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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

In the past, there were concerns that exercise might make lymphoedema worse. But research doesn't support this.

We know from research that exercise helps lymph move through the lymphatic system. This can 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 before you start any exercise. They can advise you about what you should and shouldn’t do. They might also be able to work out an exercise programme for you.

Start 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.

Cycling, swimming, and gentle aerobics or water aerobics may also be helpful.

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 heart level by putting it on a cushion or a pillow.

With leg lymphoedema, when you’re sitting put your leg up on a stool or chair. When you’re lying in bed, you can put your leg on a pillow. Don’t have your leg higher than your head. Keep it at heart level.

With lymphoedema of your head and neck, use 2 or 3 pillows to raise your head and help the fluid drain. You can also raise the head of the bed.

Deep breathing

Deep breathing before exercising can help to clear the lymphatic channels in your chest. This 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.
  • Take a slow, deep, comfortable breath in and hold it for a couple of seconds.
  • Then slowly breathe out.
  • Do this 10 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.

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 of exercises you do if your arm starts to ache. Wear your compression sleeve when you’re exercising if you have one.

These are some simple shoulder and arm exercises you should try to do every day. You can be sitting down watching television, so they’re easy to fit into your daily life.

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).

  • 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. Keep your wrist on the cushion and point your fingers to the ceiling. Then move your hand back down so your fingers point to the floor. Repeat 10 times.
  • Keep 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.

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
  • Smiling
  • Yawning
  • 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.

Information and help

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