In this article India Gooderham, a trained physiotherapist specialising in oncology and palliative care, will explore the topic of lymphoedema, what it is, who is at risk of developing it, how the lymphatic system functions and how lymph drainage exercises can greatly reduce the risk of lymphoedema or prevent existing lymphoedema from progressing.
My work as a Physiotherapist, Cancer Exercise Specialist and Cancer Yoga teacher prescribing exercise and creating home exercise programmes has taught me that for new health behaviours to become habits it is fundamentally important to understand exactly why it is going to benefit your health and wellbeing and how it works. In the case of starting daily lymph drainage exercises, knowing what your lymphatic system is, what its job is, how cancer treatments may have affected it, what lymphoedema is, and how exercise can help is always my starting point.
These exercises are for everyone who has had breast surgery, lymph node removal and/or radiation. If you do not have lymphoedema these exercises can reduce your risk of it occurring, and if you already have lymphoedema these exercises can help reduce swelling and prevent it from progressing. Always get consent from your oncologist to start these exercises.
Lymphoedema is a swelling (oedema) that develops when lymph fluid builds up in the tissues of part of the body.
If you have had breast cancer surgery and/or radiation, you may be at risk of lymphoedema. Surgery and radiation can damage the lymph vessels in and around the breast and surgery also often includes the removal of some or all lymph nodes in your armpit on the affected side. When lymph nodes have been damaged or removed, lymph fluid may not be able to drain as it should and instead builds up in the tissues, causing swelling. Breast cancer related lymphoedema (BCRL) can cause swelling of the trunk, breast, arm and hand on the affected side.
People who have had surgery followed by radiation therapy to the armpit are more at risk of experiencing this side effect.
“The great news is that most people who are at risk never develop lymphoedema as the body is amazing at healing and adapting, finding ways to bypass the damaged lymph vessels and nodes. However, lymphoedema can affect people at any time – during active treatment or months or years after treatment”India Gooderham
The lymphatic system is part of the immune system. It also maintains fluid balance and plays a role in absorbing fats and fat-soluble nutrients.
The lymphatic or lymph system involves an extensive network of vessels that passes through almost all our tissues to allow for the movement of a fluid called lymph. Lymph circulates through the body in a similar way to blood.
There are about 600 lymph nodes found in the body. These nodes swell in response to infection, due to a build-up of lymph fluid, bacteria, or other organisms and immune system cells.
Signs to look for include swelling; a feeling of tightness, heaviness or fullness in the fingers, wrist or the whole arm; and aching in the affected area. These signs may begin gradually, and they may come and go. Some people experience pain, redness or fever, which can be caused by an infection called cellulitis in the area with lymphoedema.
If you have any of these symptoms, see your doctor as soon as possible. The condition is easier to manage if it is diagnosed and treated early.
Referral to a specialist lymphoedema team can be very helpful, they can assess you and offer regular monitoring for lymphoedema. They can also fit you for compression garments that can help reduce swelling. They may also offer you treatments such as lymphoedema massage or low-level laser treatments to help with lymph flow and drainage.
How do these exercises work?
These simple, gentle exercises can help the proteins in lymph fluid to be reabsorbed. The gentle contraction of the muscles in and around your trunk, chest, arm and shoulder can assist lymph fluid to move back to your blood circulation. Returning the lymph back to the blood should reduce swelling and gently support your lymphatic system. These daily exercises should only take around 15 minutes a day.
If you already have lymphoedema these exercises can:
I have created a Lymph Drainage Exercise poster to guide you through these exercises:
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First published June 2022 Reviewed April 2023
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