There are exercises you can do to help reduce swelling caused by a build up of lymph fluid (lymphoedema). You can also position yourself in ways that help the lymph to drain.
How exercise helps lymphoedema
We know from research that exercise helps lymph move through the lymphatic system. This might help reduce swelling. Exercise makes the muscles contract and pushes lymph through the lymph vessels.
Exercises have other benefits. They can help you to keep a full range of movement and make you feel better.
Most of this research has looked at lymphoedema in the arm, and some of it at strenuous exercise. Studies looking at leg lymphoedema have also shown that exercise can help to reduce swelling.
The National Institute for Health and Care Excellence (NICE) made recommendations about exercise and lymphoedema. These are for people who have lymphoedema after treatment for breast cancer or who are at risk of developing it. The guidelines state that exercise doesn't prevent, cause or worsen lymphoedema. They also suggest that exercise may improve quality of life.
Before you start
What you’re able to do will depend on:
- how fit you were before your treatment
- the type of treatment you had
- how severe your lymphoedema is
Start exercising gently and build up slowly. Walking can be a good way to start if you haven’t done any exercise for a while. You can gradually increase the distance and the pace. Other examples include yoga, Tai chi, pilates, cycling, swimming or water aerobics.
Try to do some exercise every day. Think about how you can build it into your daily routine. You’re much more likely to carry on doing exercise if it becomes a regular part of your day.
It can often be easy to include a walk in your schedule. Try walking instead of getting the bus or driving.
When you’re sitting or lying down, it helps to position yourself in a way that helps the lymph to drain.
With arm lymphoedema, when you’re sitting, raise your arm to a comfortable level by putting it on a cushion or a pillow, but not above the height of your shoulder.
With leg lymphoedema, don't sit with your legs down instead either lie up on the sofa or put your leg up on a stool or chair. Make sure you fully support your leg with a cushion or pillow under the knee. When you’re lying in bed, you can put your leg on a pillow or raise the end of the end of the bed by about 10 cms (4 inches) using blocks under the legs of the bottom of the bed.
With lymphoedema of your head and neck, sleep with 2 or 3 pillows to raise your head and help the fluid drain. You can also raise the head of the bed by using blocks under the legs of the head of the bed.
Deep breathing exercises help the flow of the lymph fluid through the body. It allows lymph to flow into the lymph system in the chest away from the area with lymphoedema.
Deep breathing is helpful for all types of lymphoedema, even head and neck swelling. It works by changing the pressure in your tummy (abdomen) and chest. This encourages lymph to flow back into the blood system.
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.
- Rest one of your hands below your ribs.
- Take a slow, deep, comfortable breath in feeling your hand rise as your tummy (abdomen) rises.
- Then slowly breathe out, so your abdomen is flat again.
- Do this 5 times.
Below are some suggestions of exercises you could do. The Lymphoedema Support Network (LSN) has two DVDs that include information about exercises for leg and arm lymphoedema.
These exercises shouldn't be painful. You might have a feeling of stretching as you do them, this is normal. Stop doing the exercises if you have any pain and, if doesn't get better contact your doctor.
Wear your compression sleeve when you’re exercising if you have one. Try to do some exercises every day.
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 (there are tips further up this page). Doing them in the order we have them below will help you to remember to do them all as you work from your head to your hands. Try to repeat each exercise 5 to 10 times.
- Tilting - tilt your head towards one shoulder, hold for 3 seconds and return your head to the centre and then repeat on the other side.
- Turning - turn your head to look over your should as far as you can, hold for 3 seconds, return to face forward then do the same over the other shoulder. Turn your head not your body.
- Chin to chest - bend your neck down as far as you comfortably can so your chin is on your chest, hold for 2 seconds and then slowly bring your head back up so you are looking forward again.
- Shoulders up and down - relax your shoulders, bring them up to your ears, relax then drop them back down
- Shoulder rotation - rotate your shoulders forward, and then rotate them backwards
- Combined movements - sit comfortably in a chair then with your hands touch your knees then touch your shoulders.
- Pretend swimming - stand or sit on the edge of a chair then cross your arms in front of your chest and swing them out to your sides, if this is too difficult try it at waist height. You can also do a pretend backstroke.
- Exercise with a ball - pass a ball around the waist, one way and then the other.
- Rest your arm on a cushion with your hand hanging off the end. Bend your wrist down until you feel a stretch, hold for 5 seconds and slowly relax. Then bend your wrist up until you feel a stretch again and hold it for 5 secs and then relax.
- Circles - rest your arm on a cushion with your hand hanging off the edge. Turn your wrist in clockwise circles and then anti clockwise.
- Clench your hand to make a fist and then open and spread your fingers out wide.
- Thumb to finger - using your thumb touch each finger one at a time, as it becomes easier you can start doing it faster.
- Bend and extend - bend your fingers at the knuckles, keeping your fingers straight.
- Hold your hand out with fingers together then spread your fingers out, then close your fingers together again.
Talk to your doctor, physiotherapist or specialist nurse before doing these exercises or if you have any difficulties doing them.
Cut down on the number you do if your leg starts to ache. Wear your compression garment when you’re exercising if you have one.
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 (there are tips further up this page).
- 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. What exercises you'll do will depend on where you have lymphoedema.
- 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. The exercises encourage 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. 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.