The Author

Joachim Zuther, Lymphedema Specialist. Read more
Lohmann Rauscher
MediUSA

Tactile Medical

Resistive Exercises for Lymphedema

 

This is part two of a three-part series covering exercises for patients affected by lymphedema. Part one covered aerobic exercises; part three will discuss decongestive and breathing exercises.

Strength exercises improve muscular power, increase the strength in ligaments, tendons and bones, and positively contribute to weight control. Resistive exercises are typically performed in a repetitive fashion against an opposing load. Gradual progression is imperative and exercise programs should be comparable to the patient’s fitness level, while trying to accomplish an improved return of lymphatic fluid without adding further stress to an impaired lymphatic system. Certain strength exercises are beneficial for lymphedema patients and should always be performed with the compression garment or bandage in place. Resistive exercises using weights present possible problems in regard to injury or overuse. However, with appropriate precautions resistive exercises using weights can be very beneficial.

An improved baseline of strength will allow daily tasks to be performed with less effort and possibly prevent muscular or ligament sprain or strain. Improved strength can prevent against overuse syndrome and restore intramuscular balance and normal biomechanics to the involved limb and surrounding joints. When beginning a resistance program, weights should be light, with higher repetitions, as opposed to choosing the heaviest weight the patient can only lift 1-3 times. Negative effects in terms of accumulation of fluid in the affected limb (or the limb at risk) are unlikely if exercises are performed with compression in place on the involved extremity.

As some of you may know, an article published August 13, 2009 in the New England Journal of Medicine addressed the topic of weight lifting in women with breast cancer-related lymphedema. The article summarized an 18-month study performed by Dr. Kathryn Schmitz and colleagues in a controlled trial of twice weekly progressive weight lifting involving 141 breast cancer survivors with stable upper extremity lymphedema.

Shortly after this article was published, I received a large number of phone calls and email messages from patients and graduates of our lymphedema management certification courses asking us for clarification on some misleading and inaccurate statements that were made on the results of this study.

One of the more frequent questions I received from patients was: “If it is okay and safe for me to lift weights as this study suggests, is it okay then to lift heavy items at home or at work as well?”

The obvious answer to this question is “NO!”

This is not what this study suggested either, there was clearly some misunderstanding. As a result of these misconceptions, the National Lymphedema Network’s Medical Advisory Board asked Dr. Schmitz to address the many misleading statements that were made in the media about the results of her study. Fortunately, Dr. Schmitz answered the NLN’s call and her response was published in the April/June 2010 issue of the LymphLink. This response was necessary to clarify the results of this important study, and what they mean to patients living with lymphedema, or those individuals at risk of developing this condition. Click here  to read Dr. Schmitz’ response.

Video on weightlifting with lymphedema

 

Click here for a PDF Version of this Article

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9 comments to Resistive Exercises for Lymphedema

  • Thank you for your continuing information on what types of exercises are safe for people affected with lymphedema. I’m looking forward to part three of your series!

  • I hope there will be opportunity for questions and answers re: exercise and expectations of side effects.
    I look forward to the article on aquatic exercise.
    Thank you.

  • Diane Distelcamp, LANA-CLT

    Hi Joe, I’m reading your blogs with great enjoyment-very timely. I’m in the middle of writing my dissertation on resistive ex and lower extremity lymphedema. Any good sources? Research is sparse for lower extremities. Dr. Schmitz’ research is fantastic.

    Diane Distelcamp

  • Karen

    I am a BC survivor with right (dominant) arm Lymphedema. 23 nodes removed. I am also a mom with school aged kids. I tried wt Trng with a gradual increase and it did work. A couple of things we did:

    1) measured my upper arm about half way between the elbow and the shoulder before working out and after, each day I worked out, and recorded them. Although some swelling may occur long after exercise, this was the best way we could think of to check if I had done too much on a given day. I learned to be able to tell if I was doing too much.

    2) the best benefit was that I was able to lift enough weight that I can now lift groceries, a basket of laundry (divide in half, make 2 trips), and do other basic household chores.

    3) to workout, I wear a class 3 sleeve and glove. For most other non-physical daily activities like desk work and running errands, I wear a class 2. I don’t know if this is the “recommended” way to do things, but it has been working for me.

    I lift 2 days/wk, might increase to 3 (taking at least a day off between sessions) and run several times/wk (wearing the class 3 sleeve). I still feel like a freak wearing the sleeve—-I yearn to be “normal”, and I know I never will be, but I’m happy I’m now able to do some of the things I loved to do before cancer.

    Do you have any suggestions for scrubbing (housework)? That’s where my arm seems to swell the most, despite wearing the class 3 sleeve when I scrub.

    Thanks for the clarification article.

  • Bev

    Thank you for sharing this segment on exercise and lymphadema. I am especially interested in acquatics, since that is one of my chosen forms of exercise.

  • Tanya

    Hi Karen
    I found after a year I still have to go at a slow pace when doing scrubbing or housework that makes ur arm swell And breaks between

  • Hi. I am very concerned as my other arm is swollen from cancer tumor blockage in vena cava – not my lymphadema arm. The Lymphadema physical therapist wrapped it today before getting radiologist report. I don’t know if this is correct therapy for my arm with blockage…? Please reply.