“Having a healthier lifestyle and a healthier lymphatic system can help you to feel more in control of your lymphoedema day by day.”

Exercising, at any level, works our muscles harder and causes us to breathe more deeply, which in turn causes the lymphatic system to work more effectively. By improving the body’s muscle pump function lymph flow is increased and the body is enabled to rid itself of harmful substances such as bacteria. In addition, the increased movement of lymph throughout the system during exercise can reduce oedema and help to control lymphoedema.

Regular activity strengthens muscles, and will help to keep our joints flexible, which in turn helps to maintain and enhance our range of movement. Posture, body shape, confidence and independence will also improve. For those struggling with managing their lymphoedema, becoming more active can also help to reduce swelling and thereby prevent other complications from developing. Having a healthier lifestyle and a healthier lymphatic system can help you to feel more in control of your lymphoedema day by day.

Movement

Keeping active doesn’t have to mean joining a gym or going jogging; you can stay active and healthy just by doing more of the activities you normally do. Whether it’s chores around the house, tending to the garden, shopping or visiting friends; movement and exercise are achievable for most people every day. The British Lymphology societiey’s EVERYBODYCAN campaign is all about finding ‘Secret Weapons’ to help enhance everyday activities. For example:

• Whilst waiting for the kettle to boil, try stretching up onto your toes;
• When a good song comes on the radio, try “dancing” or “jigging” to the music.

One of the most beneficial exercises for lower limb oedema is very simply to point & flex the ankle joint. This relaxes & contracts your "calf muscle pump", mimicking the effects of normal "heel to toe" walking. Without this action, gravity pulls fluid to the lowest part of the body - your feet and ankles - and increases swelling.

Exercise

The right amount of activity or exercise is different for everyone, and whereas, traditionally, people with lymphoedema were advised to avoid more strenuous exercise, this is no longer thought to be the case. A recent review found there was no evidence of harm from carrying out several different forms of exercise, and found a wide range of benefits in the activities undertaken: improvement in quality of life, strength, Body Mass Index and mental health, and reduction in pain and lymphatic swelling (Panchik et al 2019).

Many forms of exercise are now thought to be safe and are known to be beneficial for lymphoedema:

Brisk Walking – although gentler walking is also beneficial
Swimming and other water-based activities, e.g. water aerobics
Yoga, pilates, aerobics
Nordic pole walking and dragon boat racing
Tai chi and qi gong
Tripudio
Set programmes of muscle pumping and strengthening exercises
Gym work
Any additional preferred activity for general fitness, e.g. dancing
Deep breathing exercises or activities involving this, e.g. singing

Adapted from Panchik et al (2019) & BLS Lymph Facts – Activity & Exercise, 2020 ( https://www.thebls.com/documents-library)

Things to consider

1. If you are planning to re-start an activity you haven’t done for a while, or are maybe thinking of trying a new activity, it’s best to begin slowly and gradually increase repetitions and intensity. If your lymphoedema worsens and does not go back to what is normal for you within 24 hours, you should ease off or stop that particular activity, remembering that as your fitness improves you should be able to return to it later.
2. It is advisable to always wear your compression garment, if you have one, when exercising. This is not necessary though for water-based activities.
3. If you find that a particular activity or form of exercise makes your lymphoedema worse, try something a little different.
4. Don’t be too hard on yourself – make sure you have plenty of breaks with shorter spells of exercise in between.
5. Drink plenty of fluids when exercising and afterwards.
6. If your chosen activity involves contact sports, you may need to take precautions to avoid injury.
7. If in doubt about any type of exercise you wish to try you should speak with your Lymphoedema Practitioner.

Remember

1. Try to be as active as you can. Immobility or reduced mobility can make lymphoedema worse - reduced muscle pumping slows lymphatic drainage and causes fluid to stay in the tissues for longer, which in turn causes heaviness and tightness of the swollen limb.
2. Even a relatively small amount of exercise can help to keep swelling under control by making the muscles work harder.
3. If any activity causes your affected limb to ache, become painful, or worsens the lymphoedema, you should ease up on this particular activity. As your fitness improves you should be able to gradually increase the amount of exercise you can comfortably do.

With these things in mind – enjoy being more active.

About the author

Jeanne started her lymphoedema career in the early 1990s, setting up the lymphoedema clinic in Durham. She then moved into a specialist clinical role across South Durham, Teesside and North Yorkshire, and in 2013 set up the Lymphoedema Service based in Imperial Healthcare Trust at Charing Cross Hospital. Jeanne is now the Lymphoedema Nurse at St Teresa’s Hospice in Darlington, where her passion for education continue

REFERENCES

British Lymphology Society (BLS) (2020) Lymph Facts: activity and exercise. https://www.thebls.com/documents-library

British Lymphology Society (BLS) (2021) EveryBodyCan Campaign. https://www.thebls.com/pages/everybodycan

Panchik D, Masco S, Zinnikas P, Lauder T, Suttmann E, Chinchilli V, McBeth M, Hermann W (2019) Effect of Exercise on Breast Cancer-Related Lymphoedema: What the Lymphatic Surgeon Needs to Know. J Reconstr Microsurg; 35(1):37- 45. Doi:10.1055/s-0038-1660832