Let's talk exercise today! We do know it is important to keep Lymphedema under control by use of compression/compression bandaging and exercise. For some time the medical community was not clear that exercise was a good idea for the Lymphedema population. Now there have been many studies showing the positive results from a regular exercise routine. The best results occur with BOTH compression and exercise. Why? Containment from the compression to support the limb AND and muscular pump action inside the limb for the optimum fluid movement.
Many individuals are nervous to start an exercise routine as they may think it could make their swelling or pain worse.. which isn't exactly true. Exercise is highly individualized and everyone needs to start out at a different level and work their way up. Activities such as mowing the lawn, or doing dishes etc, can even count as a more strenuous activity for some people. Skilled professionals will be able to help you find the right program for you.
What KIND of exercise should I start? And....
What does exercise mean to you? 🏋️♀️🚴♀️
Two kinds of exercises to consider: BOTH help move fluid with Lymphedema by increasing cardiovascular activity, breathing rates, stimulating a hyperemia response (increasing blood flow) therefore increasing BP and fluid movement by way of internal pressures in the vasculature, and muscle pump action which stimulates lymphangion vessel activity.
Resistance exercise: weight lifting or moving your body against resistance. Examples: free weight exercises, resistance bands, body weight exercises like push-ups, lunges, etc
Aerobic exercise: occurs when the body uses a lot of oxygen for a longer duration. Examples: dance classes, walking, biking, running, swimming
🏊Let's talk swimming for a second....
Swimming... ahhhh... Freedom with no compression garment, and water provides hydrostatic pressure to support the limb and help move fluid. A great activity for individuals with Lymphedema!
Well, how much Exercise is too much? ... Everyone is different!
“Progressive exercise is not associated with the development of exacerbation of breast cancer related Lymphedema and can be safely pursued with proper supervision”-- Doyle, Colleen, et al. "Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices." CA: a cancer journal for clinicians 56.6 (2006): 323-353.
But is too much exercise harmful?
It can be... but there are many ways you can prevent overdoing it. In general, be aware of activities that take you above your daily physical limit. Do not strain your body or overuse your affected limb/s. It is recommended to break activities into smaller pieces using a term OT’s like to call ”Energy Conservation” techniques. Finding the right balance for your own body is key.
You CAN exacerbate lymphedema when over-doing an activity. So learn to stay within your normal body capabilities as far as physical load.
Some RISKS:
One risk would be, being unprepared for an activity or task, aka not having your compression garment on. Make sure you have your compression garment ON. Plan ahead by knowing how heavy items are that you are lifting and regular amount "duration” and "load” or "sets" and "reps". Plan to scale back when you are deconditioned and gradually build up over time. The best plan would be sticking to a program that you can track your progress, and if you do fall away from exercies for some time you know how to cut back and then gradually increase again.
Also make sure you know how to perform an exercise correctly with new equipment at the gym or when doing a difficult household tasks like moving a large piece of furniture. Watch your posture and body alignment/body mechanics to reduce injuries. If you do have medical or health issues other than Lymphedema please discuss exercise with your doctor, PT or OT.
Signs you over did: Soreness that lasts, increase in swelling, garments that don’t fit
Exercise Precautions:
Protect limb during exercise (wear garment or compression wraps)
Do not strain to do activity
Watch for any signs of pain or discomfort especially in affected limb
Make sure you are well hydrated with water before and after exercise
Guidelines:
Consult with an OT or PT that is versed with Lymphedema before starting a program for more direction. Warm up before exercise and cool down after, a few minutes of active stretching and movement to get body ready for work. Keep smooth rhythm and stay focused on body during exercise and don't rush through movements. Deep breathing into belly will help improve intrathroacic pressure and core strength as well as move lymph fluid from abdominal area
Good news...
You can CONDITION yourself to tolerate ACTIVITY by slow progressive resistance or progressive aerobic exercise. Yes, you can work a job that involves a lot of standing. Everything should be suited and individualized to you. Your program can be created by a knowledgable OT/PT or exercise specialist.
Make sure to maintain a relationship with your CLT “Certified Lymphedema Therapist” and doctor. They can keep a baseline of measurements for you and help you get back on track if needed.
Let me know if you have any questions of how to start an exercise program/routine that suits your needs. You can do it! Just because you have Lymphedema you shouldn't miss out on all the wonderful health benefits exercise can provide.
Some great benefits of moving are: Mood boosting, improvement in cardiovascular health, decreased risk for chronic diseases, improved immune system functioning, increased muscle strength and endurance, improved function and quality of life... go get it :)
Sources:
Schmitz, Kathryn H., et al. "Weight lifting in women with breast-cancer–related lymphedema." New England Journal of Medicine 361.7 (2009): 664-673.
Courneya, Kerry S., et al. "Effects of aerobic and resistance exercise in breast cancer patients receiving adjuvant chemotherapy: a multicenter randomized controlled trial." J Clin Oncol 25.28 (2007): 4396-4404.
Ahmed, Rehana L., et al. "Randomized controlled trial of weight training and lymphedema in breast cancer survivors." J Clin Oncol 24.18 (2006): 2765-72.