Weight Lifting and Lymphedema

Lymphedema is swelling that results from a blockage that causes diminished lymph flow in the lymphatic vessels. This incapacity to properly drain the lymphatic system presents with deformation of the involved limb and can limit range of motion, cause discomfort and increase the likelihood of infection. Cancer patients who have had lymph nodes removed are at increased risk for the development of lymphedema as well as other complications of the lymphatic system. Management of lymphedema is important as the system is impaired and significant changes in swelling can be difficult to alleviate. Keeping skin and nails clean and being very cautious of preventing cuts and insect bites is critical. Beyond maintenance, is there any treatment that can increase the functioning of this vital immune network?

Weight lifting is one modality that has been shown in research and practice to help patients moderate increases in swelling. A study published in August 2009 in the New England Journal of Medicine, found that progressive weight lifting resulted in a decreased incidence of exacerbations of lymphedema, reduced symptoms and increases in strength. Previously, many practitioners discouraged strength training which prevented patients from obtaining any of the well-established benefits which include maintaining joint range of motion and function and increasing bone density. This disservice has not only cost patients function, but has created a missed opportunity to boost function of the lymphatic system without which we could not survive.

Progressive strength training for the upper body should consist of exercises that keep the shoulder socket in a neutral position by stabilizing the shoulder blades. Range of motion should be achieved without pain and exercises should be performed daily to keep lymph fluid moving. As the program progresses, exercises for which the resistence increases to moderate or heavy should be performed every other day to allow muscle and connective tissue to recover. Start with the following exercises to maintain range of motion and mobilize the lymph.

All exercises should be performed with the shoulder blades gently drawn towards one another.

1. With the spine in neutral and the crown of the head evenly drawn upwards, rotate the head side to side slowly to the end point of motion without pain. Breath slowly and deeply with even timing on the inhale and exhale.
-20 repetitions each side

2. Keeping the spine tall and neutral, slowly bend the head to the side, alternating one to the other. Be certain to lengthen the neck before bending to the side so the neck bends, but does not collapse. Breath slowly and deeply.
-15 repetitions each side

3. Standing tall, secure a theraband at chest level. Lightly grip the theraband and extend your straight arm from in front of the body out to the side while keeping it in a horizontal plane. Keep the thumb pointed up toward the ceiling, exhaling drawing the arm out to the side and inhaling drawing the arm back to the front.
-12 repetitions each side

4. Standing tall, secure a theraband at chest level. Lightly grip the theraband with both arms in front of the body at a level position. Create a rowing motion with the arms by leading with the elbows and drawing them alongside the torso. Return to the level position. Exhale when drawing the elbows alongside the torso and inhale when returning the arms to level.
-12 repetitions

All exercises should be performed without pain. Physical therapists who specialize in lymphatic issues should be consulted before undertaking a more aggressive program or if a PT evaluation has not been conducted after surgical intervention.