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Pilates

Pilates for lymphoedema: a 25-minute moving class with arm and leg options

A 25-minute Pilates class for arm or leg lymphoedema, or if you're at risk of it after cancer treatment. It starts with breathing, moves the shoulders and spine, then works the legs with them raised against a wall, adds side-lying hip work and a short strength block built up slowly, and finishes with breathing. Everything keeps moving: there are no planks or long holds, which Macmillan advises against with lymphoedema. Unlike our daily lymphoedema routine it adds Pilates mat work and strength, and unlike our Pilates for cancer class it has a leg block and builds arm strength the way the PAL weight-lifting trials did. No trial has tested this class, and the small Pilates trials disagree on whether Pilates changes swelling, so its structure is our editorial choice.

25 minBeginner17 movesA wall · A band · An anchor point · A bench or boxAbs · Shoulders · Hip flexors · Glutes · Hamstrings · Calves
Follow along: a timer, a cue and the next move, one step at a time.

Breathe (about 2 minutes)

  1. Slow breathing (6 breaths a minute)5 breaths
    Beginner · 3D demoOne hand below your ribs; breathe in slowly and deeply through your noseEasier: Breath reachHarder: Crocodile breathing (prone diaphragmatic breathing)
  2. Lateral breathing (Pilates breathing)5 breaths
    Beginner · Abs · 3D demoBreathe into the sides and back of your ribsHarder: Roll-up (Pilates)

Shoulders and spine (about 3 minutes)

  1. Shoulder rolls5 to 10 each way
    Beginner · Shoulders, Back, Neck · 3D demoThen 5 shrugs, letting your shoulders dropHarder: Shoulder CARs (controlled articular rotations)
  2. Breath reach5
    Beginner · 3D demoArms rise as you breathe in, only as high as is comfortableHarder: Slow breathing (6 breaths a minute)
  3. Thoracic rotation6 each side
    Beginner · 3D demoSitting tall, hips stillEasier: Side-lying open bookHarder: World's greatest stretch

On your back (about 7 minutes)

  1. Knee fold6 each side
    Beginner · Abs, Hip flexors · 3D demoSlow and rhythmicEasier: Supine heel slideHarder: Dead bug heel taps
  2. Supine heel slide8 each side
    Beginner · Hip flexors, Hamstrings, Quads · 3D demoSlide the heel away and backHarder: Hip windshield wipers
  3. Single-leg circle (Pilates one leg circle)5 each direction, each leg
    Beginner · Abs, Hip flexors, Adductors · 3D demoSmall circlesHarder: Corkscrew (Pilates)
  4. Wall bridge (feet-on-wall bridge)8
    Beginner · Glutes, Hamstrings, Abs · 3D demoFeet on the wall, so your legs are raised; roll up and down slowlyEasier: Glute bridgeHarder: Shoulder bridge (Pilates)
  5. Ankle circles10 pumps, then 5 circles each way
    Beginner · Calves, Shins · 3D demoLegs resting up the wall or on a cushion; point and pull your toesHarder: Ankle CARs (controlled articular rotations)

On your side (about 4 minutes)

  1. Clamshell10 each side
    Beginner · Hip abductors, Glutes · 3D demoPillow under your headEasier: Supine isometric hip abduction (belt press)Harder: Lateral band walk
  2. Side kick (Pilates side kick series)8 each side
    Beginner · Hip flexors, Glutes, Hip abductors · 3D demoMoving, not heldHarder: Side-lying leg circles (Pilates side kick series)

Strength, built up slowly (about 6 minutes)

  1. Band row1 set of 8 to 10, lightest band
    Beginner · Back, Biceps, Shoulders · 3D demoSitting or standing; smooth and slowHarder: Supported single-arm dumbbell row
  2. Wall push-up1 set of 8
    Beginner · Chest, Triceps, Shoulders · 3D demoHands on the wall at chest heightHarder: Push-up
  3. Sit to stand from a chair8
    Beginner · Quads, Glutes, Hamstrings · 3D demoArms crossedEasier: Sit to stand, pushing on the thighsHarder: Bodyweight squat
  4. Slow calf raise10
    Beginner · Calves · 3D demoA hand on the wallEasier: Seated bent-knee calf raise (soleus raise)Harder: Standing dumbbell calf raise

Finish (about 3 minutes)

  1. Mermaid (Pilates seated side bend)3 each side
    Beginner · Back, Abs, Shoulders · 3D demoSitting on a chair if the floor is hard to get down toHarder: Side bend (Pilates)
  2. Slow breathing (6 breaths a minute)5 breaths
    Beginner · 3D demoThen rest with the swollen arm or leg raised on a cushionEasier: Breath reachHarder: Crocodile breathing (prone diaphragmatic breathing)

Tips

  • Wear your compression garment if you've been given one, unless your lymphoedema team says otherwise.
  • Check your arm or leg afterwards. If it's more swollen, aching or hotter than usual, or slower to settle, do fewer next time. The British Lymphology Society's practical advice is that a little extra swelling that goes down within 24 hours is fine; it hasn't been tested in trials.
  • Build up the strength block the PAL way: add a set, then a slightly stronger band, only after a week or two with no change in the limb (our suggestion, from the PAL trial's protocol).
  • Only your legs swollen? Do every block and add 5 more ankle pumps. Only your arm? Keep the strength block light and do the hand moves from our lymphoedema exercises routine too.
  • Red, hot, painful or suddenly more swollen skin, or feeling hot, cold and shivery, can be cellulitis: stop, rest and raise the limb, and get an urgent GP appointment or call NHS 111 the same day.

The doses are suggested starting points, not a prescription. Choose a range you can control and stop for sharp or increasing pain, numbness or tingling. Get individual advice after an injury or surgery, or if you are pregnant or managing a health condition.

Guides that recommend it

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Questions people ask

How long does the pilates for lymphoedema: a 25-minute moving class with arm and leg options take?

About 25 minutes, including any warm-up and cool-down listed. Shorten it by doing fewer rounds; lengthen it by adding one.

What equipment do I need?

You need: A wall, A band, An anchor point, A bench or box. Each move links to its guide, where you can find an alternative if you are missing something.

Is it suitable for beginners?

It is written for beginners. 7 of its 17 moves have an easier option listed beside them if you need one.

How do I make it easier or harder?

Use the easier or harder option listed under each move, change the number of rounds, or adjust the rest. Progress one change at a time.