Swollen feet and legs are a regular occurrence when hiking. Roughly by the 10km mark which can be 3-4 hours depending on terrain, feet may have swollen by as much as half a shoe size.

Swollen feet have the effect of making the skin layers thinner and with less room to move in the shoe increasing the likelihood and strength of friction forces both of which can accelerate the formation of blisters.

The simplest treatment for swollen feet and legs is to elevate them.  However, while simply lying flat will reduce leg swelling, it can take many hours.

Reflecting on a common hiking strategy of 55 minutes hiking 5 minutes resting it is worth knowing the ideal position for leg elevation in order to reduce swelling, maximize flow in the veins and be comfortable.

Good positioning, perhaps assisted by a supporting backpack, can allow you to use gravity to your advantage rather than fight against it.

1. Heart low to the ground
Lie on your back so that your heart (red line shown above) will be below your legs when you elevate them. This will lower the hydrostatic pressure in the capillaries to assist reabsorption of the accumulated interstitial fluid.

2. Angled Thighs
Thighs should be angled roughly 40 degrees to the horizontal. Tilting the thigh more than 45 degrees can impair venous outflow, potentially kinking the femoral vein and simply above 45 degrees can be just plain uncomfortable.

3. Bent Knee
The knee should be bent approx. 20-30 degrees. This is a more comfortable position so the tendons around the knee are relaxed.

4. Lower Leg Angled
The arrangement of 1,2 and 3 above still allows the lower leg (knee to ankle) to be tilted 15 to 20 degrees from the horizontal thus allowing gravity to augment venous and lymphatic flow in the calf.


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