EXERCISE AND LYMPHEDEMA

With better understanding of the lymphatic system, researchers have discovered that the movement of muscles during exercise helps drain lymph out of the affected area and eventually into the bloodstream.  

For this reason, an exercise program is an important component in the treatment and management of lymphedema. 

If you are new to exercise, check with your doctor first before starting a new routine.  It is also recommended to work with your lymphedema therapist or a trained specialist for knowledge and advice!

Key messages:

- Start gradually and work up to a consistent routine

- Lymphedema needs movement to move

- If swelling worsens, reduce intensity, repetitions, time or adjust to a different exercise.

The best exercise for Lymphedema is the one that you enjoy and will do on a consistent basis.

Variety of Exercises for Lymphedema:

Diaphragmatic Breathing:
https://www.youtube.com/watch?v=DTbn8mZWdqs

Decongestive Exercises while sitting: https://www.bclymph.org/resources/Documents/Lymphatic%20Decongestive%20Stretches%20and%20Exercise.pdf

 Cycling – Cycling is a useful way of exercising your legs and seeing new places.  If you have leg swelling wear firm compression   stockings   and start short   rides on level ground.  If you have arm swelling, release your grip on the handlebar and move your shoulder as well as   squeezing and stretching your     fingers as much as possible even if this means taking frequent rests at first.  This will aid lymph drainage.   Electric bikes have become more popular recently   and although they can take the hard work out of cycling, you still need to  pedal, so they are excellent ways of keeping you fit. [1]

  Dancing - Dance exercise programs encourage healthy movements while having fun.  

  Dragon Boating – Abreast In A Boat was established in 1996 by Dr. Don McKenzie, a sports medicine physician at the University of British Columbia, to          test the myth that repetitive upper-body exercise in women treated for breast cancer encourages lymphedema. Dr McKenzie believed that by following a          special exercise and training program, women could avoid lymphedema and enjoy active, full lives. 25 women followed the program, carefully monitored by a    sports medicine physician, a physiotherapist and a nurse. and Dr McKenzie's theory was proven correct. No new cases of lymphedema occurred and none                       of  the existing cases became worse.          
                   List of BC Dragon Boat breast cancer survivor teams: https://bclymph.org/page-354173

 
 Exercise classes - Some lymphedema treatment facilities provide exercise classes as part of their treatment program.  Traditionally, these have been mild to   moderate exercises with movement, stretch bands, and activities with exercise balls.

Golf - Linda T. Miller, a Philadelphia-based physical therapist specializing in the treatment of lymphedema after breast cancer, actively encourages her patients to return to playing golf.  Their enthusiasm has been contagious and she often joins them in playing. [2]

Nordic Walking – Without seeming like an intense level of effort, Nordic walking raises the heart rate and as a result, activates lymphatic circulation. It has a significant and positive impact on posture and balance and improves upper-body strength. [3]

 Pilates - Naomi Aaronson recommends Pilates exercises because these exercises are gentle to the body while giving it a thorough workout. If Pilates   interest you, be aware that these exercises are not recommended after TRAM flap reconstruction until you have clearance from your surgeon. [4]

 Rebounding – Rebounding aids lymphatic circulation by stimulating the millions of one-way valves in the lymphatic system. 
 For videos on rebounding routines, even sitting on a chair with your feet on the rebounder follow Kelly Sturm from cancerrehabpt.com   or https://www.youtube.com/watch?v=ZxbOrd5175o

 Tennis - If you were an avid tennis player before developing, or becoming at risk for lymphedema, you will want to go back to this sport.  Again training and a   gradual return, is important.  If you were accustomed to playing singles, you might start back by playing doubles.

Triathlons - Those with, or at risk of developing lymphedema are not letting this stop them from taking part in triathlons in which they bike, swim, and run.  Again, adequate and appropriate training are important.

 
 Walking - An ideal exercise that does not require major equipment, except appropriate shoes, and can be done almost anywhere.

 Water exercises - Another ideal exercise because the water provides total body compression and it cushions tender joints and makes   movement easier.  Because of the pressure of the water, it is not necessary to wear compression when doing exercises with the affected limb in the water. [5]  

Yoga and other stretching exercises - These are activities that move the skin, muscle, and other tissues in the affected area and help to relieve the feeling of tightness that often accompanies lymphedema.  They also help regain a range of motion in an affected area, increase flexibility, and increase freedom of movement.  Stretching exercises are also relaxing; however, because they do not improve endurance or strength, these activities need to be part of a balanced exercising program.

[1] The lymphoedema support Network

[2] “When can I Play Golf Again” by Jeanette, no longer a former golfer.  Voices of Lymphedema. Edited by A. Ehrlich and E. McMahon PhD. Lymph Notes. 2007, pages 97-98.

[3]  Nordic Walking in Canadian Lymphedema Framework (CLF) Pathways Winter 2017

[4] “Pilates Exercises” by Naomi Aaronson (Recovercises For Wellness) Voices of lymphedema.  Edited by A. Ehrlich and E. McMahon PhD. Lymph Notes. 2007, pages 91-93.

[5] “Aquatic Therapy” in Living Well with Lymphedema. A. Ehrlich, A.Vinjé-Harrewijn, PT, CLT-LANA and E. McMahon PhD. Lymph Notes, 2005, pages 185-194.