Lymphedema is a condition involving a buildup of fluid in the body. The lymph system drains and transports lymph fluid throughout the body, and filters the waste produced by our body’s cells before returning the lymph to the bloodstream.
Some cancer surgeries and treatments can put survivors at a higher risk for developing the condition. Depending on the type of cancer and the treatments involved, lymphedema can affect the legs, arms or torso.
The risk is ongoing. Many cases develop within the first year after treatment, but new research has shown that lymphedema can develop even after 60 months. One 5-year study found that lymphedema cases continued to develop in the fifth year.
Lymphedema is not a life-threatening condition, but there is no cure. In earlier stages, it is manageable. However, if left untreated for a long time lymphedema can get progressively worse and cause other complications.
The relationship between exercise and lymphedema is not straightforward. Exercise does increase the amount of lymph fluid that your body has to process. Any muscle strain or injury can increase the workload for the lymph system, which may overload an already-stressed lymph system.
On the other side, the constricting and release of muscles helps to pump lymph fluid through the body. In addition, increased deep breathing from exercise encourages lymph to move out of the limbs and toward the heart where it is returned to the bloodstream. Exercise can also help maintain a healthy weight. This is important since excess weight appears to be a factor in the development of lymphedema. And finally, maintaining enough strength to handle the challenges of daily life means you are less likely to strain your muscles when you need to do something – whether that’s picking up a crying child, carrying the groceries, shoveling snow, playing tennis, or windsurfing.
Not too long ago, many doctors, if they mentioned lymphedema at all, recommended that their patients not use the affected limb to avoid the risk of strain or injury. We were told to never lift more than a few pounds, never carry groceries, never carry a purse or bag on that side. Many of us refused to be pushed to the sidelines of our lives simply because we were unlucky enough to have had cancer. We, along with some lymphedema therapists and willing doctors, slowly discovered that we could be strong. Over the years we have provided a large body of anecdotal evidence that exercise is good for us in spite of our lymphedema risk.
Research is finally catching up to what we have been proving for years: that leading an active, strong life is not only possible, but is beneficial for people at risk for lymphedema. A recent study from the University of Pennsylvania School of Medicine found that women with lymphedema who took part in a regular, progressive weight training program had fewer flare-ups compared with non-weight lifters. Lifting weights had no detrimental effects and showed significant benefits for women with lymphedema. Further evidence from that study shows that weight training may reduce the chances of developing the condition in the first place.
No one should be limited by their disease or their survival! So exercise, lift weights. But do it right.
It’s a good idea to take measurements of your affected limb before starting an exercise program. Measure around your arm or leg in several places: upper arm/leg, just above the elbow or knee, forearm/calf, and wrist or ankle. Write it down and periodically recheck it. That way you’ll be able to keep track of any early signs of swelling. Also look out for a feeling of fullness or heaviness.
If you do develop some swelling, talk to your doctor or lymphedema therapist.
When you do start exercising, start off very easy to see how your body reacts. Your body does learn to compensate for the damaged lymph system; it learns to redirect the lymph to other nodes. But it’s important not to overload your system all at once. So begin slowly, and progress in a gradual and safe manner.
If you are used to being active, a slow progression can be frustrating. But remember, you’re in this for a lifetime, not just a month. An injury or strain can set you back weeks, months, or more.
And also remember that lymphedema is a lifelong risk. If you take some time off and lose muscle tone, don’t just jump back in. Start off easy again and build back to where you were.
The risk of lymphedema is real and should not be ignored, but it is not a reason to avoid exercise, especially weight training. You simply need a safe, slowly progressive plan.
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- ^ Amer J. Lymphedema Occurrence Rates 1 to 5 Years after Breast Cancer Diagnosis. Presented at the 2010 Breast Cancer Symposium of the American Society of Clinical Oncology, San Antonio, TX.
- ^ Schmitz, et al. Weight Lifting in Women with Breast-Cancer-Related Lymphedema. New England Journal of Medicine, Aug. 13, 2009, vol. 361, no. 7, pp. 664-673.