Everyone, whether they have lymphoedema or not, is encouraged to do at least 150 minutes of moderate aerobic activity per week and strength exercises on two or more days per week to stay healthy or improve health1. And, if you have lymphoedema, or are at risk of developing it, then exercise and movement becomes even more important.
To begin exercising with lymphoedema, a progressive approach is absolutely crucial. That is, start with gentle exercise and gradually increase the intensity over a period of time. This applies to everyone, regardless of your fitness level and even if you have been used to high intensity exercise previously. This may hopefully avoid the risk of sudden, increased swelling, and strains and/or injury to muscles. It also allows you to observe how the affected area (or at-risk area) is responding to your new exercise program.
You will likely have been given specific, simple lymphoedema exercises, relating to the affected area, to be done on a daily basis, by your healthcare professional. These exercises should be continued alongside additional exercise that is incorporated into your weekly schedule. The additional exercise ideally needs to include a combination of three main types of exercise.
1. Aerobic exercise
Aerobic exercise increases the heart rate and breathing rate during the period of exercise. It may also help maintain a healthy weight, which is very important for those with lymphoedema. Examples of aerobic exercise include brisk walking, jogging, dancing (such as Zumba™ or FitSteps™), cycling and exercising in water – this is an excellent form of exercise for those with lymphoedema. Instead of brisk walking, why not try Nordic Walking? Ideal for those who also have neck, back and/or shoulder problems. If you are interested in cycling but are not sure if you have the stamina for steep hills, an electric bike may be something to consider.
2. Strength exercises
Strength exercises that involve the major muscles (legs, hips, back, abdomen, chest, shoulders and arms). For example, push ups or lifting weights (kettlebells or free weights). The important thing is to remember to gradually increase the weight over a period of time. Strength exercises using a form of resistance (such as power-bands) will help to improve/tone muscles and increase the strength in ligaments, tendons and bone density. Pilates maybe a useful option for many as this requires the use of your own body weight, helping to develop a strong core and condition your body at the same time.
Flexibility which involves gentle stretching of the muscle, skin and other tissues (particularly scars/joint contractions) to try to increase your range of movement. Yoga, for example Hatha yoga with its slow, rhythmical movements (also mimics lymphatic flow) is ideal for beginners and Vinyasa yoga, which is more intensive and provides more of a workout, is ideal for those who have practiced yoga for longer. Click here to watch a yoga video that aids lymph flow, provided by the Lymphoedema Support Network. Stretch classes can also help and often use a variety of tools such as stability balls, yoga bricks and poles. T’ai Chi may be useful. This combines deep breathing with slow, graceful moves helping to improve balance, posture and mobility.
Whatever type of exercise you decide to do, please remember to wear your compression garment at the same time to ensure an improved lymphatic return. Most importantly, remember that gradual progression is vital to prevent adding further stress to an already impaired lymphatic system. Speak to your healthcare professional about your exercise program, before you start, to ensure that it is suitable, especially if doing resistance exercises.
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