What are the best exercises for lymphoedema?
Two kinds: a daily routine of gentle pump moves for the swollen limb, starting with deep breathing (Cancer Research UK's arm and leg routines, 5 to 10 of each), and regular walking, cycling or swimming with strength training 2 to 3 times a week. Your muscles act as the lymphatic system's pump, so any movement helps. Build up slowly, and wear your compression garment if you've been given one.
Does exercise make lymphoedema worse?
No: for lymphoedema after breast cancer, NICE says there's no evidence that physical activity, including arm exercise, will make it worse. Across 36 studies, exercise didn't worsen lymphoedema and improved pain, strength, tiredness and quality of life. Build up gradually and watch how your limb responds.
Can I lift weights with lymphoedema?
Yes, if you start light and build up slowly. In the PAL trial, women with arm lymphoedema who lifted weights twice a week for a year had no more swelling than those who didn't and half as many flare-ups. Start upper-body moves with no weight or about 0.5 kg, add the smallest step only after a week with no change in the arm, and have a few supervised sessions first if you can.
Should I wear my compression sleeve or stockings when I exercise?
UK lymphoedema charities say yes, if you've been given one, though you don't need it in the pool. Small trials found that exercise didn't worsen lymphoedema with or without a garment, so international guidance says it's an individual decision. Follow your lymphoedema practitioner's advice, and ask if it's uncomfortable.
What exercises help leg lymphoedema?
Marching, knee bends, heel raises, ankle pumps and circles, and toe curls, 5 to 10 of each, at least twice a day, plus walking, cycling or swimming. When you rest, put your leg up on a stool or the sofa with your knee supported, and avoid sitting for long periods. The evidence for leg lymphoedema is weaker than for arms, but it points the same way.
Is swimming good for lymphoedema?
Yes. Macmillan says swimming can help because it gently massages the lymphatic vessels, and the Lymphoedema Support Network says you don't need your garment in the water. If your legs are affected, look after your feet around the pool and treat athlete's foot promptly.
What exercises should I avoid with lymphoedema?
None is banned, but Macmillan advises avoiding static holds such as the plank, and the British Lymphology Society says to protect your skin in contact sports. The bigger rule is to build up slowly, because too much too soon can increase swelling. If one activity always makes your limb swell, try a different one.
Can exercise prevent lymphoedema after breast cancer?
It may lower the risk. In women at risk after breast cancer, weight lifting didn't raise the chance of developing lymphoedema, and with 5 or more nodes removed the risk was lower (7% against 22%). Reviews suggest about a 30% lower risk with exercise, though the evidence is low certainty.
What should I do if my arm or leg swells more after exercise?
If it stays more swollen, aches, feels hotter or takes longer to settle than usual, do less next time and build up again more slowly. The British Lymphology Society's practical advice is that a little extra swelling that goes down within 24 hours doesn't mean you need to cut back, though this hasn't been tested in trials. Contact your lymphoedema specialist about any change that doesn't settle.
What are the signs of cellulitis, and what should I do?
Painful, hot, swollen skin that may look red (harder to see on brown or black skin), often with flu-like symptoms: get an urgent GP appointment or call NHS 111 the same day. Call 999 (911 in the US) if you also have a very high temperature or feel hot, cold or shivery, a fast heartbeat or breathing, confusion, or feel faint. Rest and raise the limb, and go back to activity once you feel better.
Do lymphatic drainage exercises or massage help?
Lymphatic drainage exercises are the pump moves in this guide, and they help fluid move. The specialist massage, manual lymphatic drainage, added nothing worthwhile to compression, skin care and exercise in a trial of 194 people, and NICE doesn't recommend for or against it. Self-massage taught by your lymphoedema service can be part of your daily care.
Is lipoedema the same as lymphoedema? What exercise helps lipoedema?
No: lipoedema is a build-up of fat, usually in both legs equally with the feet spared, often painful and easily bruised, and almost always in women. Lipoedema UK recommends low-impact exercise such as swimming, walking in water, cycling, walking and yoga, plus strength training, and compression can ease the pain. Fluid swelling can develop alongside it, especially with obesity or reduced mobility.