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Exercise Advice

Exercise improves your health
and feeling of well-being.

WILL EXERCISE CURE LYMPHEDEMA?

Once lymphedema has developed, it does not go away and therefore exercises cannot cure it.

However when exercises are done as part of a complete decongestive therapy (CDT) program, they are extremely beneficial in maximizing the decongestion of a swollen limb.

Studies have been conducted to determine how much exercises is beneficial and to identify which sports activities are safe to participate in. The news is good; however, there are precautions.

  • Tissues affected by lymphedema do not always react to excessive stress immediately.
  • Instead, this reaction may be delayed.
  • For this reason, restarting a favorite sport should be undertaken with caution.
  • Ideally, with guidance from a qualified trainer.

CANCER PATIENTS ALSO BENEFIT FROM EXERCISES

In a study at the Abramson Cancer Center of the University of Pennsylvania, Kathryn Schmitz, PhD, MPH, an exercise physiologist, helped to determine the extent to which a slowly progressive program of strength-training exercises is safe for breast cancer survivors with or without symptoms of lymphedema.

According to Dr. Schmitz, "This problem affects up to one-half of the nearly two million breast-cancer survivors alive in the U.S. today – which means that there may be as many as one million women suffer from some form of lymphedema . . . "Further, the psychological effects are enormous," "Indeed, many women have reported that they would rather have another mastectomy than lymphedema – because it's a painful, constant, and debilitating reminder of their breast cancer."

Dr. Schmitz, is an exercise physiologist, who believes that strength training, is an intriguing intervention for breast-cancer survivors since there is evidence that exercise improves health parameters and quality of life.

According to Schultz, "Although exercise can't necessarily ward off breast or other cancers, regular fitness will help patients withstand treatment better with fewer side effects, and improved recovery.

EXERCISE ADVICE

Exercise is an essential component of lymphedema treatment because it is the movements of muscle and joint pumps increase the rate of lymph flow up to 15 times above the resting rate.

  • Exercise is an essential part of the Complete Congestive Therapy (CDT) program that manages the swelling of lymphedema.
  • This is because exercise helps drain to lymph out of the affected area and eventually into the bloodstream.
  • Exercise is also part of a healthy lifestyle. It increases your energy level, helps to burn more calories to maintain a healthy weight, and increases your feeling of well-being.

BASIC EXERCISE PRECAUTIONS

The following is general information about types of helpful exercises; however success depends on how faithfully you follow through on your exercise program!

  • Before beginning any exercise program, check with your therapist and/or physician.
  • Exercise moderately and avoid overuse of your affected limb as you gradually build-up your strength and ability.
  • Rest 20-30 minutes between Manual Lymph Drainage Massage and exercising.
  • DEEP ABDOMINAL BREATHING should be included before and after every exercise program. This is true because it is relaxing and yet it stimulates the flow of lymph.
  • Carefully follow the “warm up” and “cool down” steps of your exercise program.
  • Wear your compression garment during exercise, except when exercising in the water. If you have questions about this, check with your therapist.
  • Do not wear tight and restricting clothing while exercising. For example avoid tight bra straps or underwear.
  • Perform each exercise in a slow and controlled manner.
  • If any exercise causes pain, decrease number of repetitions or do not perform that particular exercise again for several days.
  • Try not to get overheated and be sure to drink plenty of water to keep your body well hydrated.
  • Stop exercising if you encounter any sign of trouble such as increased swelling or pain. Check with your therapist or physician before restarting your exercise program.
  • Indications that you have over exercised do not always develop immediately. Frequently pain or over-use symptoms are not obvious for several hours.
  • Alternate each contraction of the muscle with equal time of full relaxation.
  • To avoid soreness, slowly and progressively increase exercises.
  • After exercising, drink water, rest and elevate the limb for 15 to 20 minutes.

ENDURANCE EXERCISES

Endurance exercises, which are also known as aerobic exercises, increase your heart rate and breathing rate for an extended period of time. These activities improve the circulation of both blood and lymph and aid in the flow of fluid away from the affected areas.

Examples of endurance exercises include

  • Bicycling
  • Jogging
  • Step aerobics
  • Walking

RESISTANCE-TRAINING

Resistance-Training, also known as strength training exercises, require that muscles exert a force against some form of resistance. Research has determined that activities such as bench pressing are beneficial.

It is believed that this type of exercise is beneficial for those with lymphedema because the contraction of the muscles causes a pumping action that helps to move lymphatic fluid away from the affected area and back toward the chest. These exercises also encourage deep breathing to ensure an adequate supply of oxygen to the tissues. This exercises the chest and abdomen in a manner that stimulates lymphatic drainage.

SUGGESTED VARIETIES OF ACTIVITIES

Pilates are a good exercise.

  • PILATES is a mind/body exercise techniques that stretches and lengthens the body with flowing movements and it is unique because many of the exercises are performed lyming down in a gravity reduced or eliminated position -- under the guidance of an instructor who is familiar with lymphedema.
  • DANCING is pleasant and it is an excellent part of an exercise program to encourage healthy movements while having fun.
  • GOLF according to Linda T. Miller, a 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 a round.
  • TENNIS is often a sport that enthusiasts want to return to. 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.
  • TRIALATHOLONS in which you bike, swim, and run are a possibily if you have adequate and appropriate training. If this is an exercise you enjoy, dont let having lymphedema, or being at risk of developing it stop from competing.
  • YOGA AND OTHER STRETCHING EXERCISES that move the skin, muscle, and other tissues in the affected area, 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 since they do not improve endurance or strength, these activities need to be part of a balanced exercising program.

AN EXERCISE TO AVOID!

  • At one time, the use of a trampoline was recommended as a lymphedema exercise since the bouncing exercise improved the lymph circulation. 
  • However because of the very high injury rate, this exercise is no longer recommended.

REFERENCES:

  • Exercises by Nicole Gergich, M.P.T., C.L.T.-L.A.N.A.
  • Breast Cancer Survivors: Prevention, Treatment and Attenuation of Persistent Adverse Effects of Treatment. Including Lymphedema? by K. Schmitz.
  • Lymphedema: Exercise Guidelines by Sonja M. Maul PT, CLT-LANA. St. Luke’s Idaho Elks Rehabilitation Services (SLIERS), March 2009.
  • “WHEN CAN I PLAY GOLF AGAIN?” by Jeanette, who is longer a former golfer.

@ 2014 Lymph Notes.com This information does not replace the recommendation of a qualified physician.
 

Got a question or comment? Post in the 'Self-Care for Lymphedema' forum.
Category: Self-Care for Lymphedema Updated: 2014-03-18


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