Swollen Knuckles

[Wert]

Anyone ever experienced swollen/aching knuckles after a diving? I contacted dan and they said its likely a syptom due to an overly tight drysuit wrist seal. I recently started diving dry and this weekend was the first time I ever used a dive light. After three dives in two days my right hand is slightly swollen, particularly around the knuckles, and aches a little. Symptoms only appear on my right hand, which after examining my drysuit is the tighter of the two wrist seals, and also the hand I hold the light in.

Anyone ever deal with this before? How long until the swelling should go down? Its been about 24 hours since my last dive. Symptoms appeared about 2-3 hours after unsuiting and are still present. Symptoms appeared after diving on both days.... just seem to be worse now after the third dive.

 

[cutlass]

The bottom-feeder of old posts dredges up another

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The short story is that DAN is probably right. The long story might go as follows:

As a first guess, blood pools behind veins which have been constricted, resulting in swelling. But this should resolve quickly after the constriction is released and normal flow is restored.

However, it may be that the tight cuff is acting more or less like a wrist tourniquet*. Clenching the hand (while holding the light/torch), thick gloves, and cold can constrict blood vessels and further reduce blood availability in the hand. All these factors may result in a shock-like condition; i.e. inadequate tissue perfusion of the hand.

When tissue is deprived of blood supply and then that supply returns, stressed cells might not react kindly. Its most common form is the "pins and needles" effect, familiar to just about everyone. But in the presence of even modest cellular damage, there may be a more pronounced inflammatory response which includes swelling and pain**. Swelling about the knuckles is often noticed first because of the easily seen decrease in mobility and increase of tension in the overlying skin. These effects are described as "reperfusion injury" of which you may be experiencing a mild form. (The cold may also be helping to spare this injury from being worse by slowing metabolism.) This type of swelling may be slow to resolve, being dependent on how fast cellular waste products can be drained from tissue and the halting of the inflammatory process. The condition may be cumulative if not allowed to resolve completely before a repeat event.



*IIRC, there have been a few investigations into using wrist tourniquets for hand surgery. I've also seen impromptu versions in a couple of street cases....
** Again IIRC, this effect was described in investigations of forearm tourniquets, again in relation to hand surgeries.

 

[TSandM]

Sorry, I somehow missed this when it was originally posted, and thank you, cutlass, for finding it and posting a good answer.