Exercise and Lymphedema

Exercise improves your health and feeling of well-being.

Will Exercise Cure Lymphedema?

Once lymphedema has developed, it never goes away and therefore exercises can not cure it. However when exercises are done as part of a complete decongestive therapy (CDT) program, they are beneficial in maximizing limb decongestion. [1]

Studies are being conducted to determine how much exercises is beneficial and what 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, the reaction may be delayed. For this reason, starting back to a favorite sport should be undertaken with caution and, ideally, with guidance from a qualified trainer.

Cancer Patients Can Benefit from Exercise

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 and without symptoms of lymphedema. [2]

According to 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."

Schmitz, who is an exercise physiologist, believes that strength training, is an intriguing intervention for breast-cancer survivors as there is evidence that exercise improves health parameters and quality of life. According to Schultz, though exercise can't necessarily ward off breast or other cancers, that regular fitness will help patients withstand treatment better with fewer side effects, better recovery.

Exercise Advice

• Exercise is an essential component of lymphedema treatment because the movements of muscle and joint pumps increase the rate of lymph flow up to 15 times above the resting rate. [3]
• 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 the 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 or physician.
• Exercise moderately and avoid overuse of your affected limb. Gradually build-up your strength and ability.
• Rest 20-30 minutes between Manual Lymph Drainage Massage and exercising.
• Include Deep Abdominal Breathing before and after every exercise program 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 restricting clothing while exercising (e g. Bra straps, tight underwear, etc.
• Perform exercise in a slow, controlled manner. If any exercise causes pain, decrease number of repetitions or do not perform that particular exercise.
• 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 do not become obvious for several hours.
• Alternate each contraction of the muscle with equal time of full relaxation.
• Progress exercises slowly as to avoid soreness.
• After exercising, rest and elevate the limb for 15 to 20 minutes.

Endurance Exercises,

Endurance exercises, also known as aerobic exercises, increase your heart rate and breathing 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 affected areas. Examples of endurance exercises including bicycling, jogging, step aerobics, and 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

The use of a trampoline use, at one time, recommended as a bouncing exercise for lymphedema. However, because of the high injury rate, this exercise is no longer recommended.

• Dancing is pleasant and an excellent part of an exercise program to encourage healthy movements while having fun. Exercising together with a dance group such as “Healthy Steps” from The Ledbed Method provides the added motivation and pleasure of being part of a group.
• Golf according to 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.
• 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.
• Triathlons 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 because they do not improve endurance or strength, these activities need to be part of a balanced exercising program.

More Exercise Information

• See the article Water Exercises for Lymphedema
• See the article Nordic Walking
• See the article Pilates and Lymphedema

References:

[1] Exercises to cure lymphedema? by Nicole Gergich, M.P.T., C.L.T.-L.A.N.A.

[2] "Cancer Patients Can Benefit from Exercise"  a study conducted by Kathryn Schmitz, PhD, MPH and announced in the St. Louis Post Dispatch July 2009.

[3]The Human Body Explained by P. Whitfield. Henry Holt and Company, 1995, page 128.

[4] Exercise for Lymphedema Benefits Supported by Studies by Bonnie B. Lasinski, MA, PT, CLT-LANA

[5]  NLN Position Statement on Exercise, 2009

[6] Exercise for Women With or at Risk for Breast Cancer–Related Lymphedema by D. Bicego, et al. Physical Therapy, Vol. 86, No. 10, October 2006, pages 1398-1405.

[7] Lymphedema: Exercise Guidelines by Sonja M. Maul PT, CLT-LANA. St. Luke’s Idaho Elks Rehabilitation Services (SLIERS), March 2009

[8] “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.

[9] “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, page pages 97 and 98

© LymphNotes.com 2009. This information does not replace the advice of a qualified health care professional.

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Category: Self-Care for Lymphedema Updated: 2010-02-05