Lymphoedema
Exercise and Lymphoedema
Everyone should attempt to maintain a healthy weight and be physically fit within
the limitations of their age and any physical or medical conditions. To become
physically fit one needs to undertake a range of exercise.
It is now clear from a range of studies that exercise from the cells and tissues) may stay in the tissues.
is generally safe and beneficial. Exercise includes If it stays for a long time (weeks and months) it’s
many different types of physical movement. best referred to as lymphoedema.
The three main groups of exercise are: aerobic,
We and the NLN (via their position statement)
strength, and flexibility.
would like you to know that you can use the
There are many other types of exercise that have benefits of any system of exercise as long as you
health benefits such as Pilates, yoga, Tai Chi, follow the general safety principles (undertake
Qigong, aquatic exercise, trampoline rebounding, within your limits, warm up and warm down)
breathing and relaxation that have not yet been of exercise with lymphoedema, seek medical
adequately studied in people with lymphoedema. or qualified health professional guidance (e.g.,
Medical Oncologist, Lymphoedema Specialist), and
The National Lymphoedema Network of the USA
use caution in starting any new exercise program.
(NLN) indicates a person at risk of lymphoedema
or with lymphoedema can use the benefits of any
system of exercise if he/she follows the general One of the most important
safety principles of exercise with lymphoedema,
seeks medical guidance, and uses caution in principles to is warm up and
starting any new exercise program. warm down.
These actions can vary widely between
What happens when you individuals, but might involve gentle bending
and straightening at a constant speed or keeping
exercise? the limb still while increasing the tension (e.g.,
When you undertake an exercise program your stretching). This movement of the muscle groups
heart rate (and often blood pressure) rise. This and or the limb or area of the body is important.
helps supply your muscles with oxygen and Remember to take some deeper breaths during
nutrients and helps your body remove waste warm up and warm down if you are able to do so.
products. During this process the load on your
lymphatic system (which can be likened to a
sewerage system) increases, and its flow increases. Compression or no compression
This is generally okay for a normal lymphatic during and after exercise?
system, but when a lymphatic system has been
This is a difficult question to answer. It’s really up
disrupted by surgery or radiotherapy the load it
to you the individual. We suggest that if you have
can take without showing signs of overload can
a bandage on and normally wear a garment during
be less, often leading to fluid accumulation in
the day that you leave it on for your exercise/
the tissues (called oedema). Even after you have
activity. If you do not have a garment then we
finished your exercise your heart rate and blood
suggest you pay particular attention to how
flow and pressure might be higher than at rest.
your arm feels in the hour or two after the initial
It is important to remember this as it can mean
bouts of exercise. If it feels ‘full’ or tighter or your
higher loads on your lymphatic system.
fingers seem a little swollen then it may be worth
Even when your lymphatic system is normal, considering purchasing (ideally with the help of a
you can expect to get some short term fluid health professional familiar with your condition)
accumulation in the tissues. In people without a compression garment and utilising one or more
lymphoedema, this fluid is soon removed. When of the following suggestions below to help relief/
the lymphatic system is not working well that fluid remove lymphoedema symptoms. page 1
(and its contents – which includes waste products
Key points 5) Take some deep breaths during the day. At
other times of the day taking a good deep
1) Warm up and warm down! If you are at risk breath in and breathing out slowly is good for
of lymphoedema or already have it the warm helping clear the lymph vessels in the upper
down period is crucial. After exercise, the load parts of the arm and chest of lymph. This in turn
on the lymphatic system is generally higher, so helps keep the fluid levels under control.
you need to keep the lymph in it flowing by
slow decreasing levels of activity. 6) Whenever your arm or hand starts to feel a little
heavy and or has a ‘full’ feeling we suggest you
2) Keep your garment or bandage on during undertake the gentle breathing and arm exercise
exercise. If you have been undertaking your program.
exercise with a bandage on or garment on then
you would have noticed that your arm will feel 7) Contact your health professional of GP if you
warmer than the other one. That’s OK but it are in any doubt. If the fullness persists then we
does mean this arm will take longer to cool. suggest you contact a qualified lymph therapist,
You might think it’s a good idea to remove your your specialist or GP.
garment or bandage at this time for a while. Therapist listings are available at
While the information available is not strong it http://nlpr.asn.au/ or call the Lymphoedema
does seem that it is better to leave it on! This Research Unit at Flinders Medical Centre on
means the compression helps vary the pressures 82044903 for further advice. Therapists listed
in the tissues and helps pump the lymph along. on this website are private practitioners so you
3) To wear or not to wear? Another general point will need to enquire about costs involved with
about garments and bandages. If you don’t treatment. Flinders Medical Centre does not
wear them 24 hours a day (which is totally OK), currently have a publicly funded service.
and you wear them only during waking hours,
it’s best to put them on as early as possible after
you get out of bed. It’s also VERY important not
to take them off until you are in bed. If you take
them off earlier the fluids they were holding out
of the tissues may accumulate.
4) Undertake a gentle arm exercise and breathing
program after any exercise program and before
you go to bed. This has been clinically trialled
at Flinders Medical Centre and while not a
large trial, it suggested that undertaking this
program helps clear the lymphatics of the chest
of fluids - and thus creates space for the fluids
to enter when they leave the arms (see attached
program). You will see that we recommend this
program be undertaken 5 times a day to attain
maximum benefit.
For more information
Prof Neil Piller
www.ausgoal.gov.au/
Medical Oncology
creative-commons
Flinders Medical Centre
Bedford Park
South Australia 5042
Telephone: 08 8204 4711
Facsimile: 08 8204 6160
If you require this information in an alternative
language or format please contact SA Health on page 2
the details provided above and they will make
every effort to assist you.
© Department for Health and Ageing, Government of South Australia.
All rights reserved.
This document was prepared by
Prof Neil Piller, Director of the Lymphoedema Research Unit,
Department of Surgery, School of Medicine, Flinders University.
Reviewed September 2013. Next review September 2016
