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Swollen feet and ankles

Old 07-16-08, 07:23 AM
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Swollen feet and ankles

I returned home Monday evening from an eight-day, 400-mile ride around Lake Champlain in VT, NY and QC. I towed my Croozer Cargo trailer full of my stuff behind my Bianchi Axis.

Yesterday, I noticed my feet and ankles were quite swollen. The swelling did not go down yet; they look just as swollen today.

I've made a couple of other 400-500-mile rides in the past and never noticed this swelling. On day two of this trip, I became dangerously dehydrated and almost had to quit. I was wondering if this has something to do with my swelling... maybe my body is retaining extra fluids in response.

Any thoughts? I'm wondering if I should see a doctor or if this is a common post-ride thing.


Ride safe,
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Old 07-16-08, 05:53 PM
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Yeah, gaining weight, and having your ankles swell, after long rides is normal.

Here's what happens ...

-- when you're on the ride, you drink less than your body needs ... especially when you're sweating a lot.
-- your body compensates, by trying to store as much as it can ... and you'll notice your urine output decrease.
-- when you finish the ride, you're thirsty so you drink quite a bit ... and your body continues to store it for a day or two because it thinks you might hop back on the bicycle again at any moment.
-- because your body is still in storage mode even when you're not using it up anymore, you gain weight and your ankles swell ... your cells are full of water.
-- two or three days later ........... you'll spend a day or two peeing like you've never peed before, and your weight will return to normal.



Happens to me after every century or longer ride.

For example, I rode a century on Saturday ... I gained 3 lbs and have lost it now. I rode 200 kms 3 weeks ago ... gained 3 lbs, lost 3 lbs a few days later. Every time!
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Old 07-16-08, 06:00 PM
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I'm 100% sure you have gout.
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Old 07-16-08, 06:41 PM
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Pregnant?
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Old 07-16-08, 07:09 PM
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Originally Posted by Machka
Yeah, gaining weight, and having your ankles swell, after long rides is normal.

Here's what happens ...

-- when you're on the ride, you drink less than your body needs ... especially when you're sweating a lot.
-- your body compensates, by trying to store as much as it can ... and you'll notice your urine output decrease.
-- when you finish the ride, you're thirsty so you drink quite a bit ... and your body continues to store it for a day or two because it thinks you might hop back on the bicycle again at any moment.
-- because your body is still in storage mode even when you're not using it up anymore, you gain weight and your ankles swell ... your cells are full of water.
-- two or three days later ........... you'll spend a day or two peeing like you've never peed before, and your weight will return to normal.



Happens to me after every century or longer ride.

For example, I rode a century on Saturday ... I gained 3 lbs and have lost it now. I rode 200 kms 3 weeks ago ... gained 3 lbs, lost 3 lbs a few days later. Every time!

I think you probably hit it on the head. I did happen to hop on the scale when I got home, wondering if I lost some weight. I was bummed to find myself heavier, but I hadn't been on the scale for a while so figured I must have started the ride weighing more than I thought. Your explanation would cover the swelling and weight gain.

I haven't gotten laid in ages, so I'm fairly sure I'm not pregnant. And since gout is an STD, that kind of rules it out too, right? ;-)

Ready to commence peeing in earnest,
desmobob

Last edited by desmobob; 07-16-08 at 07:19 PM.
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Old 07-16-08, 07:37 PM
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Gout is an arthritis .... and I highly doubt that's your problem.

https://www.arthritis.ca/types%20of%2...ut/default.asp
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Old 07-16-08, 07:41 PM
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Originally Posted by Machka
Yeah, gaining weight, and having your ankles swell, after long rides is normal.

Here's what happens ...

-- when you're on the ride, you drink less than your body needs ... especially when you're sweating a lot.
-- your body compensates, by trying to store as much as it can ... and you'll notice your urine output decrease.
-- when you finish the ride, you're thirsty so you drink quite a bit ... and your body continues to store it for a day or two because it thinks you might hop back on the bicycle again at any moment.
-- because your body is still in storage mode even when you're not using it up anymore, you gain weight and your ankles swell ... your cells are full of water.
-- two or three days later ........... you'll spend a day or two peeing like you've never peed before, and your weight will return to normal.
Right general idea, completely wrong reasons.

What's actually happening is

1. When your urine output goes down, you're in hypovolemic shock. So, in order to maintain blood flow to important stuff like your brain and kidneys, the body releases several hormones, namely aldosterone and ADH, to hold on to sodium ions, which actually causes you to retain water.

2. This is no "anticipation of another ride"--your body is recovering from shock. There's a laundry list of inflammatory mediators that are released, but one of the effects is that capillaries start to leak, i.e. release intravascular fluid, into the interstitial space, i.e. between the cells. Because of gravity and the physiology of venous return, interstitial edema tends to be most visible/noticeable at the ankles, but you might also feel it around joints, rings might feel a little tight, etc. And despite having tons of water on board, you're still dehydrated, because the fluid you have is leaking out of your vascular system.

