Lymphedema is an abnormal lymph fluid buildup. Blockages or interruptions of lymph fluid within the lymphatic system produce swelling. Depending on the cause of the lymphedema, doctors suggest different treatment options. If an infection is the cause of lymphedema, prescribed antibiotics assist in eliminating the swelling. Most often, an individual exercise program is managed by a physical or occupational therapist to decrease the occurrence of lymphedema.
Lymphatic System
The lymphatic system is an extensive arrangement of lymph vessels and lymph nodes. Lymphatic vessels collect excess fluid from body tissues, the lymph nodes filter it, and the thoracic duct empties it back into the blood stream. Within the nodes, foreign substances and infectious agents contact cells of the immune system, which stimulate an inflammatory response resulting in swollen lymph nodes. Lymph node removal or malfunction lead to an accumulation of excess tissue fluids, which produce profound tissue swelling.
Lymphedema
Lymphedema occurs most often in the arms and legs. It appears days, months or years after a lymphatic injury. Injuries occur from infections, cancer, surgery, scar tissue, trauma or radiation. As lymph fluid accumulates, swelling usually arises in one arm or leg, including the fingers and toes. The limb will feel heavy and usage is restricted. Avoiding infections, maintaining adequate nutrition and regular exercise programs help prevent lymphedema.
Exercise Theory
Exercise is an important aspect of lymphedema treatment and prevention. Mild exercise promotes lymph flow, moving fluid to the thoracic duct and into the blood. Lymph fluid flow is entirely dependent on the surrounding muscular activity. Therefore, many doctors suggest progressive exercise, tailored to each person's needs. A progressive exercise program starts gradually with simple exercises and moves to higher impact, thus avoiding injuries and complications. Usually, compression garments or bandages are used on affected limbs during exercise. Daily exercises should be done until a normal range of motion is reached, then continued at three times a week.
Arm Exercises
Exercises for lymphedema need to be planned with a certified lymphedema therapist. Beginning exercises include palms up and elbows straight for stretching arms above the head, bending elbows and clasping hands behind the head, then pushing elbows together in front of the body, and placing hands on the same shoulders to move elbows in circles. Exercises can be intensified to standing exercises, such as hanging arm circles with weights, to weight machines, aerobics and swimming. Careful monitoring allows gradual increase without limb overuse. Too much exercise can increase lymphedema.
Leg Exercises
Daily activity needs consideration for proper lymphedema exercise program assignment. If lymphedema occurs in a leg, mild exercises may be required for persons who work standing or moderate exercises for those who sit all day. Beginning exercises for leg lymphedema include lying flat and bending the affected leg while sliding the heel towards the buttocks, lying flat while flexing and pointing the foot, and while seated straightening the uninvolved leg with a five-second hold and repeating with the involved leg. Perform exercises slowly and increase exercise intensity as directed by the therapist or doctor. When doing exercises with one leg, always keep the opposite leg slightly bent to reduce back strain.
Other Exercises
Many lymphedema exercise programs include muscle stretches and abdominal breathing exercises. A study by Dicken Ko in 1998 at Massachusetts General Hospital and published in the "Archives of Surgery" used 21 additional exercises to complement extremity exercises for lymphedema. Abdominal breathing is accomplished by inhaling through the nose and exhaling slowly through the mouth. During inhalation, the navel moves outward and recedes upon exhale. Shoulder and neck stretches, along with head turns, help loosen muscles in areas near the thoracic duct. Such exercises have a positive impact on lymphedema treatment .
References
- Cleveland Clinic; Lymphedema
- Mayo Clinic; Lymphedema
- Cancer Supportive Care Programs; Living with Lymphedema
- Imaginis; Lymphedema
- Spectrum Health; Lymphedema Lower Extremity Exercises
- "Archives of Surgery;" Effective Treatment of Lymphedema of the Extremities; Dicken Ko, Robert Lerner, Guenter Klose, A. Benedict Cosimi; 1998
