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EXERCISE & LYMPHEDEMA

Updated: Feb 21, 2022





Unlike the blood circulatory system, the lymphatic system does not have a heart to pump it around the body. It is a one-way trip from the tissue to the bloodstream and while lymph fluid is slowly propelled through the vessels by small pumps within some of its vessel walls, it is majorly influenced by muscle contractions, arterial pulsations, and breathing mechanisms. Since exercise influences all of these lymphatic circulatory aids, why wouldn’t it help lymphatic flow?


A mix of cardiovascular, strength and endurance exercise is beneficial for your heart, lungs and to decrease age related degeneration. Exercise increases energy, helps to decrease stress, makes our muscles and bones stronger and prolongs our independence as we age. It has also been linked in the prevention of many chronic diseases such as cancer, obesity, diabetes and heart disease. Research evidence shows that about fifty percent of decreased functional ability that occurs between the ages of thirty and seventy are not due to aging, but to an inactive lifestyle. Exercise for those who are age sixty-five and above helps with balance, strength, flexibility, coordination and therefore reduces the risk of falls. Canadian guidelines suggest two and a half hours a week of moderate to vigorous activity that can be broken down into sessions of ten minutes or more. Additionally, adding activity that targets muscle and bone at least two days per week for strengthening is beneficial.


Research has proven that it is safe to exercise if you have lymphedema. In fact, it is an integral part of lymphedema treatment. Many people with lymphedema find exercise difficult due to the heaviness of the limb, joint aches or mobility problems and therefore think they can’t exercise at all. When I mention exercise to my new clients, many immediately think of strenuous, sweat producing, heart rate increasing aerobic type exercises like running and high intensity workouts and it is not until I explain more about lymphatic flow exercise that I see relief in their faces.


EXERCISE WITH LYMPHEDEMA


Exercise may not have been a regular part of your weekly routine before you developed lymphedema and everyone has unique health issues. This is why you should always consult your doctor and a physical therapist to help guide you in what you can do physically when beginning any new exercise routine. It is also important to wear your compression garment while exercising. The properties of the garment will prevent further swelling and help your lymph and blood circulation as you pump those muscles. If you were physically active prior to cancer treatment and want to get back to what you had been doing, it is wise to start slow with the advice from your surgeon and a physical therapist as your energy requirements and physical movement abilities may be impaired and require a slow and steady pace to return to pre-treatment levels. See the following link from the Canadian Cancer Society for tips on exercise after breast cancer surgery.

https://www.cancer.ca/~/media/cancer.ca/CW/publications/Exercises%20after%20breast%20surgery/32071-1-NO.pdf

Additionally, the University Health Network has this great booklet called "Functional Rehab After Breast Cancer Surgery".

https://www.uhn.ca/PatientsFamilies/Health_Information/Health_Topics/Documents/Your_Functional_Rehabilitation_After_Breast_Surgery.pdf


Always check with your personal healthcare provider first. You may want to print these and go through them with your surgeon, specialist or physiotherapist to get specifics on what you are able to to at the moment.


Lymphatic flow exercise

Lymphatic flow exercises are those that involve breathing and gentle movement to get muscles contracting and lymph moving. The following are examples of some simple ways to help your lymphatic flow.

  1. Deep diaphragmatic breathing exercises: Not only good for moving deeper lymphatic fluid, but also a great relaxation exercise!

  2. Gentle abdominal crunches

  3. Knee bent, single leg to chest movements

  4. Seated or standing marching in place

  5. Ankle alphabets (writing the alphabet letters with your foot) or foot pumping up and down

  6. Walking. If you have arm lymphedema, the use of walking poles helps to get your whole arm moving

  7. Dancing

  8. Pool activities: water aerobics or aqua lymphatic therapy class, walking in the shallow end and for arm lymphedema exercising with arm under the water and fingers pointing toward the bottom of the pool for best use of compression effects of the water

  9. Tai Chi

  10. Qi Gong

  11. Yoga

  12. Pilates

  13. Pedaling: Done on a bicycle, stationary cycle or from your armchair. For arm swelling, place the pedaling device on a table top and use your arms to pedal.

  14. Mini-trampoline: "health bounce" where the toes do not leave the mat. If you have problems with balance, there are some that have a handrail to hold on to. Ensure before you buy that you have discussed using the mini-trampoline with your doctor, that you do your research to buy a quality trampoline and know that each has a weight limit and some are meant to be used only by children.

Check out this video on using a mini-trampoline for lymphedema. In my opinion, if you have not used a mini-trampoline before, I would call this an intermediate level exercise video even though it says it is for beginners. If you are just starting out, try just light bouncing with feet on the surface of the trampoline for 3-5 minutes and work your way up to doing the exercises shown in this video. You need to listen to your body to see how you feel. You can also skip to the end to do the seated version. HAVE FUN!

https://www.youtube.com/watch?v=ZxbOrd5175o



REMEMBER TO:

  1. Consult your doctor before beginning any new exercise activity

  2. Consult a physiotherapist for a sustainable journey and to prevent injury

  3. Add some cardio exercise to your routine

  4. Know your limits and listen to your body

  5. Wear your compression garment during exercise


Movement is the key to improved quality of life, improved cardiac and lymphatic function, and prevention of obesity and chronic disease.


Resource Articles


Lane, K., Worsley, D., McKenzie, D. (2006). Exercise and the Lymphatic System: Implications for Breast-Cancer Survivors. Sports Medicine, 35(6),461-471.


Kwan, M. et al (2011). Exercise in patients with lymphedema: a systematic review of the contemporary literature. Journal of Cancer Survivorship. 5:320-336. DOI: 10.1007/s11764-011-0203-9


Tidhar, D., Katz-Leurer, M. (2010). aqua lymphatic therapy in women who suffer from breast cancer treatment-related lymphedema: a randomized controlled study. Journal of Supportive Care In Cancer 18:383-392. DOI: 10.1007/s00520-009-0669-4


Resource Websites


Public Health Canada.

https://www.canada.ca/en/public-health/services/publications/healthy-living/physical-activity-tips-adults-18-64-years.html


Public Health Agency of Ontario

https://cbpp-pcpe.phac-aspc.gc.ca/chronic-diseases/#:~:text=What%20are%20chronic%20diseases%3F,be%20treated%20but%20not%20cured.

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