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leg_exercises

Leg Exercises for Lymphedema

Whether you have arm lymphedema or leg lymphedema, exercise is still critical to your overall health and a vital part in successfully managing lymphedema.

There are very few commercials on television that I like, but one is where we are told “bodies at rest, tend to stay at rest; bodies in motion tend to stay in motion.” Count me in as one who wants to stay in motion as long as I possibly can.

Exercise (1) helps maintain over-all body health (2) improves your mental out-look (3) help control weight. All of which are critical for those of us with lymphedema.

Many of the leg exercises I will share are actually those that were prescribed for and taught to me during the past several years at a rehab hospital and by my home physical therapist.

The list of exercises is in no way complete, so do take time to go through both our external exercise links and our internal exercise links. We have many pages in our forums of specific types of exercise and they are all listed below.

Pat

Jan. 1, 2012

Lymphedema and Exercise

One thing that really bothers me is when I hear of people with lymphedema who give up on any activity of exercise because they have this condition. You have to want more from life than just being a couch potato, exercising only your thumb as you click that TV remote.

I envision life like a football game. The doctor may say you can only go to the 10 yard line. But, you must with all endeavor try for that goal. Even if you only really the 50 yard line, you know that you gave it your best shot!

To stay as healthy as you can, exercise is absolutely necessary, this is true for lymphedema people and non-lymphedema people. The body simply was not designed to sit on that back side for decades. I am a very strong proponent of doing as much as you can despite lymphedema. The key is to understand what type and how much exercise you can undertake.

Remember also, the lymphatic system does not have its own pump, like the heart. It moves through action, exercise and activity. Getting on and keeping an exercise activity will help increase that lymph flow.

Relationship between lymphedema and exercise

This comes from Lymphedema Therapy website and is a great little note on what exercises do for our bodies.

“What does all this have to do with exercise? A review of the acute and chronic effects of exercise is helpful to understand how the limb at risk or a lymphedematous limb might respond to various types of exercise. The acute responses to exercise include increases in heart rate, stroke volume, cardiac output, blood flow to active muscles, systolic blood pressure, arteriovenous oxygen difference, ventilation, oxygen uptake, and a decrease in blood pH and plasma volume.

Chronic adaptations to exercise include biochemical changes in skeletal muscles, decreased resting heart rate, decrease in total body fat, blood lipids, and the density and strength of bone and connective tissue.

During exercise, blood is redirected to the muscles. At rest, only 21% of the cardiac output goes to the muscles, compared with as much as 88% during exhaustive exercise. As the body heats up, an increasing amount of blood is directed to the skin, to conduct heat away from the body core.1 Remember that lymph transport has to be equal to or greater than lymph load. When you exercise, your muscles need extra blood to supply the oxygen needed for your muscles to do the work of the exercise. Extra blood flow means that extra water will remain in the extracellular spaces needing transport via the lymphatic system.”

How Much Exercise is Too Much?

This is strictly an individual measurement. The initial amount of exercise you will be able or should do depends on your overall health, your exercise history and any additional co-morbidities (illnesses) you might have.

It is critical that you not over do it so as to trigger an inflammatory response in your body or legs. Inflammatory responses always cause additional swelling as fluid rushes to the point of injury.

Will Any Exercise Cure or lymphedema Prevent Lymphedema?

NO

For information on this, please refer to our pages How to Prevent Lymphedema and How to Cure Lymphedema

While it will not prevent or cure lymphedema, it can lessen the conditions severity and impact on your life.

Not to mention the fact that life is simply a lot more fun if you are able to do things and participate in various activites.

Cautions and Considerations

Remember, there are only three factors that will affect what type of exercise you will be able to do with lymphedema.

1. Accompanying medical conditions. These include, but are not limited to heart problems, diabetes, pulmonary conditions. You must check with your physician.

2. Stage and type of lymphedema. Obviously those with arm lymphedema would have a problem with bowling. But those with leg lymphedema and no arm lymphedema or involvement shouldn't. Stage 1 & stage 2 lymphedema would present no problem with hiking and walking. At stage 3, it is more difficult. So take the type and stage of your lymphedema into consideration.

3. Risk of injury is also a factor. At any stage you should consider the consequences of broken bones, torn ligaments and sprained muscles. These can be a serious complication with lymphedema.

Other points to remember

1. Work with your therapist and physician to design an exercise program that is both safe and effective for you.

2. Your should always wear the appropriate lymphedema garment when undertaking any exercise.

3. Swimming - Hot tubs, pools (especially community pools) and lakes during the summer (in warmer climates any time of the year) present an increased risk for all types of infections because of bacteria. I urge caution there.

