Suggested exercise for lymphedema?


Question from Deborahann: I am recently diagnosed with lymphedema in my left arm and truncal lymphedema on my left side. I am concerned about the amount of exercise I can safely do without causing further discomfort to myself. I love to walk, hike and cycle and infrequently lift weights. What would you suggest as the best form of exercise to engage in now?
Answers - Julie Gralow, M.D. My general recommendation for my patients is to speak to a physical therapist who really understands. I encourage physical activity, and have many patients with lymphedema who do dragon boating and light weight-lifting. They tell me certain physical activities help the lymphedema, but I'd strongly encourage getting help from a physical therapist trained in this area. You can do harm in the short term. It's not uncommon for a little bit of an increase in fluid, and fluid can be seen transiently after some of these exercises. You need to pay attention to the cues your body gives you and cut back if you're doing too much.

One cue to watch for is whether the fluid goes quickly with gentle massage, in which case I don't think there's serious damage. But if the fluid doesn't move easily and it seems to tip (the dent you make with your finger stays there for a while), that would be a cue, especially if after exercise, that you want to pick a different activity. If you're getting a lot more pain after you've done a particular activity, that is something that's important to tell your physical therapist and health care team because it could be a sign there's something happening that we should not be pushing.
Miriam Nelson I agree completely. What's important for women to realize is that even though you may have a condition where you may have to limit certain exercises, your whole body still needs to be fit and healthy. You need to find an exercise that your body does well and that you enjoy. If you become more sedentary, it's likely you'll gain weight and put yourself at risk for heart disease and possibly risk of recurrence.

So you need to find the activity you enjoy and that your body tolerates. We've done a lot of work with women and strength training where I work, and a number of women have had lymphedema that's been transient and controlled. They have done exceptionally well with dragon boating and with strength training, both upper and lower body. Because of this, it doesn't mean you can't lift weights or do these exercises; you just have to follow the lymphedema carefully.
Judith Sachs Could one of you describe dragon boating for us?
Julie Gralow, M.D. Dragon boating is really an Asian sport, and at least in the Pacific Northwest it's quite popular, not just among cancer patients, but as a general activity. The dragon boat, as we've evolved it in Canada and the US, holds about 20 rowers sitting two by two. There's a tiller in the back guiding, and in the front is a drummer or someone beating in rhythm. It's really quite physically active. We have a group here in Seattle called Team Survivor Northwest that has an active program. They take part in competitions, including cancer competitions. There are lots of teams from different cities here in the Northwest.

When you're really in a heat, and you're rowing fast, you can't keep it up for more than a couple of minutes. It's very aerobic. It's a great team sport, which is why many of our women cancer patients like it. Some people are into individual sports, like running while listening to music, but others would rather have that community feeling. It's a support group of sorts when you're out there with other cancer survivors. It's very motivating to be part of a group like that. You have to show up because if you don't have all the 20 people on the boat, especially in a competition, you don't even get to compete. You're committed to other people, so you do it.
Miriam Nelson It's lots of fun to watch too!

On Wednesday, January 18, 2006, our Ask-the-Expert Online Conference was called Physical Activity and Breast Cancer. Miriam Nelson, Ph.D., Julie Gralow, M.D., and moderator Judith Sachs answered your questions about the many issues related to physical activity and breast cancer.

The materials presented in these conferences do not necessarily reflect the views of Breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.

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