Reducing your risk of lymphoedema

We do not know why some people develop lymphoedema and others do not. But following the advice in this section may help to reduce your risk of lymphoedema.

Anyone who has had surgery or radiotherapy that affects their lymph nodes is at risk of developing lymphoedema. The risk is greater if:

• the lymph nodes in the armpit, groin or neck are affected
• you have had both surgery and radiotherapy to the lymph nodes
• you are overweight.

You may have had just 1 or 2 lymph nodes removed. This is called a sentinel lymph node biopsy (SLNB). Or your doctors may have removed a complete group of nodes. This is called lymph node clearance. 

Having a complete group of lymph nodes removed increases the risk of lymphoedema. If you have had an SLNB, you are still at risk of getting lymphoedema, but the risk is lower.

If an area becomes inflamed or infected, the body makes extra fluid. If this area of your lymphatic system is not working properly, the build-up of fluid could cause lymphoedema. Fatty tissue that blocks the lymph nodes can also stop the lymphatic system from working properly.

Being overweight or having a skin infection called cellulitis may cause swelling in someone who is at risk of developing lymphoedema. Or it may be that some people’s lymphatic systems do not work as well as others.

Following the advice in this section may help to reduce your risk of lymphoedema.

You may be advised to avoid pressure on the area. This is because it can affect the flow of lymph fluid. This depends on which part of the body is at risk.

If possible, you should avoid:

• having your blood pressure taken from the arm at risk
• having needles in the arm at risk – for example having injections or blood samples taken
• wearing tight jewellery such as rings, watches, bracelets, ankle bracelets or toe rings
• wearing tight clothing such as tops with tight armholes, waist bands, or bra straps.

Muscle activity helps improve the flow of lymph fluid in the body. Regular exercise and keeping active encourages the fluid to drain. It also helps with joint movement.

Gentle stretching exercises can help your arm or leg return to normal after surgery or radiotherapy. You should do exercises gently and start gradually. A physiotherapist will usually show you what exercises to do. It is important you do them for as long as they advise after surgery. This will help you recover.

After your treatment finishes, you can usually get back to any physical activity or exercise you did before. Or you may decide to do something new. 

It is important to start slowly and gradually increase the intensity. You may need to be more careful with certain types of exercises. These include lifting heavy weights, or playing physical contact sports. This is because they are more likely to injure the skin or muscles in the area at risk of lymphoedema. These sports may be fine if you have always done them, but check with your GP or lymphoedema specialist first.

Physical activity will help you to:

• feel better generally
• maintain your weight
• breathe more deeply, which helps lymph fluid flow.

Breathing exercises on their own, or as part of yoga or pilates, can also help. Ask your physiotherapist or specialist nurse for advice about exercise.

Here are some tips to help reduce your risk of developing lymphoedema when travelling:

• Avoid sitting in the same position for the whole journey.
• Move around often, and do gentle stretching exercises if you are on a plane or train.
• During long car journeys, make regular stops to get out and walk around.
• Wear comfortable clothes and shoes, and avoid tight-fitting clothes.
• Use a suitcase on wheels that you can pull, to avoid extra strain on your muscles.

Even if you do not have lymphoedema, you may need to wear travelling socks during a long flight, to prevent a clot in your legs. Talk to your doctor or pharmacist who will be able to advise you. They can tell you how helpful a compression garment might be in your situation.