Just Swell...but WHY?

arny - 2009-05-04 11:33 AM Anytime you have swelling, especially of the legs/ankles/calves, you have to check for pitting edema. You take one finger and press it into the swollen area...press and remove...if the indentation of the finger stays there, it is called "pitting edema" and can be a sign of issues with cardiac return/water retention which does need to be checked by a GOOD and receptive doctor. The swollen hands during long runs is pretty much the norm for lots of people I know that run marathons. It should resolve straight away and there definitely should NOT be any pins/needles at all...that is a bigger issue. For sure, you need to keep on top of any swelling...and if it is calf and one leg only...consider things like blood clots which can happen after sitting for long periods, flying, and so on...some people just seem really susceptible(esp if you are on the pill).

AdaBug - 2009-04-28 9:33 PM

Noticed with my last longish run that my hands swelled, to an almost uncomfortable degree---rings became tight, and I could feel the skin stretch when making a fist. The previous long run, indoor track 120', with readily available water/gatorade/food there was nothing like this 90' outdoor run.  Then, again this afternoon, on a short run I felt the beginning of swelling again.

WHY do we swell?  Is it the heat?  Is it salt? Too little or too much water?

Thanks!

Dr Hammer - 2009-05-04 3:55 PM

Many things could cause this.   It could be a simple as mechanics.  Clenched fists do not allow blood to flow back up the extremity.  Therefore, blood/fluid pools and swelling occurs.   I was trained to run with a light touch on my fingers tips.  Think of holding a potato chip during your run.  You can’t crush it.  You have to deliver it intact to the finish.

 

Centripetal/centrifugal forces.  As you run and swing your arms the centrifugal force assists the arteries in carrying blood to the distal portion of your arms (your hands) but the venous (return) system requires the assistance of the muscles get the blood back to the heart.  While you run the majority of muscle activation is in the shoulder girdle and not in the elbow, wrist and hand.  So any blood below the shoulder has a hard time getting back. Coupled with the intermittent unusually-high pressure in the subclavian veins from the heavy breathin, venous return may not be optimal. Not sue how I feel about that one.  I can see it especially if one is really clenching the fists.

 

Gravitational influence and differences in fluid pressure. Your hands are typically hanging in a gravity dependent position below the heart. The pressure to your hands is greater than the pressure away from your hands.  Consequently, the change in gradient causes the serum (fluid part of the blood) to leak into the space between the cells and cause edema.  

 

Diet.  You may not be consuming enough protein which can cause your albumin (found in the blood) to be low.  It can cause changes in osmotic pressures in your vascular system.  High albumin fluid is drawn into the circulatory system, low albumin fluid is drawn out into the tissues.   Or, an electrolyte *imbalance* could be at fault.  You either have either too much or too little sodium.