There are exercises you can do to help reduce swelling caused by a build up of lymph fluid (lymphoedema). You can also position yourself in ways that help the lymph to drain.
How exercise helps lymphoedema
We know from research that exercise helps lymph move through the lymphatic system. This might help reduce swelling. Exercise makes the muscles contract and pushes lymph through the lymph vessels.
Exercises have other benefits. They can help you to keep a full range of movement and generally help you feel better.
Most of this research has looked at lymphoedema in the arm, and some of it at strenuous exercise. Studies looking at leg lymphoedema have also shown that exercise can help to reduce swelling.
The National Institute for Health and Care Excellence (NICE) made recommendations about exercise and lymphoedema. These are for people who have lymphoedema or who are at risk of developing it after treatment for breast cancer. The evidence suggests that exercise doesn't cause or worsen lymphoedema. It may also improve quality of life.
Before you start
Talk to your doctor or lymphoedema specialist before you start any exercise. They can advise you about what you should and shouldn’t do.
When you start exercising
Start exercising gently and build up slowly. Walking can be a good way to start if you haven’t done any exercise for a while. You can gradually increase the distance and the pace.
Other examples include:
yoga
Tai chi
Pilates
cycling
swimming and aqua aerobics
a programme for muscle strengthening exercises created specifically for you
other exercise you enjoy doing, for example, dancing
Let your instructor know about your lymphoedema or the risk of lymphoedema. You may need to make some adjustments to your exercise programme.
Check the swollen area or area at risk of swelling during and after exercising. If you think there are any changes or you have any concerns stop the exercises and contact your lymphoedema specialist.
Try to do some exercise every day. Think about how you can build it into your daily routine. You’re much more likely to carry on doing exercise if it becomes a regular part of your day.
What you’re able to do will depend on:
how fit you were before your treatment
the type of treatment you had
how severe your lymphoedema is
Positioning yourself
When you’re sitting or lying down, it helps to position yourself in a way that helps the lymph to drain.
With arm lymphoedema, when you’re sitting, raise your arm to a comfortable level by putting it on a cushion or a pillow.
With leg lymphoedema, when at rest try not to sit with your legs down. Instead either lie up on the sofa or put your leg up on a stool or chair. Make sure you fully support your leg with a cushion or pillow under the knee. Also, try to avoid sitting for long periods of time.
With lymphoedema of your head and neck, sleep with 2 or 3 pillows to raise your head and help the fluid drain.
Exercise suggestions
Below are some suggestions of exercises you could do including videos to show you how to do them.
Exercise should not cause problems. But if you notice any changes in the affected area you must stop and contact your nurse or physiotherapist.
Deep breathing
Deep breathing exercises help the flow of the lymph fluid through the body. It's helpful for all types of lymphoedema, even head and neck swelling. It works by changing the pressure in your tummy (abdomen) and chest. This encourages lymph to flow back into the blood system.
Deep breathing can also help you to relax.
You can do these breathing exercises while sitting up in a chair or in bed, or while lying down.
Relax your shoulders and upper chest.
Rest one of your hands below your ribs.
Take a slow, deep, comfortable breath in through your nose, feeling your hand rise as your tummy (abdomen) rises.
Then slowly breathe out through your mouth, so your abdomen is flat again.
Do this 5 times.
These exercises shouldn't be painful. You might have a feeling of stretching as you do them, this is normal. Stop doing the exercises if you have any pain and, if doesn't get better contact your doctor.
Wear your compression sleeve when you’re exercising if you have one. Try to do some exercises every day.
Sit upright in a chair with your arm comfortably on your lap, on a cushion or on the arm of your chair. Start with some deep abdominal breathing (there are tips further up this page). Doing them in the order we have them below will help you to remember to do them all as you work from your head to your hands. Try to repeat each exercise 5 to 10 times.
Neck exercises
Tilting - tilt your head towards one shoulder, hold for 3 seconds and return your head to the centre and then repeat on the other side. Keep your shoulders still while doing this exercise.
Turning - turn your head to look over your should as far as you can, hold for 3 seconds, return to face forward then do the same over the other shoulder. Turn your head not your body.
Chin to chest - bend your neck down as far as you comfortably can so your chin is on your chest, hold for 2 seconds and then slowly bring your head back up so you are looking forward again.
Shoulder exercises
Shoulders up and down - relax your shoulders, bring them up to your ears, relax then drop them back down
Shoulder rotation - rotate your shoulders forward, and then rotate them backwards
Arm exercises
Combined movements - sit comfortably in a chair then with your hands touch your knees then touch your shoulders and lift your arms as much as possible without pain, touch your shoulders and then your knees.