4. Be sure to wear your compression garments or wraps when exercising.

Consult with your physician before undertaking any exercise program

Bicycle Riding

One thing I actually found to be a great exercise while in Dr. Stwart's lymphedema hospital was bicycle riding on a statoinary bike. The one I used also was the type that you could push/pull back and forth on the handle bars with your hands. This added a little extra workout.

Because of the serious complications that would be involved with a bone break, fracture or a flesh wound, I tend not to be a big

Swimming

Without any question or argument, swimming or water exercises are the very best exercise for leg lymphedema. If you have access to a safe, clean swimming source, I urge you to participate in it. The gently rhythm of the water acts like manual decongestive therapy and you will be amazed at how it reduces the swelling.

Walking

Despite what you might think, this really is a good exercise for leg lymphedema. Standing still in one spot is a definite no-no for us as the fluid just settles down into the leg. But, walking a steady pace acts somewhat like pumping action in help the fluid to move out of the leg.

You can add to the benefits of walking also by carrying a weighted object in each hand while swinging the arms forwards and backwards as you walk.

This is also much much safer then jogging and you have less of a chance of injury or in triggering any type of inflammatory response in your legs.

If you don't have a place to walk, you might also consider buying a treadmill or even an ellipitical trainer if your health would permit using it.

Incidentally, walking up and down the stairs can be a great stamina building exercise. Should you choose to do this, you must be extremely careful not to trip. Infact, I would recommend this only if your lymphedema is under control and the swelling is not to great.

Low Impact Leg exercises I.

While Sitting in a Chair

(1.) While sitting in a chair with good posture, hold legs straight out and (bend) pull your feet towards your body. Thinking of the motion as a pumping motion. Repeat ten times

(2.) While sitting, preferably with legs up, flex or tighten your leg muscles, starting with your foot, then lower leg/calf, then thigh. The motions should always go from foot to thigh.

(3.) While sitting in a chair, extend one leg up, holding for five seconds. Repeat ten times

(4.) Sit in a chair with one leg extended in front of you, slightly to the side. Slowly lean forward and reach toward the extended foot with both hands. Hold the stretch for a few seconds. Repeat on the other side.

(5.) Sitting toward the edge of a chair with good posture and knees bent, place a ball in between your knees; press the knees together to squeeze the ball, taking about 1 to 2 seconds to squeeze. You should feel the resistance in your inner thighs. Slowly release, keeping slight tension on the ball so that it does not fall. Repeat 8 to 10 times. Rest. Do another set of 8 to 10 repetitions. Modification: For a greater challenge, change the count of the squeezes by squeezing the ball and holding for 5 seconds, then releasing again. Or, do short, quick pulsing squeezes.

While Standing and/or lying

(1.) While standing or lying on your side: Stretch left leg back behind you. Bring left knee toward your chest then straighten leg. Repeat with other side. Do at least ten times (if you are able without trauma or pain).

(2.) Stand evenly on both feet with your back straight. Hold the back of a chair for balance if you wish. Slowly rise up as if standing on your tip toes, hold for a count of 3 and then slowly lower. Repeat 10 times.

(3.) Stand as before but with feet slightly apart. Bend at the knees and straighten to a standing position. Repeat 10 times.

(4.) Stand with feet together, slowly lift the affected leg out to the side, hold for a count of 3 then lower back to the starting position. Repeat 10 times and change legs.

(5.) While standing, with legs slightly apart, slowly life the leg straight out in front of you. Switch back and forth with each leg. Repeat ten times (per leg).

(6.) While standing at the kitchen counter, place two finger tips on the counter. Stand on one foot lifting the other heel off the floor, standing on your toes (as you strengthen your muscles, try to alternate your heels as shown in the picture above). Slowly lower your heel to the floor and repeat. Once you are on your toes control your lowering. Do not just drop down to the floor. Repeat: 10-15 times

(7.) Hold chair or table with one hand, then one fingertip, then no hands; then do exercise with eyes closed, if steady. Stand straight, directly behind chair or table, feet slightly apart. Hold chair or table for balance. Slowly lift one leg to side, 6-12 inches. Slowly lower leg and repeat with other leg. Your back and knees are straight throughout exercise.

(8.) This is a great inner thigh stretch exercise.

Begin in a standing position and take feet greater than hip distance apart with toes pointing slightly outward to the corners of the room. Slowly lean to the right side by bending the right knee, keeping your left leg straight. Rest your hands on your right leg for support. Make sure the bent knee does not jut beyond your toes. Feel the inner thigh of your left leg lengthen as you hold the stretch for 10 seconds. Slowly come back up to the starting position and repeat on the left side, keeping the right leg straight and bending the left knee this time.

Come back to center and repeat the stretch on both sides. Modification: Hold onto the back of a chair for more support.

Exercises lying on a bed or other firm surface.

(1.) This exercise can be done with your leg(s) on two/three pillows to make it easier. Lying flat on your back slowly bring your knees up to your chest, straighten your leg(s) and slowly lower your leg(s) back down to the bed or pillows. Repeat 10 times.

