Decorative image

Exercise, positioning and lymphoedema

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
Talk to your doctor or lymphoedema specialist (nurse or physio) before you start any exercise. They can advise you about what you should and shouldn’t do.

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.

Positioning yourself

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.  

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

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 through your nose, feeling your hand rise as your tummy (abdomen) rises.
  • Then slowly breathe out through your mouth, so your abdomen is flat again.
  • Do this 5 times.

Exercise suggestions

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. 

Neck exercises
  • 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. Keep your shoulders still while doing this exercise.
  • 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.
Shoulder exercises
  • 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
Arm exercises
  • Combined movements - sit comfortably in a chair then with your hands touch your knees then touch your shoulders and lift your arms as much as possible without pain, touch your shoulders and then your knees
  • Pretend breast stroke 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.
Wrist exercises
  • 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.
Hand exercises
  • 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.

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 garment when you’re exercising if you have one. Try to do some exercises every day. 

You can do some of them sitting in a chair, while watching television. Try to do them at least twice a day. Start with some deep breathing (there are tips further up this page).

Try to repeat each exercise 5 to 10 times.

  • Curl your toes up and then stretch them out.
  • With your heel on the floor point your toes away from you then pull your toes towards your chin.
  • Lift your foot off the floor. Then circle your ankle clockwise, then anticlockwise.
  • Lift your foot off the floor then straighten and bend your leg.
  • Marching - you can march on the spot or do this sitting down, lift one knee and then put it down, then lift the other knee and put it down.
  • Hip and knee bends - lie on your back, then lift one leg up bending your knee in towards your body then slowly stretch it out and back down, repeat with the other leg
  • Leg cycles - lie on your back, raise your legs up one at a time and cycle them in the air.
  • Ankle raises - stand up holding on to a firm surface, raise your heels off the floor so you feel a squeeze in your calf muscles, relax down so your feet are flat on the floor then repeat.

Other types of exercise can also help to get your leg muscles moving, such as walking, swimming or cycling.

Using your head, neck and shoulder muscles may help to reduce swelling. Your physiotherapist or specialist nurse will usually go through these exercises with you . 

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.

Try to do some exercises every day once or twice a day. It is better to do some every day even if you need to reduce how many you do. Aim to do between 5 and 10 of each exercise.

Do the exercises slowly and gently, don't rush them. You can rest between exercises. It might help to do them in front of the mirror so you can check that your shoulders are back and relaxed. 

Neck exercises
  • Head tilt - tilt your head towards one shoulder until you feel a stretch on the opposite side. Hold for 2 seconds then straighten up. Repeat on the other side. Keep your shoulders still while you're doing this exercise.
  • Head turns - turn your head to look over your shoulder as far as you can, hold for 2 seconds. Slowly go back to the start position. Repeat on the other side. Keep your shoulders still while doing this exercise.
  • 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.
Shoulder exercises
  • Shoulders up and down - relax your shoulders, bring them up to your ears, relax then drop them back down. Repeat.
  • Shoulder rotation - rotate your shoulder forward, then rotate them backwards.
Mouth exercises
  • Open and close your mouth.
  • Blow kisses, blow out imaginary candles.
  • Smile - an exaggerated one
  • Say the vowels in an exaggerated way - a, e, i, o, u.
  • Chew sugar fee gum but only if you don't have any swallowing problems.
Jaw exercises
  • Side to side - slide your lower jaw one way and then the other.
  • Jaw forward - push you lower jaw forward then relax and repeat it.

Deep breathing exercises will help generally with moving the lymphatic fluid through your body (there are tips further up this page). 

There aren't any specific exercises to do. Physical activity encourages fluid to drain into the lymphatic system in the abdomen. Walking, swimming, yoga, pilates and Tai chi all might hlep to encourage the lymph to move. 

Information and help

Dangoor sponsorship

About Cancer generously supported by Dangoor Education since 2010.