3. 2-3 days later, as the inflammatory reaction resolves, fluid is mobilized back out of the interstitial space and goes back into the blood vessels again. The body senses this as your heart stretches a bit, and it signals the release of all the sodium, hence the peeing like a race horse.

Make no mistake--it is NOT GOOD for your body to do this. It's a similar physiologic response to undergoing major trauma or a large surgical procedure. If you're getting that from a bike ride, you've done something wrong in terms of hydration and/or nutrition on your ride and you've sustained pretty significant injury.
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Last edited by DrPete; 07-16-08 at 07:52 PM.
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Old 07-16-08, 08:09 PM
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Thanks for the reasons ... mine were something of a guess based on observation. However, it happens to many, I'd venture to say most, long distance cyclists ... and we all recover just fine with no ill effects.
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Old 07-17-08, 04:35 AM
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That's enlightening-- and a little disturbing!

Most people will do just fine, but I don't know that inciting that kind of physiologic response would ever be considered recreational for me. You randonneurs are weird folk.
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Old 07-17-08, 05:55 AM
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Originally Posted by Machka
Gout is an arthritis .... and I highly doubt that's your problem.

https://www.arthritis.ca/types%20of%2...ut/default.asp

Machka,

I was joking about gout being an STD.


DrPete,

Thanks very much for the detailed explanation. As I mentioned in the original post, I did get dangerously dehydrated on day 2 of the eight-day ride. The temperature and relative humidity were both in the 90's and I was sweating profusely. I was towing a heavy trailer for the 80 miles we rode that day and I nearly had to drop out.

I consider this an important lesson learned on hydration.

Ride safe,
desmobob
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Old 07-17-08, 09:08 AM
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Hypovolemic shock is overstating it. This is a dire emergency. Let's call it hypovolemia and the normal compensatory processes so well described.
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Old 07-17-08, 09:10 AM
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Originally Posted by EGreen
Hypovolemic shock is overstating it. This is a dire emergency. Let's call it hypovolemia and the normal compensatory processes so well described.
There are classes of hypovolemic shock, ranging from mild to at-death's-door. "Shock" in lay terms does have the connotation of a dire emergency, though. This was close, as the OP is describing it.
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Old 07-17-08, 09:33 AM
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Originally Posted by DrPete
There are classes of hypovolemic shock, ranging from mild to at-death's-door. "Shock" in lay terms does have the connotation of a dire emergency, though. This was close, as the OP is describing it.
Well whether or not the OP lost 15-25% of intravascular volume , which is the criteria for hypovolemic shock, cannot be known, crucial is that he does not take becoming 'seriously dehydrated' for granted as it can have serous consequences well beyond swollen ankles! How about fatal dysrhythmias for one!
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Old 07-17-08, 06:06 PM
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Originally Posted by DrPete
That's enlightening-- and a little disturbing!

Most people will do just fine, but I don't know that inciting that kind of physiologic response would ever be considered recreational for me. You randonneurs are weird folk.
I've done 133 rides between 162 kms (100 miles) and 1200 kms (1200K randonnees) ... I'd have to say that for at least half of them, I've experienced the ankle-swelling-and weight-gain-then-peeing-like-crazy thing. And it's been happening on ALL my long rides lately. Usually I just gain 3 or 4 lbs, and my ankles puff up like balloons for a night or two, then it's all back to normal.

I aim to drink about 750 mls of water and/or sports drink every 1 to 1.5 hours when I ride, but sometimes I don't quite reach that goal. I'd rarely say I'm severely dehydrated though on those long rides ... and yet, I'll still gain weight and swell up a bit.



BTW - There are some interesting articles on hydration and long distance rides on this site:
https://www.ultracycling.com/siteindex.html
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Old 07-18-08, 06:13 AM
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Originally Posted by EGreen
Well whether or not the OP lost 15-25% of intravascular volume , which is the criteria for hypovolemic shock, cannot be known, crucial is that he does not take becoming 'seriously dehydrated' for granted as it can have serous consequences well beyond swollen ankles! How about fatal dysrhythmias for one!


I had been sweating profusely for hours in the high heat and humidity. The water in my water bottles was hot and I wasn't drinking as much as I should have. I was getting the feeling I might crash or collapse... even when I sat down to rest in the shade, my heart and breathing rate wouldn't slow down. I felt I had to urinate, but when I stopped, I managed only a single tiny squirt.

I finally got to a store and drank two bottles of cold Powerade while sitting in the shade. After about 15 minutes, I felt good enough to ride again (we were on a tight schedule to catch a ferry), but I would have preferred to rest much longer.

After drinking another litre of Powerade and more water later, I started to feel better. Some hours later, I felt back to normal.

Good riding,
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Old 06-07-23, 11:23 AM
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Salt Capsules?

