Sunday, February 13, 2022

The Big Hand Syndrome

Since my accident last year, my wife and I have been going for longer walks (since I could not run then). We enjoy the time together since it gives us a chance to share our thoughts, talk things out and simply hang out.

What we have noticed is that our hands are often swollen at the end of these hour long walks. It never happens when we go for a run, only after a walk.

Looking through some endurance related forum boards revealed that this is fairly common among ultra runners too. Ultra runners complain that their hands look like a "blown up rubber glove" or having fingers that feel "tight and hard to bend".

I've tried looking for research regarding the causes of hand swelling during walking/ moderate exercise, but not much can be found. It has been suggested by one published report that one out of four people will experience swollen fingers/ hand while walking. Women seem to be more commonly affected than men. 

There have also been suggestions that arm motion, heat-related issues or metabolic changes may play a part but nothing seems conclusive. 

One study (reference below) referred to the post-walking hand swelling as the "big hand syndrome".

It is suggested that hand swelling may be a result of the way our bodies and blood vessels respond to blood flow during exercise. Since exercise increases blood flow to our heart, lungs and our lower limb muscles (while walking) blood flow to our hands is reduced. This makes our hands cooler while the blood vessels react by opening wider, leading to swelling in the hands. 

As you contiune on your walk, your muscles try to dissipate the heat generated by pushing blood to the vessels closest to the surface of your body. This response makes you pespire and can also contribute to hand swelling.

In hot, sunny and extremly humid Singapore, skin blood flow and circulation may be compromised and regulation of body temperature will be more difficult, even during light exercise. Vasodilation (opening of blood vessels) occurs to cool our bodies by pespiring.

Depending on how much water we drink and our bodies' ability to cool itself, this may create a fluid imbalance, leading to excess fluid in the skin and underlying tissues.

Some papers also suggest fingers/ hand swelling can be a early sign of hyponatremia, but I don't think so. It would be very unlikely that one can get hyponatremia from walking for an hour or two. 

Trust me on this, I've had hyponatremia before and the more serious and obvious signs and symptoms include vomiting, cramps, giddiness, disorientation, diarrhoea and convulsions. I had most of those symptoms and that landed me in the hospital intensive care unit (ICU) for a few days after a ultra running race in Hong Kong back in 2000. Now you know what I mean when I say I'm a cat with 9 lives. I've definitely used up a few of those 9 lives. 

Unfortunately, there is no fool proof way to reduce or prevent exercise related hand swelling. What we found helped was opening and closing your fingers frequently when walking and/ or making exaggerated arm swings or circular actions with your elbow. 

Taking off your rings (like my wife in the picture above) and loosening your watch strap if you wear one will make it less uncomfortable.

All smart endurance athletes know it is important to pay attention to their bodies and it's natural to wonder if suasage-like fingers are symptoms of something sinister. Fortunately, hand swelling is just a slightly annoying, but not harmful, response to exercise. 


Ravaglia FF, Leite MG Leite, Bracellos TF et al (2011) Post Ambulatory Hand Swelling (Big Hand Syndrome): Prevalence, Demographics And Association With Dog Walking. ISRN Rheumatol. DOI: 10.5402/2011/65995

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