I saw this article in Outside Magazine Online and was shocked to find the theory my friends and I had for having puffy hands while hiking wasn't completely wrong but it wasn't totally correct either. We had always thought that our blood was settling in our hands because we hung our arms below our heart while hiking causing our hands to puff up so the thing to do to cure this condition was to raise our hands above our head to let the blood flow back down into other parts of our body.

WOW, OUR THEORY WAS PARTIALLY CORRECT...actually, there is a condition called hyponatremia which makes a hiker's hands puff up, but only hikers whose bodies are low on a vital substance their body needs. If you want to know what it is click on the link below.


http://www.outsideonline.com/fitness/fitness-coach/Why-Do-My-Hands-Puff-Up-on-Long-Hikes.html

My swollen hands stopped swelling once I started using hiking poles.

I think it is something other than hyponatremia, because I would often get swollen hands, but not the other symptoms of that problem. And I am sure I am not over indulging in water.

But it is an interesting idea. One could easily test it by consuming lots of salt and checking if hands still swell.

As I understand it, hyponatremia is not necessarily too much water: its too little salt. Can be caused by excessive flushing with water, but can also just be electrolyte depletion through sweating and balanced water intake, no?

I had the same experience with hiking poles BTW, and found the swelling was also alleviated by lightening up on the pack, loosening straps and removing pack for rest stops: the circulatory thing

applying occam's razor ( a principle stating that among competing hypotheses, the one which makes the fewest assumptions should be selected ) to this phenomenon, i believe that your original hypothesis is correct.

the medical term for this sign / symptom is dependent edema.

think how you get fat ankles when flying in an airplane for any distance.

think how steve c, and myself and probably more folks, resolved this issue merely by using hiking sticks. their use gets the hands and arms up and moving which in turn helps moves the fluid from the otherwise lower (dependent) and relatively non-moving position.

it is also possible that hyponatremia may play a role.

but for me, in this case, occam works.

is it possible that hyponatremia causes hand swelling?
yes

is it likely that hyponatremia causes hand swelling?
no. even the Dr in Lynn's article says 9 times out of 10 it is just blood/fluid pooling in the extremity ,whether upper or lower.

That is why many of us notice hand swelling after just a one hour walk or hike so it cannot be hyponatremia that quickly. The Dr in the article is referring to Ironman-type stuff where severe hyponatremia would cause much more than some minor hand swelling, ie, brain swelling with loss of coordination, even seizures, etc, etc. Also, he is on the Gatorade payroll. I am not. There is an appropriate use for electrolyte replacement but a one hour walk is not one of them. Even a full ride up and down Whitney should not pose a problem unless it is 90+ degrees, the person ill with bad vomiting or diarrhea, certain chronic illness, extremes of age, certain medicines, other exceptional circumstances.

People often carry a baton or a stick around to squeeze intermittently (instead of statically/isometrically) to pump the veins out, so to speak. That does help.

Harvey, I like the idea of you and me getting on the Gatorade payroll! Free Product!

I also have been plagued by hand swelling, and also find that hiking poles cured it.

I am positive that it is related to the process by which blood/fluids are returned to the heart. Blood is pumped out by the heart through the arteries, as we all know.

However, the return system, the veins, are a low-pressure system dependent upon muscle contraction to work. One reason that sitting on an airplane for hours may produce leg swelling, and that getting up and walking along the cabin every hour often prevents the swelling.

Lymphatic drainage may also be involved, but the time frame involved would suggest a faster working system, such as the venous return circulation.

What is with this sudden media hype about hyponatremia? First, it was suddenly impossible for a person to go to the grocery store without toting the ubiquitous bottle of water, now the answer to every sports malady is somehow connected to hyponatremia.

It almost reminds me of the Carb-demonizing trends that pop up in diets every decade or so.

Dr. Lankford

I just found another thread that talks about HYPONATREMIA.

Check out the General Discussion forum ... look for the thread titled ' Bushwalker Died From Drinking Too Much Water '.

I think hyponatremia is a national problem. It is related to the water, which is clearly inferior in it's native state.

Just as all water needs to be filtered (at the very least), all water needs to be supplemented.

Isn't it great to be protected by the Magic of the Market?

Clearly.

Pretty weird to attribute swollen hands to hyponatremia. I see it a lot -- people often ask about it. I've always assumed it was due to initial fluid imbalance when hiking at altitude and that fluid accumulates in the tissues. I find that about a week after arriving at altitude (=> 10,000) I start pissing a lot for a day or so.

On the other hand (heh, heh, heh) I don't find my hands swelling a whole lot, though perhaps a little. And, this is obviously anecdotal and based on only my own theory -- I'd never bothered to research it, just assumed!

But I have seen it in people with and without hiking poles. As a side note, I do see a few people every year, hiking with poles, who get an allergic reaction apparently to the sun. They show very small blisters on the hand, which is always elevated and very exposed to the sun. I recommend gloves or even a bandana or gauze and the problem seems to go away.

Finally, hyponatremia is a definite problem. I know of two fatalities in the last 5 years in Sequoia Kings (actually, one just outside the park). There was one case I responded to. The guy survived, but was in a coma for two days or so (got him out at last light. Doubt he would have survived the night...). The first symptom I'm aware of is weakness and an altered mental state. We were told at one of our medical refreshers some years ago that it was extremely rare and we'd be unlikely to see it. Not so. Grand Canyon has a major education effort to make sure people not only drink fluids, but eat as well to maintain both carbs but also electrolytes.

Interested in the swollen hand thing though. It does happen a lot. As above, always assumed the body was retaining fluids. Comments from docs??

George