harder for blood to pass through this organ.

As a result, blood backs up into your lower body, and fluid accumulates in your abdomen (ascites) and legs. You may also develop yellow eyes and skin (jaundice).

Malnutrition

The blood level of a protein called albumin is low when you’re malnourished. Albumin helps keep fluid in your blood vessels. Without it, fluid leaks into the soft tissue.

Certain medications

Some medications can cause peripheral edema, including drugs for:

  • contraception: estrogen-containing birth control pills
  • diabetes: rosiglitazone (Avandia), pioglitazone (Actos)
  • high blood pressure: calcium channel blockers, such as amlodipine (Norvasc) and nifedipine (Adalat CC, Afeditab CR, and Procardia XL)
  • inflammation: nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil)
  • Parkinson’s disease: pramipexole (Mirapex)
  • seizures: gabapentin (Neurontin)

Should You Worry About Sock Indentation Marks On Your Legs?

If you wear very tight socks, sock marks will appear on your legs the moment you remove them after a long day. However, your legs may be signaling underlying health conditions. Peripheral edema is one of them. If the marks are mild and do not happen often, then you should not worry. If the marks recur or the swelling gets worse, it could be a sign of a chronic health problem such as diabetes or heart disease.

Sock indentation marks often take the exact shape of the socks worn. These indentations are not normal even when they happen occasionally and should be evaluated by a health professional.

Peripheral Edema is The Most Common Trigger

Your feet, ankle, and lower legs are the most common places you will see edema resulting from fluid buildup in your body. Defined as palpable swelling resulting from increased fluid volumes in a tissue, it can happen in any part of your body. But because of the forces of gravity, it appears as painless swelling in the lower extremities of your body. Understand that there is localized and generalized edema. Generalized appears in the form of collected fluid volumes in many body organs, and localized occurs in certain parts of your body. Leg edema is the most common localized type.

Peripheral edema is not painful and is mostly caused by a systemic problem within your kidney or heart or issues with veins within the area affected. If you only have swellings in the legs without pitting, you could be having problems with your lymphatic system or thyroid. Pitting edema is when indentations are left when pressure is applied behind on the skin. The skin around the affected area may feel heavy and tight, and could also appear stretched and shiny.

How Does Peripheral Edema Occur?

Edema occurs when fluid from the capillaries flow inside the interstitial space. The condition can be a clinical sign of various diseases, with its progression often accompanied by physiological changes. It is a process triggered by increased pressure within the smallest blood vessels – the capillaries. Capillaries distribute oxygenated blood to tissues and transport it to the veins from the tissues.

Pressure build-up within the capillaries forces water out of the blood vessels and distribute it in the tissues. This then leads to an increase of protein in the blood causing more fluid to be pushed back to the vessels. The factors contributing to the formation of periphery edema include:

  • Obstructed lymphatic drainage
  • Increased hydrostatic pressure
  • Increased vessel wall permeability
  • Water retention in tissues
  • Increased tissue oncotic pressure

What Causes Peripheral Edema?

Older people are at a higher risk of having large collections of fluid around the feet. Standing or sitting for too long can also cause swelling. After taking off shoes or socks, you may notice socks indentation marks. The signs are not always a cause for worry, unless the pitting does not clear up quickly. One of the most serious causes of peripheral edema is venous insufficiency. Certain antidepressants such as blood pressure medications can also contribute to the occurrence of edema. Should you swell when you’re under medication, let your doctor know.

Venous Insufficiency

Venous insufficiency is a condition that can be signaled by swollen feet and sock indentation marks. If you have had clots in your legs, you may be at risk of this condition. When the walls of the veins inside your legs become weak, and the valves repelling blood into your veins get damaged, venous insufficiency is likely to occur. Because of the damage to the valves, some of the blood flows back and collects in the veins of the legs and feet. Compression stockings, in this case, will be necessary to maintain a steady flow of blood. Avoid tight socks that could leave indentations behind.

When to See Your Doctor

Persistent peripheral edema needs a physical examination for proper diagnosis. Because some conditions linked to sock marks and swelling are serious, the underlying cause needs to be established. Edema resolves after the treatment of the underlying cause. A detailed medical history, imaging tests, urine, and blood tests may be needed.

If only one leg is affected, there could be a possibility of cellulitis. Sock marks could also be a sign of existing blood clots in the leg, a condition known as deep vein thrombosis. Report this to your doctor immediately to prevent the clot from finding its way to the lungs. Should it settle in your lungs, pulmonary embolism, a fatal condition could set in.

Peripheral edema becomes more apparent with age and can often be controlled with home care such as elevating the legs, limiting the dietary intake of sodium, and standing less. If it persists, it may be a signal of severe illnesses such as congestive heart failure. Reporting sock marks to your doctor early enough can be a means of preventing edema complications.

Foot Care Facts
All You Need To Know About Sock-Line Hyperpigmentation

Sock-line hyperpigmentation (sock line bands) is a condition caused by socks that are too tight or have constrictive elastic bands. The condition is often found in infancy, when baby socks restrict blood circulation.

Sock-line hyperpigmentation shows itself via thin, raised lesions, marks or rings around a person’s ankles or calves. The marks are usually red and oftentimes look like burns. According to the British Journal of Dermatology, the hyperpigmentation (which is when the skin becomes darker than the surrounding skin) may fade over time, but it usually causes permanent scarring.

© Stefan Kranefeld/Westend61/Corbis

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Sock-line hyperpigmentation is caused by socks or trousers that are too tight on an adult or baby’s lower legs and ankles. The tightness, especially from elastic bands, causes inflammation in the dermis (lower layer of skin) or in the subcutaneous fat. The hyperpigmentation can appear after just a couple of hours of a person or an infant wearing socks that are too tight.
Sock-line hyperpigmentation is different from amniotic band syndrome, which develops in the womb and can cause similar symptoms in newborn babies.

Treatment and Prevention

Unfortunately, though it is a harmless condition, sock-line hyperpigmentation is a permanent condition that usually causes scarring. If you or your baby’s skin shows chaffing or other signs of irritation from socks or pants, you may want to apply a topical antibacterial ointment or spray such as Dermatol. However, check with your child’s doctor or pediatrician before applying medication to his or her skin.
Preventing sock-line hyperpigmentation is as simple as making sure your and/or your infant’s socks and pants aren’t too tight. Try choosing socks and pants made out of soft, natural material that do not contain restricting elastic or rubber bands. When trying new socks or pants, always place a finger between your baby’s skin and the band of the sock or pants to make sure the items aren’t too tight.

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