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Exercise and Lymphoedema

Exercise and Lymphoedema
 
Exercise is thought to help the person with lymphoedema as movement:
  •  improves the pumping of the lymph along the vessels
  •  increases the uptake of fluid back into the lymph vessels
  •  keeps the joints flexible
  •  strengthens muscles and prevents muscle wasting.

Advice on exercise fits into two categories - general exercise and specific lymphatic exercises.

walking.jpgGeneral Exercise
Until recently it was thought that people with lymphoedema could not undertake strenuous exercise but research has shown that weight lifting and aerobic exercise did not make women with breast cancer more likely to develop lymphoedema or make lymphoedema worse for those with the condition. However exercise should be gentle in the first year to eighteen months after surgery. Some people think that if some exercise is good then more must be better. This may not be the case. Exercise should be reduced if it causes heaviness, aching or swelling. A gentle build up is important.

Daily exercise as tolerated is helpful. The best form of exercise is exercise you enjoy doing. Try walking, swimming, cycling, or rowing. Some tips are:
  •  start slowly and build up
  •  wear your compression bandage or garment unless swimming
  •  during swimming no compression garment is needed as the water provides the pressure. Keep the temperature of water below 34º or lower for lap swimming
  •  keep a track on whether exercise affects the limb / area - monitor and modify
  •  keep cool during exercise - try wetting the compression garment with fresh water
  •  drink plenty of water (this is not reported as making the lymphoedema worse)
  •  if you have skin and tissue shrinkage from surgery (e.g. mastectomy) start gently, increasing the flexibility of the shoulder and chest
  •  use your affected limb as normally as possible but use with care
  •  some sports put strain on the lymphatics – notice how your body responds. If you don’t wear a compression garment try wearing one when you exercise
  •  try out different things and see what works for you
  •  it is important to warm up and warm down ( i.e. start and finish slowly)
  •  vary the exercises doing smaller numbers of a range of exercises and then repeat the circuit. Rotating the exercises produces less muscle soreness than doing multiple sets of the same exercises in one go.

Specific Lymphatic Exercises
Lymphatic exercises are: 
  • gentle slow movements 
  • designed to stimulate the lymph flow and open up the lymph nodes
  •  done in sequence to drain fluid systematically
  •  undertaken daily.

In a study by Casley-Smith & Casley-Smith, (1997) people who did lymphatic exercises daily for 3 months before starting massage treatment had less of a reduction from massage. It is thought that the exercises had reduced the limb size before the other treatment started.

Exercises are available from Lymphoedema Therapists. Michael Mason has excellent handbooks.
 
Useful Links

The following exercise programmes are especially helpful for lymphoedema:

Pinc and Steel Exercise programme (available in New Zealand)
Healthy Steps:The Lebed Method (available in Wellington, NZ - contact Di Graham for information) 
Nordic Walking
Casting for Recovery (available in New Zealand)


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