Exercise, positioning and lymphoedema
This page tells you about exercise and lymphoedema. There is also information about movement and positioning your limb. You can read about
Before you start any exercise, talk to your doctor or lymphoedema specialist. They can advise you about what you should and shouldn’t do. They may be able to work out an exercise programme for you. What you are able to do depends on how fit you were before your treatment, the type of treatment you had, and how severe your lymphoedema is.
It is important to start gently and build up slowly. If you haven’t done any exercise for a while, walking can be a good way to start. Try to do some exercise every day. Think about how you can build it in to your daily routine.
Deep breathing before exercise can help to clear the lymphatic system in your chest. This allows lymph to drain into the lymph system in the chest from the area with lymphoedema. It is a good technique that can help anyone who has lymphoedema.
Try to avoid doing exercise that involves repeating the same movement for long periods of time. If you have any aching, a feeling of heaviness or if your swelling gets worse, stop and speak to your lymphoedema specialist. You may need to reduce the amount of exercise you are doing.
Some exercises can reduce swelling in particular areas of the body. Your specialist will be able to tell you what to do and how to build up the exercises gradually.
You can view and print the quick guides for all the pages in the Treating lymphoedema section.
Exercise helps lymph fluid move through the lymphatic system. This helps to reduce lymphoedema swelling because exercise makes the muscles contract and push lymph through the lymph vessels. Exercises have other benefits. They can help you to keep a full range of movement and generally make you feel better.
In the past some doctors were worried that exercise may make lymphoedema worse. The evidence does not support this. We know from research that exercise can improve the movement of the lymph fluid through the lymphatic system. This can help to reduce swelling.
Most of this research has looked at lymphoedema in the arm and some of it was looking at strenuous exercise. A few studies looking at leg lymphoedema have also shown that exercise can help to reduce swelling.
NICE (The National Institute for Health and Care Excellence) are reviewing the guidelines for exercise and lymphoedema following breast cancer treatment.
What you are able to do depends on
- How fit you were before your treatment
- The type of treatment you had
- How severe your lymphoedema is
Before you start any exercise, talk to your doctor or lymphoedema specialist. They can advise you about what you should and shouldn’t do. They may be able to work out an exercise programme for you.
It is important to start gently and build up slowly. If you haven’t done any exercise for a while, walking can be a good way to start. You can gradually increase the distance and the pace. Other helpful types of exercise are cycling, swimming, and gentle aerobics or water aerobics.
Try to do some exercise every day. Think about how you can build it in to your daily routine. It can often be easy to include a walk in your schedule. You are much more likely to carry on doing exercise if it becomes a normal part of your day. For example you could walk for short journeys, rather than getting the bus or driving.
Below are some suggestions of exercises you could do. The Lymphoedema Support Network (LSN) has 2 DVDs that include information about exercises for leg and arm lymphoedema.
Deep breathing before exercise can help to clear the lymphatic system in your chest. This allows lymph to flow into the lymph system in the chest from the area with lymphoedema. Deep breathing is helpful for all types of lymphoedema, including swelling in the head and neck area. It works by changing the pressure in your abdomen and chest, which encourages lymph to flow back into the blood. Deep breathing can also help you to relax.
You can do these breathing exercises while sitting up in a chair or in bed, or while lying down.
- Relax your shoulders and upper chest
- Take a slow, deep, comfortable breath in and hold it for a couple of seconds
- Then slowly breathe out
- Do this 10 times
Before doing these exercises talk to your doctor, physiotherapist or specialist nurse. You should also talk to them if you have any difficulties doing the exercises. Reduce the number you do if your arm begins to ache. If you wear a compression sleeve, you need to wear it when you are exercising.
These are some simple shoulder and arm exercises you should try to do every day. You can be sitting down watching television. Sit upright in a chair with your arm comfortably on your lap, on a cushion or on the arm of your chair. Start with some deep breathing.
- Clench your hand to make a fist and then open and spread your fingers out wide – repeat 10 times
- With your arm on the cushion and your palm facing down, bend your hand backwards from the wrist so that your wrist stays on the cushion and your fingers point to the ceiling. Then move your hand back down so your fingers are pointing to the floor – repeat 10 times
- With your arm straight on the cushion and your palm facing upwards lift your arm up so that your hand touches your shoulder – repeat 10 times
- Put your hand behind your back so that the back of your hand is touching your bottom, then lift your hand up your back as far as you can without discomfort – repeat 10 times
- Sit upright and lift your arm up so that your hand is behind your head– repeat 10 times
Before doing these exercises talk to your doctor, physiotherapist or specialist nurse. You should also talk to them if you have any difficulties doing the exercises. Reduce the number you do if your leg begins to ache. If you wear a compression garment, you need to wear it when you are exercising.
Sit comfortably in a chair. You can do the exercises while watching television. Try to do them twice a day. Start with some deep breathing.
- With bare feet, curl your toes up and then stretch them out – repeat 10 times
- With your heel on the floor point your toes away from you then pull your toes towards your chin – repeat 10 times
- Lift your foot off the floor then circle your ankle clockwise 10 times, then anticlockwise 10 times
- Lift your foot off the floor then straighten and bend your leg – repeat 10 times
Other types of exercise can also help to get your leg muscles moving, such as walking, swimming or cycling.
Using your head and neck muscles may help to reduce swelling. Your physiotherapist will show you some exercises to do depending on where you have lymphoedema. Changing your facial expression uses a lot of different muscles. It can feel a bit odd to do this in front of people, so you may prefer to do them on your own. But try to do them as often as you can.
- Frowning, including pulling your mouth downwards
- Chewing – you could chew sugar free chewing gum
Pelvic floor and tummy (abdominal) exercises can help to use muscles in the genital area. This can help to control lymphoedema. It encourages the fluid to drain into the lymphatic system in the abdomen. Your lymphoedema specialist will tell you how to do these exercises.
You need to tighten the muscles around your bottom and the muscles you use to pass water. Remember to keep your buttock and thigh muscles loose and remember to breathe naturally.
Tighten and release the muscles 10 times quickly. Then do it 10 times slowly, holding the muscles tight for a count of 10, and then loosening them.
When you are sitting or lying down it helps to position yourself to help the lymph to drain.
If you have arm lymphoedema and are sitting in a chair, put your arm on a cushion or a pillow so that it is slightly raised.
If you have leg lymphoedema and you are sitting, put your leg up on a stool or another chair. When lying in bed you can put your leg on a pillow but don’t have it higher than your head.
If you have lymphoedema of your head and neck, use 2 or 3 pillows to raise your head and help the fluid drain.
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