Soft and puffy cartoon characters or toys can seem pretty cute. You press on them and they giggle, or they just look so wonderfully squeezable, and some even grow giant sized and destroy half of New York City. But, unlike these enjoyable rotund cartoon characters, having soft and puffy ankles isn’t pleasant at all.

Swelling is one of those things your body does when things aren’t going so great. When you’re injured, your body sends additional blood to the damaged area to promote healing, which means that there’s a lot of extra fluid hanging around. Or, swelling in the ankles can be indicative of a heart problem. Heart failure, poor blood circulation, pulmonary hypertension (high blood pressure in the arteries that connect the heart to the lungs) or overall high blood pressure can also cause ankles to swell, as can diseases or conditions such as Hepatitis B or C, gout, arthritis, infections, tumors, lymphatic problems, or varicose veins.

In short, just knowing you have swollen ankles doesn’t exactly tell you what’s wrong with you.

While your larger-than-usual ankles may be one of your symptoms, you’re also likely to have other symptoms as well, depending on your disease or condition. For instance, if arthritis is your problem, your ankles will probably also feel stiff and painful, and the condition may get worse over time. Infections will likely be accompanied by pain and fever, and injuries by warmth and redness as well as pain.

If you’re experiencing heart failure, you’re likely to find yourself short of breath when you’re active as well as when you lie down. You’ll probably also feel pretty tired. In addition to your ankles, your legs, feet, and even belly may swell, and you may develop a persistent cough. Those suffering from pulmonary hypertension may experience similar symptoms, as well as chest pain, fainting spells, and an irregular heartbeat.

Hepatitis B often comes with a yellowing of your skin and eyes (jaundice), fatigue, loss of appetite or nausea, weight loss, a swollen stomach as well as ankles, an unusually long time for bleeding to stop, and the appearance of veins that look rather spider-like (called spider angiomas).

Your podiatrist is a softie for soft and puffy things just like the rest of us. But he or she knows that swollen ankles aren’t something to keep around and cuddle. When you go to your podiatrist’s office, he or she will probably want a thorough medical history, and will ask questions about your swollen ankles. These may include questions about how long they’ve been swollen, whether any of your other joints are swollen, whether the swelling comes and goes, whether you leave a dent if you press on your swollen ankle and then remove your finger, what activities or time of day seem to make the swelling worse or better, and any other symptoms that may be present.

There are numerous tests available to get to the heart (as it were) of your puffy problem. These may include blood tests (useful for finding Hepatitis B or other infections), X-rays (often used to pinpoint injuries), and examination of fluid drawn from the joint. (If chronic Hepatitis B is suspected, your doctor may recommend a liver biopsy.)

Naturally, treatment depends entirely on your diagnosis. For instance, you may be able to treat arthritis with pain medications, anti-inflammatory meds, orthotics, or surgery. Infections can be combated with anti-viral or anti-bacterial medications, and high blood pressure can be treated using a variety of different pharmaceuticals. Conditions such as heart failure may require more complex treatments.

Fortunately, your doctor is great at figuring out ways to get your ankles back to normal. Because even if puffy things are cute in general, no one likes a puffy ankle.