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    Edward R. Laskowski, M.D.

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Question

Hand swelling during exercise: A concern?

What causes hand swelling during exercise? I walk several times a week, and my fingers get puffy to the point that I can't get my rings off.

Answer

from Edward R. Laskowski, M.D.

Hand swelling during exercise is a fairly common problem. The cause isn't completely clear, but hand swelling appears to be a result of the way your body and blood vessels respond to the increased energy demands of your muscles during exercise.

Exercise increases blood flow to your heart and lungs, as well as to the muscles you're working. This reduces blood flow to your hands, making them cooler. In turn, the blood vessels in your hands may overreact by opening wider — which could lead to hand swelling.

As you continue to exercise, your muscles generate heat that makes your system push blood to the vessels closest to the surface of your body, to dissipate heat. This response triggers perspiration and may also contribute to hand swelling.

In rare instances, endurance athletes develop hyponatremia (hi-po-nuh-TRE-me-uh) — an abnormally low level of sodium in the body. Swollen fingers and hands may be a sign of hyponatremia, but other signs, such as confusion and vomiting, are more prominent than is swelling. Drinking too much water, particularly during a marathon or similar long, strenuous event, may cause your body's sodium to become so diluted that you become hyponatremic. Confirmed hyponatremia requires immediate medical attention.

There's no proven way to prevent or reduce most exercise-related hand swelling. Before you exercise, you may want to remove your rings and loosen your watchband. During exercise, it may help to do occasional forward and backward arm circles. You might also stretch your fingers and then make fists several times during exercise.

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References
  1. Garrett WE, et al. Exercise and Sport Science. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2000:110.
  2. Steele KD. Principles of healthy exercise. In: Birrer RB, et al. Sports Medicine for the Primary Care Physician. 3rd ed. New York, N.Y.: CRC Press; 2004:56.
  3. Dresner AJ, et al. Sports medicine. In: Rakel RE, ed. Textbook of Family Medicine. 7th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com. Accessed June 17, 2010.
  4. Laskowski ER (expert opinion). Mayo Clinic, Rochester, Minn. June 17, 2010.
AN01403 Aug. 6, 2010

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