(2.) Still lying flat on your back, raise your leg(s) up in the air and slowly ‘cycle’ in the air keeping your back firmly in contact with the bed. The leg should be kept straight.

(3.) With leg straight, point toes towards to floor, then toward nose. This is the same concept of “pumping” mentioned previously while sitting. Repeat ten times.

(4.) Keeping back straight, push back against the floor and tighten buttocks. Repeat ten times.

(5.) Place your feet about shoulder width apart. Keeping your torso vertical and a slight arch in your lower back, start the movement by bending the knees.

(6.) Lying on you side, slowly lift your leg off the ground 6-8”. Repeat ten times per leg.

Go only as far down as you feel comfortable when first starting out. If you can go down until your thighs are just below parallel, do so. This is the full range goal.

Using leg power, push yourself back up to the start position. Use your grip on the bar only for balance unless you absolutely need to pull yourself up.

Low Impact Leg exercises II.

Only do these if you can undertake the low impact exercises I. without causing strain or damage to yourself. DO NOT start with these exercises.

(1.) Quad Sets: Sit down on a straight surface, and tighten quadriceps muscles as tightly as possible. Push the back of your knee towards the floor/surface that you’re sitting on. Hold for 5 seconds, relax for 3 seconds. Repeat 10-15 times.

(2.) Straight Leg Raises: Lying on back or in a sitting position, tighten quadriceps and lift leg 12-20 inches off the floor, making sure the leg is kept straight. Bend other leg to remove strain from low back. Hold for 5 seconds, then lower leg slowly. Relax for 2 seconds. Repeat 10-15 times.

(3.) Wall Slides: Leaning on wall, slowly lower buttocks toward floor until your thighs are parallel to the floor. Hold for 3-5 seconds. Tighten quadriceps muscle as you return to starting position. Repeat 10-15 times.

(4.) Side-Lying Hip Abduction: Lying on side, tighten muscle on front of thigh, and then lift your leg 12-20 inches. Hold for 5 seconds, then lower leg. Repeat 10-15 times.

(5.) Side-Lying Hip Adduction: Lying on side, cross your legs, upper over lower and then tighten muscle on front of thigh, then lift lower leg 8-10 inches.

(6.) Simple Squats: Stand up straight, and use a squatting motion to bend your legs until they are parallel to the floor. Keep your back straight and keep looking up. Do not bend you knees over your toes. Rather, keep your buttocks as far back as you can, and do not lean forward. Stretch your hands when your legs are parallel to the floor to keep your balance. Hold for 3-5 seconds. Repeat 10-30 times.

Tips to Consider for Leg Lymphedema Exercise

Both light exercise and aerobic exercise (physical activity that causes the heart and lungs to work harder) help the lymph vessels move lymph out of the affected limb and decrease swelling.

Talk with a certified lymphedema therapist before beginning exercise. Patients who have lymphedema or who are at risk for lymphedema should talk with a certified lymphedema therapist before beginning an exercise routine. (See the Lymphology Association of North America Web site for a list of certified lymphedema therapists in the United States.)

Wear a pressure garment if lymphedema has developed. Patients who have lymphedema should wear a well-fitting pressure garment during all exercise that uses the affected limb or body part.

When it is not known for sure if a woman has lymphedema, upper-body exercise without a garment may be more helpful than no exercise at all. Patients who do not have lymphedema do not need to wear a pressure garment during exercise.

Breast cancer survivors should begin with light upper-body exercise and increase it slowly. Some studies with breast cancer survivors show that upper-body exercise is safe in women who have lymphedema or who are at risk for lymphedema. Weight-lifting that is slowly increased may keep lymphedema from getting worse. Exercise should start at a very low level, increase slowly over time, and be overseen by the lymphedema therapist. If exercise is stopped for a week or longer, it should be started again at a low level and increased slowly.

If symptoms (such as swelling or heaviness in the limb) change or increase for a week or longer, talk with the lymphedema therapist. It is likely that exercising at a low level and slowly increasing it again over time is better for the affected limb than stopping the exercise completely.

More studies are needed to find out if weight-lifting is safe for cancer survivors with lymphedema in the legs.

Treatment of Lymphedema National Cancer Institute

References - Resources

Lymphedema Exercise External Links

Exercise Step Up, Speak Out

Decongestive and Breathing Exercises for Lymphedema Joachim Zuther - Lymphedema Blog and Academy of Lymphatic Studies (ACOLS)

Lymphedema and Exercise FAQS

Exercise Lymphoedema Association of Australia

Exercise Question NLN

Exercise Review

Stretching and Flexibility - Working Toward the Splits

Lymphedema People Exercise Links

Lymphedema People pages on Vitamins, Nutrition

About Lymphedema People

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