- Question from Sue: What types of exercises are to be avoided in order to prevent lymphedema? Are machines at the health club a benefit, or harmful even when using low weights? Are stretches good or bad?
Sara Cohen, OTR/L, CLT-LANA
When someone has lymphedema, his or her lymph system has trouble removing excess fluid from the tissue. When someone exercises and uses resistance, excess fluid can build up in the tissue. There are different opinions about what's the best form of exercise with lymphedema. There are some schools of lymphedema therapy that recommend doing progressive resistive exercise. This means using weights in a gradual manner so that you use a lighter weight first, and then slowly use a heavier weight. There are other schools of lymphedema therapy that suggest that people with lymphedema shouldn't use any weights. A lot of the decision about whether to use weights or not is very individual, because there are some people who use weights and don't notice any worsening of their swelling, and others use weights and the swelling gets worse. So the decision about whether to use weights or not has to be based on your individual situation. You should discuss this with your therapist.
I don't recommend a specific limit to weight, because for one person, five pounds may be fine, and another person's arm may swell after doing any resistive activity. The other thing I want to point out is that repetitive exercise or activity can also cause an increase in fluid production in the tissue. This means that even doing something lightweight, but in a repetitive way, like cleaning a table, wiping a window, or working at the computer for an extended period of time, can fatigue the muscles in the arm and can cause an increase in swelling.
- Marisa Weiss, M.D. One of the jobs of our muscles is to push the lymphatic fluid through the channels with each contraction, so if your muscles get tired, then they're less likely to exert this pumping action.
- Sara Cohen, OTR/L, CLT-LANA Some exercise is very helpful, and very important in the management of lymphedema. Lymphedema therapists will prescribe a set of exercises that are non-fatiguing that will help stimulate the lymphatic system, and doing those types of exercises in conjunction with compression around the arm is very helpful to the lymph system.
- Saskia Thiadens The safest and, in my opinion, best exercise for upper extremity lymphedema is swimming. You don't hurt yourself, and patients will greatly benefit from this. Some of my patients wear an older sleeve in the water. Once the sleeve becomes wet, there is more compression in the garment and this can actually help the swelling as well.
- Sara Cohen, OTR/L, CLT-LANA Exercise is one way of stimulating the muscles. Activity is another important issue for many lymphedema patients. Certain activities like tennis, golf, and bowling—using different types of equipment, can be done in moderation for some women with lymphedema, and other women have trouble when they do these activities. There's no rule about whether or not someone should engage in these activities or not. Part of the decision about whether to continue with an activity has to do with the value that the person places on that activity, as well as the effect on the arm.
- Marisa Weiss, M.D. I encourage my patients to be active, but also to be cautious. So for my patients who love to garden, I encourage them to wear gloves that go above the elbow to prevent cuts. For patients who like to bake and be in the kitchen, it's important to protect the arms and hands against burns and cuts. If you like to go out in the woods and explore nature, it's important to protect your skin against sunburn, bug bites, and exposure to poison ivy and other plants that may cause trauma to your arms and hands.
On Wednesday, July 17, 2002, our Ask-the-Expert Online Conference was called Arm Lymphedema Prevention and Management. Sara Cohen, O.T.R./L., C.L.T.-L.A.N.A., Saska Thiadens, R.N. and Marisa Weiss, M.D. answered your questions about preventing and managing arm lymphedema.
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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