Pretend breast stroke swimming - stand or sit on the edge of a chair then cross your arms in front of your chest and swing them out to your sides, if this is too difficult try it at waist height. You can also do a pretend backstroke.
Exercise with a ball - press the ball between your hands, pressing slowly.
Wrist exercises
Rest your arm on a cushion with your hand hanging off the end. Bend your wrist down until you feel a stretch, hold for 5 seconds and slowly relax. Then bend your wrist up until you feel a stretch again and hold it for 5 secs and then relax.
Circles - rest your arm on a cushion with your hand hanging off the edge. Turn your wrist in clockwise circles and then anti clockwise.
Hand exercises
Clench your hand to make a fist and then open and spread your fingers out wide.
Thumb to finger - using your thumb touch each finger one at a time, as it becomes easier you can start doing it faster.
Bend and extend - bend your fingers at the knuckles, keeping your fingers straight.
Hold your hand out with fingers together then spread your fingers out, then close your fingers together again.
These exercises shouldn't be painful. You might have a feeling of stretching as you do them, this is normal. Stop doing the exercises if you have any pain and, if doesn't get better contact your doctor.
Wear your compression garment when you’re exercising if you have one. Try to do some exercises every day.
You can do some of them sitting in a chair, while watching television. Try to do them at least twice a day. Start with some deep breathing (there are tips further up this page).
Try to repeat each exercise 5 to 10 times.
Marching - you can march on the spot or do this sitting down, lift one knee and then put it down, then lift the other knee and put it down.
Hip rotations - bring your foot forward and draw a semi-circle, keep your other knee slightly bent, hold on to a stable surface if you need help with your balance
Curl your toes up and then stretch them out.
Knee exercises - sit on a chair and do marching
Lift your foot off the floor then straighten and bend your leg.
Ankle raises - raise your heels off the floor so you feel a squeeze in your calf muscles, relax down so your feet are flat on the floor then repeat.
With your heel on the floor point your toes away from you then pull your toes towards your chin, you can do this sitting in a recliner chair or lying in bed.
Lift your foot off the floor or bed, then circle your ankle clockwise, then anticlockwise.
Other types of exercise can also help to get your leg muscles moving, such as walking, swimming or cycling.
Using your head, neck and shoulder muscles may help to reduce swelling. Your physiotherapist or specialist nurse will usually go through these exercises with you.
These exercises shouldn't be painful. You might have a feeling of stretching as you do them, this is normal. Stop doing the exercises if you have any pain and, if it doesn't get better contact your doctor.
Try to do some exercises every day once or twice a day. It is better to do some every day even if you need to reduce how many you do. Aim to do between 5 and 10 of each exercise.
Do the exercises slowly and gently, don't rush them. You can rest between exercises. It might help to do them in front of the mirror so you can check that your shoulders are back and relaxed.
Neck exercises
Head turns - turn your head to look over your shoulder as far as you can, hold for 2 seconds. Slowly go back to the start position. Repeat on the other side. Keep your shoulders still while doing this exercise.
Head tilt - tilt your head towards one shoulder until you feel a stretch on the opposite side. Hold for 2 seconds then straighten up. Repeat on the other side. Keep your shoulders still while you're doing this exercise.
Chin to chest - bend your neck down as far as you comfortably can so your chin is on your chest, hold for 2 seconds and then slowly bring your head back up so you are looking forward again.
Shoulder exercises
Shoulders up and down - relax your shoulders, bring them up to your ears, relax then drop them back down. Repeat.
Shoulder rotation - rotate your shoulder forward, then rotate them backwards.
Mouth exercises
Open and close your mouth.
Blow kisses, blow out imaginary candles.
Smile - an exaggerated one
Say the vowels in an exaggerated way - a, e, i, o, u.
Chew sugar free gum but only if you don't have any swallowing problems.
Jaw exercises
Side to side - slide your lower jaw one way and then the other.
Jaw forward - push your lower jaw forward then relax and repeat it.
Deep breathing exercises will help generally with moving the lymphatic fluid through your body (there are tips further up this page).
There aren't any specific exercises to do. Physical activity encourages fluid to drain into the lymphatic system in the abdomen. Walking, swimming, yoga, pilates and Tai chi all might help to encourage the lymph to move.
Pelvic floor exercises may also help. These target and strengthen the muscles in your pelvis. Your doctor or specialist nurse will talk you through what to do. You can find out more about how to do pelvic floor exercises on the NHS website.
The British Lymphology Society (BSL) has a campaign called EveryBodyCan. It has information about lymphodema and activities you can do to keep your lymphatic system healthy.
