Exercise with leg lymphedema
Fitness Item: Leg Lymphedema Exercise …
I am writing this article from two points of view, as an experienced fitness trainer / strength coach who has studied health issues for many years and as a patient who suffers from leg lymphedema on a daily basis. I’ve been able to maintain my lymphedema pretty well, but that’s because I’ve read a lot about it, listened to my doctors, and have extensive knowledge about exercise. It is on my mind every day, almost every time because it takes a lot of effort to maintain it properly. I have included the description of lymphedema below.
Lymphedema is difficult to treat and must be maintained all day, every day. There is no cure for lymphedema. I have had lymphedema in my leg since my cancer surgery in 1991. I went from being a gym coach and a fitness trainer who exercised daily to being bedridden after my surgery as a result of my lymph nodes being removed along with cancer. My life changed drastically, but I went back to work and learned to maintain it as soon as possible. Several doctors told me that I would be bedridden for the rest of my life and that I would never work again. That was in 1991.
So what is lymphedema? Here’s the definition from the National Lymphedema Network …
“Lymphedema is an accumulation of lymphatic fluid in the interstitial tissue that causes swelling, most often in the arms and / or legs, and occasionally in other parts of the body. Lymphedema can develop when lymphatic vessels are missing or impaired (primary), or when lymph vessels are damaged or lymph nodes are removed (secondary).
When the deterioration becomes so great that the lymphatic fluid exceeds the lymphatic transport capacity, an abnormal amount of protein-rich fluid accumulates in the tissues of the affected area. If left untreated, this stagnant, protein-rich fluid not only causes tissue channels to increase in size and number, but also reduces oxygen availability in the transport system, interferes with wound healing, and provides a means culture for bacteria that can cause lymphangitis (infection). “
So what kind of exercise can a lymphedema patient do? That depends on the patient and if they have medical clearance to exercise. Once authorized for exercise, the best exercise to reduce leg swelling is swimming because the person is horizontal, moving, and performing a non-impact movement. The second best exercise for a person with lymphedema in the legs is riding a recumbent bike. It is also non-impact, it is a constant movement and the legs are slightly elevated.
If the patient is in good physical condition and has lymphedema under control (as much as possible), you can use the elliptical machine. That is, if they can tolerate it from a physical and medical point of view. Make sure the lymphedema patient has permission from their doctor to exercise, especially vigorous exercise like the elliptical. Keep the person with lymphedema OUT OF THE TREADMILL. Walking and running make leg swelling MUCH worse because they are high impact. Imagine someone putting ice cream in an ice cream cone and then packaging it. The swelling becomes dense, packed if not properly maintained. The more serious it is, the more difficult it is to treat.
In my experience, it can take an hour with the leg elevated before the swelling BEGINS to go down and several days or weeks for it to drain completely. People with lymphedema should wear their compression stockings if their doctor prescribed them and sleep with their legs elevated every night, unless their doctor tells them otherwise. It is important to keep moving and perform only non-impact exercises. For example, squats are often better than standing lunges for someone with lymphedema. The walking lunge is an impact exercise. DO NOT encourage a person with lymphedema in the legs to participate in exercise classes that include impact exercises. If they are in good shape, spinning classes will maintain circulation and help them lose or maintain a healthy body weight. It’s about keeping the body moving without ANY impact exercises.
Note that if the lymphedema is from a new surgery, the patient MUST be cleared to start exercising because if he starts exercising before the doctors allow him to, it will cause problems with the lymphatic system. My doctors told me that the swelling from the surgery would never go down if I started exercising too early and that it would cause permanent damage. They told me to wait a full year after my surgery before I would be allowed to exercise my legs. I waited 10 months and couldn’t take it anymore. I HAD to exercise again because it was what I enjoyed and it was my life. Not being able to exercise my legs was extremely difficult for me because I spent my entire life in the gym. Again, make sure the lymphedema patient has FULL medical clearance to exercise.
Here’s something that a lot of people don’t know. When a person with lymphedema is not moving and does not have compression stockings on their leg, they should keep their legs elevated to avoid swelling. Something as simple as queuing at the grocery store could cause enough bloating to keep a person in bed the next day. Swelling begins in less than a minute, literally when you are standing or sitting without your leg elevated. It is truly a challenge every minute of the day to prevent leg swelling and those around lymphedema patients need to be patient and considerate.
There is a lot of information about lymphedema. It is primary or secondary. Secondary lymphedema would be caused by something like cancer surgery. Mine is secondary because I had lymph nodes removed from the upper thigh of one leg during my cancer surgery. If left unchecked, lymphedema can end up being elephantitis. Yes, it is a real medical condition and it is very serious. There are lymphedema support groups throughout the US The National Lymphedema Network has a lot of information.
Let me know how I can help you …
Karen Goeller, CSCS