Jacqui Eaton, Lymphoedema Physiotherapist
Secondary lymphoedema following cancer or cancer treatment is due to damage, blockage or removal of lymph nodes and vessels causing fluid to accumulate in the affected areas and into the limbs. Long-term changes include; tissue thickening and fibrosis, fatty deposits, skin changes, reduced range of motion and the potential for infection.
Exercise is vital for individuals with lymphoedema. It is important to maintain a healthy body weight as an increase in weight and obesity has been shown to increase the risk of developing lymphoedema and worsening lymphoedema if already evident1. There are also specific exercises and hydrotherapy exercises for improving and maintaining lymphoedema. Recommendations for exercises for individuals with lymphoedema include:
- Keep active and avoid sitting for long periods of time.
- Start with gentle exercise and gradually work up to more challenging exercise.
- Avoid strenuous exercise if your body isn’t used to it.
- 30 minutes of moderate exercise 5 times per week is recommended.
- Monitor your “at-risk” or affected limb before, during and after exercising for these signs and symptoms: discomfort, heaviness, tightness, fullness, swelling, burning, itchiness, numbness, pins and needles, temperature changes, redness of the skin, indentations from clothes or accessories, such as socks, watches etc.
- Elevating limb whilst exercising will assist lymph return.
- Don’t exercise in hot weather.
- Ideal water temperature for aqua aerobics and swimming is about 28-29oC, 30-32oC is also acceptable, but over 34oC is too hot. Don’t use hot baths, showers, saunas or spas.
- Yoga, Qi Gong, gentle dancing and Tai Chi are all recommended as the rhythm is slow and compliments the lymphatic system.
- Walking or Nordic walking with poles is acceptable.
- Modified gym programs using low loads and avoiding high impact activities is suggested.
- Resistance training twice per week is recommended.
- Care must be taken with exercise that may cause overheating of the body, such as strenuous exercise that increase heart rate and blood pressure, including netball, squash, hockey, running. If possible, it is best to avoid the overheating caused by these activities.
- Try exercising during the cooler parts of the day, such as early morning or late afternoon.
- Ensure you perform a thorough warm-up and cool-down. Have a cold or luke-warm shower after exercising and elevate the limb for 30 minutes. Contact sports should be avoided as these may worsen lymphoedema.
For further information or to book an appointment please contact our Lymphoedema Physiotherapists or reception on 02 4975-1622.
- Best Practice for the Management of Lymphoedema. International Consensus. London: MEP Ltd, 2006.