Lymphedema, also referred to as lymphatic obstruction, is a condition of chronic edema that is due to obstruction or genetic malformation of lymph or blood vessels. Lymphatic vessels can be obstructed due to injury, surgery, infection or radiation. It is a disfiguring, painful condition with a risk of serious infections. Lymphedema makes daily life difficult and may cause depression and isolation. Once it has developed it is not curable, but daily maintenance can help prevent a worsening of the condition. Maintenance includes lymph drainage massage, wrapping with non-elastic bandages, compression sleeves or stockings, and exercise.
Resistance Exercises
Resistance training with weights has been shown to benefit lymphedema patients, according to the National Lymphedema Network, when exercises are introduced slowly and increased gradually; compression garments are worn, and the patient rests adequately between sets. The affected or at risk limb should not be exercised to the point of fatigue. Weight training increases blood flow, which can increase the fluid load on the lymphatic system unless non-elastic bandages or compression sleeves or stockings are worn during exercise. According to Sit and Be Fit, you should exercise larger muscles first, the muscles of the neck, shoulders, back and hips. Then exercise smaller muscles of the lower legs, forearms and hands.
Stretching Exercises
Stretching exercises can help maintain joint flexibility, enhance lymph flow and preserve range of motion in the affected or at risk limb. However, the same rules that apply to weight-resistant exercises apply here also. Stretching should be introduced slowly and increased gradually, and compression garments should be worn during exercise. Overstretching can cause injury and the resulting inflammation increases the fluid load in the affected limb, making swelling worse.
Aerobic Exercise
Aerobic exercises, or cardiovascular training, such as walking, jogging, cycling and swimming, increases overall health but also increases blood flow and may exacerbate swelling of the affected or at risk limb. Performing exercises with compression bandages in place makes the muscles work harder while reducing lymph production and therefore limits additional swelling. According to Bonnie Lasinski, a physical therapist and certified lymphedema therapist, swimming, brisk walking and cycling have a lower risk of injury than high speed activities like tennis, racquetball, jogging, skiing, football or soccer, which put more stress on the extremities.
Benefits
Exercise helps lymphedema patients maintain overall health as well as helping to keep the swollen limb flexible and strong. It helps maintain range of motion and keeps joints flexible. However, because exercise increases blood flow, it can make swelling worse unless the exercises are performed while wearing non-elastic bandages or compression garments. If you have lymphedema, you need exercise but should consult with your doctor or physical therapist to make sure you are not overdoing exercise and making the swelling worse.
References
- "Breast Cancer Res Treat;" Progressive resistance training in breast cancer: a systematic review of clinical trials; Cheema B, Gaul CA, Lane K, Fiatarone Singh MA; Jul. 2007.
- "J Clin Oncol;" Randomized controlled trial of weight training and lymphedema in breast cancer survivors; Ahmed RL, Thomas W, Yee D, Schmitz KH;Jun 2006
- "Lymphology;" Low Intensity Resistance Exercise for Breast Cancer patients with arm lymphedema with or without compression sleeve; Johansson K, Tibe K, Weibull A, Newton RC. Lymphology; Dec. 2005
- "J Surg Oncol;" Improving the physical status and quality of life of women treated for breast cancer; Turner J, Hayes S, Reul-Hirche H; June 2004
- Lymphedema Therapy: Lymphedema and Exercises
