Lymph Drainage and Exercise
In the past if you had surgical removal of lymph nodes, or damage to them through radiation, your medical team would have advised you not to lift any object that weighted more than 5 lbs. Lymphedema was a concern. Current research suggests that restricting the amount of weight lifted may not result in lymphedema.
The Lymph System
The lymph system transports waste from the body, aids the circulatory system in delivering nutrients and helps the body to guard against disease.The fluid moved is call the lymph. Lymph nodes, spleen, tonsils and Peyer’s Patches are part of this system. Lymph flows up, moving from feet and hands, to the subclavian veins. If nodes have been removed or damaged the lymph may become stagnant causing the surrounding tissue to swell and lymphedema may occur.
Exercise causes contraction of the muscles. When muscles contract they stimulate lymphatic flow. Resistance exercise is perfect for increased flow; muscles contract and lengthen. Mind-body exercise can also aid in lymphatic flow through the contractions of the lungs and diaphragm.
How to Begin
First and foremost, your medical team should provide clearance. If you have lymphedema, wear a compression garment. Take measurements in the arm just above the 5” above the wrist fold and 5” above the elbow fold. If you notice any change in the measurements after exercise, touch base with your medical team. Monitor the legs by watching for any redness, swelling or feeling of heaviness.
You will want to start with one set of exercises covering the major muscle groups and alternate upper body with lower body. If working with machines: leg press; chest press; back row; overhead press; bicep curls; triceps extensions; and, back extensions. An opposite arm leg raise on all fours will target your back extensors and the pilates knee fold will strengthen the abdominals. Begin with light weights, 1-2 lbs for the upper body, and the lowest plate setting for the leg press. Complete 8-12 repetitions of the exercise. If after several exercise sessions there are no side effects, you may increase the weight by approximately 5%. Add stretches for each of the muscle groups you just worked, and, your workout is complete.
Ahmed, R.L., Thomas, W., Yee, D., & Schmitz, K.H. (2006). Randomized controlled trial of weight training and lymphedema in breast cancer survivors. Journal of Clinical Oncology, 24(18), 2765-2772
Bicego, D., Brown, K., Ruddick, M., Storey, D., Wong, C., & Harris, S.R. (2006). Exercise for women with or at risk for breast cancer-related lymphedema. Physical Therapy, 86(10), 1398-1405.
Buckley, Lorelei The Lymphatic System – Another Reason to Exercise. Electronic document, http://www.byregion.net/articles-healers/Exercise_Lymphatic.html, accessed May 7, 2007.
Cheema, B., Gaul, C.A., Lane, K., & Fiatarone Singh, M.A. (2008). Progressive resistance training in breast cancer: A systematic review of clinical trials. Breast Cancer Research and Treatment, 109(1), 9-26.
de Rezende, L.F., Franco, R.L., de Rezende, M.F., Beletti, P.O., Morais, S.S., & Gurgel, M.S. (2006). Two exercise schemes in postoperative breast cancer: Comparison of effects on shoulder movement and lymphatic disturbance. Tumori, 92(1), 55-61.
Didem, K., Ufuk, Y.S., Serdar, S., & Zumre, A. (2005). The comparison of two different physiotherapy methods in treatment of lymphedema after breast surgery. Breast Cancer Research and Treatment, 93(1), 49-54.
Havas, E., Parviainen, T., Vuorela, J., Toivanen, J., Nikula, T., and Vihko, V. 1997 Lymph flow dynamics in exercising human skeletal muscle as detected by scintography. The Journal of Physiology 504(1):233-239.
National Lymphedema Network. (2008b). NLN position paper: Lymphedema risk reductionpractices. Retrieved May 15, 2008, from http://www.lymphnet.org/pdfDocs/nlnriskreduction.pdf
Young-McCaughan, S., & Arzola, S.M. (2007). Exercise intervention research for patients with cancer on treatment. Seminars in Oncology Nursing, 23(4), 264-274