Exercise and movement

By Melanie Thomas, National Clinical Lead Lymphoedema, Welsh Government

Symptoms to look for include:

 achiness, tingling, discomfort, or increased warmth in the hand, arm, chest, breast, or underarm areas
 feelings of fullness or heaviness in the hand, arm, chest, breast, or underarm
 tightness or decreased flexibility in nearby joints, such as the shoulder, hand, or wrist
 “bursting” or “shooting” pain sensations, or pins and needles
 tenderness in the elbow
 slight puffiness or swelling in your arm, hand, chest, or breast, with a temporary indentation of the skin when you
press on it with your finger (this is called pitting edema)
 veins or tendons in the hand are harder to see, and/or the knuckles look less pronounced, or once-wrinkled skin looks
younger or smoother
 trouble fitting the arm into a jacket or shirt sleeve that fit well before
 bra feels tighter, does not fit the same, or leaves an indentation on the skin
 noticing that the two sides of the back look different in size (asymmetrical)
 difficulty getting watches, rings, or bracelets on and off
 changes in skin texture or appearance, such as tightness, redness, or hardening
 rash, itching, redness, pain, or warmth of the skin
 fever or flu-like symptoms

It does not seem that long ago that Wales, like many other countries, was struggling to support people with lymphoedema.
Through continued political pressure and increasing awareness and communication, inequity of lymphoedema service provision
ceased in 2011. The development of the Welsh Lymphoedema Network enabled all people with lymphoedema to be assessed
and treated, regardless of where they resided in Wales. We currently have seven Health Boards in Wales and seven
Lymphoedema services. Each is managed by a Clinical Lead lymphoedema therapist and the whole network is overseen by me,
the National Clinical Lead. As part of our lymphoedema development programme, Lymphoedema Network Wales has created
exercise leaflets that we are willing to share with the LSN for patient benefit.

Exercise is vital in lymphoedema management. Exercise is not just about putting on a pair of trainers and going to a gym, it’s
much more. In Wales we are focussing more on movement, activity and exercise. Moving your body will help the muscles pump
lymph fluid through the body. Exercise helps you improve and maintain flexibility and keep your bones strong. Being more
active helps you achieve and maintain a healthy weight, and it may improve your emotional wellbeing. Moving your body and
exercising decreases stress and frustrations, as well as people who exercise, are generally happier! Exercise also improves your
metabolism, increases your concentration and decreases your chances of other diseases such as heart problems.

Tips for Patients with Lymphoedema

 Wear your compression garment or bandages when exercising to get the best out of the muscle pump action
 Do a little every day and build up to about 30 minutes of activity, 5 days a week
 Set yourself personal and achievable goals. Sometimes keeping a record of how much activity you do can be beneficial
 Pace yourself, use your common sense; listen to your body when it says ‘I am tired’

 Drink plenty of water
 Wear sensible clothing and shoes
 Do not exercise if you feel unwell
 Make moving your body a part of your life

Ideas for Moving

 Walking on the spot, walking with or without a pet, walk to a friend’s home, walking groups
 Parking further away from the shop entrance; getting off at an earlier bus stop
 Cleaning the house
 Hide the remote control for the television
 Gardening and even shopping
 Activities like jogging, cycling, bowling or dancing
 Water activities such as walking in the water, aqua aerobics, swimming
 Vibration plates such as the Power Plate and VibroGym have proved to be beneficial in patients with lymphoedema
 ‘Fun’ exercise can be using a console (Wii, Xbox or similar) with games that allow you to play sports whilst sitting down

Breathing Exercises

Breathing exercises help to move lymph fluid around the body. This is an easy activity to do and helps with relaxation and
reducing stress. 


 Sit or lie down with your shoulders relaxed and hands resting below your ribs
 Breathe in and feel your stomach rising (imagine a balloon inflating under your hands)
 Slowly breathe out and press gently inwards with your hands
 Repeat five times
Specific Exercises for Lower Limb Lymphoedema

 Repeat 10 times both sides

 You can increase the number of repetitions as you get stronger
Specific Exercises for Upper Limb Lymphoedema

 Repeat 5 times both sides

 You can increase the number of repetitions as you get stronger
If your mobility is limited, you can still exercise. Try the following:

1. Move your arms when in bed or on the chair:


 Repeat 5 times for both sides. You can increase the number of repetitions as you get stronger

2. Move your legs when in bed or on the chair


 Repeat 10 times for both sides. You can increase the number of repetitions as you get stronger
Remember, exercise does not have to be vigorous it’s about making exercise a daily part of your life. Walk more, use the stairs
instead of the lift – basically move your body. Even people who cannot easily walk can gain excellent benefits if they do chair
exercises or just stepping on the spot holding on to the sink. Small amounts of change add up and become a big change in your
own self-management of lymphoedema. Start small, I know patients who started a walking group and now regularly run 5K
every week. Raise funds for the LSN by doing a charity fun walk. This could be the start of a new, fitter, you, which will help
your lymphoedema both physically and you mentally.