Managing lymphoedema with physical activity

Physical activity is important for managing lymphoedema. Physical activity:

• works your muscles, which increases the flow of lymph fluid through the lymphatic system and helps move it away from the swollen area
• can help you maintain a healthy weight, which can reduce lymphoedema swelling
• keeps your joints flexible, maintaining and improving your range of movement.

Physical activity can also help you feel better about yourself and reduce stress and anxiety.

You can use your affected limb for all your normal activities, but take care with anything that might cause muscle strain. You may have to wait until the swelling improves to do some activities.

Here are some simple exercises to reduce arm swelling:

1. Sit comfortably and support your arm at shoulder height – you could use pillows. Make a fist and then stretch your fingers out straight. Repeat this exercise as many times as feels comfortable.
2. With your arm supported by a cushion or pillow, try bending and straightening it at the elbow.
3. Check that your shoulders are level by looking at your posture in the mirror. Practise shrugging, and then dropping your shoulders slowly. Count to 5 as you do this.
4. Slowly circle your shoulders together forwards, then backwards.

The type of activity you do could be gentle stretches, or something that you enjoyed before.

There may be some types of physical activity that you will need to take more care with. You may need to be careful if there is a high risk of muscle strain or skin injury. Always ask your lymphoedema specialist for advice and talk to your doctor before you start.

Some good types of exercise include:

• swimming
• walking
• stretching exercises
• yoga

Swimming and aqua aerobics are helpful if you have problems with your joints, as they put less strain on them.

There are ways you can position your limb when resting that can prevent fluid from building up.

Careful positioning when resting or sitting can reduce swelling for lymphoedema in an arm, leg, or the head and neck.

• Place a cushion on the arm of a chair. Rest your arm on this when sitting down – this will fully support it and raise it slightly.
• Try not to lift your arm above shoulder height for too long – it may reduce blood flow to your arm and make you more uncomfortable.
• Try not to leave your arm in the same position for too long – it is more helpful to move muscles regularly.

• Sit with your legs uncrossed.
• Raise your legs as often as you can when you are sitting. Lie with your legs up on a sofa, or fully supported on a footstool.
• Try not to keep your leg in the same position for too long.
• Get up and move about at least once an hour, if you can.
• Avoid standing still for long periods of time.

If you have to stand for a long time, these exercises can help stop fluid building up:

1. Raise yourself up onto your toes and lower back down again. This helps tense and relax your calf muscles.
2. Shift your weight from one leg to the other. Transfer your weight from your heels to your toes, as if you are walking on the spot.
3. Try rocking back on your heels and forward onto your toes a few times.

It can help lymph fluid to drain if you slightly raise your head and upper body while you sleep. You can do this by:

• raising the head of the bed slightly – for example by
• using blocks under the legs of the bed using a foam wedge under your upper body and head
• using pillows.

Try to keep your head in line with your body, so your neck is not bent too far forward. This will help fluid to drain.