I hope this conversation can be brought back to life—I'm late to the party...

I get the swollen ankles thing especially at the beginning of a season of riding and when it's especially hot out. I know it's coming when I feel the need—post ride—to 'guzzle' water. On a better day, I just drink water and I'm fine. But on guzzle days I can't seem to quench my thirst. I've tried to take Salt Stick capsules and felt like I had figured out the proper balance, but I'm sitting here 3 days after a 50 mile ride with big bloaty feet. If I were wearing shoes, I'd have fat water-balloon bulges. So, to the question finally:

Too much salt or not enough?

Details are: I'm 64, and ride 100—200 miles/week, I try to stay on a low carb-high fat diet but have to have beer. 6 ft tall, 145 lbs, don't smoke.

Thanks in advance!

A
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Old 06-07-23, 01:24 PM
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A Dough

Bringing back old conversations is frowned upon my many of us. For one thing it's old information and many times the participants are no longer active. Also a lot of the longer threads had feuds going on between members and it serves to rekindle those feuds.

Your question in itself is reason enough to just start a new thread. That way you get people talking to you and not responding to the OP or other members from the hey day of the thread.

But as to your issue, maybe edema. Maybe not. For sure you should get it checked out. If you've been riding regularly, then salt or not salt you shouldn't be swelling like that. IMO!

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Old 06-07-23, 04:22 PM
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Gotcha. I'll start a new thread......
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Old 06-07-23, 05:01 PM
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Originally Posted by A Dough
Gotcha. I'll start a new thread......
Well I wouldn't do that either at this point. Then someone might ding you for double posting.

You'll probably get a few answers in here if they make it down to your post before deciding to respond to the OP or another reply. You might ask a moderator to separate it out, but it's already here and this post wasn't so long with replies that others won't figure it out. Though some of us can be quite snotty about those reviving necro threads. But I'm sorta betting you found that thread as a result of a Google, Bing or Yahoo search and thought you'd get involved here.

But not to worry you about the swelling, there are some quite serious conditions that might need to be checked and ruled out by a doctor. Liver, kidney's and even some heart issues can be among the more serious of them.
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Old 06-07-23, 05:12 PM
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Make sure to get checked for DVT and superficial thrombosis in a large vein. Back in 2019 I had a superficial clot in my greater saphenous vein that went from my ankle almost to my groin.
Once you get your swelling issue sussed out, get some compression socks and wear them regularly. Elevate your feet at least 6" above your heart on a regular basis as well, you'll notice some relief.
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Old 06-07-23, 09:27 PM
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It was great to see those old posts by Machka anyway! Thanks.

I've been severely dehydrated, have done long bike tours, and randonneuring in hot weather - never had that happen. Do I do something different? Looking at the above, I drink enough that I have to pee every 3 hours. If I don't, I stop and drink until I do. Other than that, I drink to thirst not to a schedule. I take enough electrolytes, separate from my water so I can vary their quantity, to maintain enough of the thirst to . . .pee every 3 hours. I have no idea whether that sort of a regime would help but it works for me.

When I've been dehydrated, it was because it was hot and watering locations were too far apart for the containers on my bike, or else it was so hot and I was climbing so hard that I sweated out more water than my stomach could process. Stopping in the shade and drinking fixed that latter problem. I've drunk as much as 70 oz. in 20 miles.
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Old 06-07-23, 09:36 PM
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Gout?
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Old 06-08-23, 06:38 PM
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Originally Posted by DrPete
Right general idea, completely wrong reasons.

What's actually happening is

1. When your urine output goes down, you're in hypovolemic shock. So, in order to maintain blood flow to important stuff like your brain and kidneys, the body releases several hormones, namely aldosterone and ADH, to hold on to sodium ions, which actually causes you to retain water.

2. This is no "anticipation of another ride"--your body is recovering from shock. There's a laundry list of inflammatory mediators that are released, but one of the effects is that capillaries start to leak, i.e. release intravascular fluid, into the interstitial space, i.e. between the cells. Because of gravity and the physiology of venous return, interstitial edema tends to be most visible/noticeable at the ankles, but you might also feel it around joints, rings might feel a little tight, etc. And despite having tons of water on board, you're still dehydrated, because the fluid you have is leaking out of your vascular system.

3. 2-3 days later, as the inflammatory reaction resolves, fluid is mobilized back out of the interstitial space and goes back into the blood vessels again. The body senses this as your heart stretches a bit, and it signals the release of all the sodium, hence the peeing like a race horse.

Make no mistake--it is NOT GOOD for your body to do this. It's a similar physiologic response to undergoing major trauma or a large surgical procedure. If you're getting that from a bike ride, you've done something wrong in terms of hydration and/or nutrition on your ride and you've sustained pretty significant injury.
This!
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Old 06-09-23, 12:21 PM
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When your urine output goes down, you're in hypovolemic shock.
I hope DrPete isn't a physician.
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