Exercise with leg lymphedema
Fitness article: exercise with lymphedema of the leg…
I am writing this article from two points of view, as an experienced fitness/strength trainer who has studied health issues for many years and as a patient who suffers daily from leg lymphedema. I have been able to maintain my lymphedema quite well, but that is because I have read a lot on the subject, listened to my doctors, and have extensive knowledge about exercise. It’s on my mind every day, almost all the time because it takes a lot of effort to keep it right. I have included the description of lymphedema below.
Lymphedema is a difficult thing to treat and must be sustained all day, every day. There is no cure for lymphedema. I have had lymphedema in my leg since my 1991 cancer surgery. I went from being a gym coach and fitness trainer who worked out every day to being bedridden after my surgery as a result of having lymph nodes removed along with cancer. My life changed drastically, but I got back to work and learned to keep it as soon as possible. Several doctors told me that I would be bedridden for the rest of my life and 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 damaged (primary) , or when lymphatic vessels are damaged or lymph nodes are removed (secondary).
When the damage 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 the availability of oxygen in the transport system, interferes with wound healing, and provides a culture medium. for bacteria that can cause lymphangitis (infection).”
So what kind of exercise can a lymphedema patient do? That depends on the patient and if you have medical clearance to exercise. Once cleared for exercise, the best exercise to reduce leg swelling is swimming because the person is in a horizontal position, moving, and performing a movement without impact. The second best exercise for a person with leg lymphedema is riding a recumbent bike. It is also non-impact, it is a constant movement and the legs are raised slightly.
If the patient is otherwise in good physical condition and has controlled lymphedema (as far as possible) they can use the elliptical machine. That is, if they can tolerate it from a physical and medical standpoint. Make sure the lymphedema patient has permission from their doctor to exercise, especially vigorous exercise like the elliptical. Keep the person with lymphedema OFF 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 wrapping it up. The swelling becomes dense, compressed if it is not properly maintained. The more severe, the more difficult it is to treat.
In my experience, it can take an hour with the leg elevated before the swelling STARTS to go down and several days or weeks for it to drain completely. People with lymphedema should wear compression stockings if prescribed by their doctor and sleep with their legs elevated every night, unless otherwise directed by their doctor. It is important to keep moving and only perform non-impact exercises. For example, squats are often better than walking lunges for someone with lymphedema. The walking lunge is an impact exercise. DO NOT encourage a person with lymphedema in the leg to participate in exercise classes that include impact exercises. If you are in good shape, spinning classes will maintain circulation and help you lose or maintain healthy body weight. It’s all about keeping the body moving without ANY impact exercise.
Note that if the lymphedema is from a new surgery, the patient MUST be cleared to start exercising because if you start exercising before the doctors allow you to exercise, 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 would cause permanent damage. I was told to wait a full year after my surgery before I could exercise my legs. I waited 10 months and couldn’t take it anymore. I HAD to get back to working out 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 whole life in the gym. Again, make sure the lymphedema patient has FULL medical clearance to exercise.
Here’s something a lot of people don’t know. When a person with lymphedema is not moving and does not have compression stockings on the leg, he must keep his legs elevated to prevent swelling. Something as simple as standing in line at the supermarket could cause enough swelling to keep a person in bed the next day. Swelling begins in less than a minute, literally, while standing or sitting without lifting your leg. It is truly a challenge every minute of the day to keep the leg from swelling and those around lymphedema patients must 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 my upper thigh on one leg during my cancer surgery. If lymphedema is not controlled it can end up being elephantiasis. Yes, it is a real medical condition and it is very serious. There are lymphedema support groups throughout the United States. The National Lymphedema Network has a lot of information.
Let me know how I can help you…
Karen Goeller, CSCS