Lymphoedema often occurs after breast cancer surgery. See our simple exercises and tips to reduce symptoms.

Lymphoedema is a swelling in part of the body, usually caused by damage to the lymphatic system, and it can often occur after breast cancer surgery. We’ve put together some tips and exercises that can help, created with experts in the fields of lymphology and physiotherapy.

 

Physical activity promotes lymphatic drainage and can reduce secondary lymphoedema after breast cancer surgery. Once damaged, lymph nodes cannot be repaired. The good news is that with a bit of practice, the adjacent lymph nodes can learn to do the work of their injured counterparts. Exercise helps this process, but it is important not to overdo it: increasing exercise gradually over time is key, particularly when it comes to lifting on the operated side. Here are some tips and simple exercises that can help.

 

Things that can help

 

Swimming and aqua-gymnastics: The pressure of the water and the contractions of the muscles press on the tissue, stimulating the transport of the lymphatic fluid.
If you already have lymphoedema or problems with your veins, make sure that the water temperature is not higher than 30° Celsius, as heat increases the lymphatic flow.

 

Caution: You should avoid swimming if you are still having radiotherapy. The radiation usually causes the skin to redden and develop tiny cracks. This increases the risk of infection – especially from germs in the locker room or in fresh water.

 

Nordic walking, horse riding or moderate strength training in the gym: Lymphatic vessels work in a similar way to our heart: they pump the lymph through the body. The forward and backwards arm movement during Nordic walking or horse riding cause the lymph nodes to relax and contract, stimulating the flow of the lymph fluid. Strength training that activates muscle contraction can also help move lymph back to the veins and into the circulation.

 

Yoga and Pilates: The lymph nodes and the movement of lymphatic fluid are stimulated both by the flexing and relaxation of muscles and by the deep breathing, which is part of yoga and Pilates practice.

 

The following exercise can help train your breathing:

 

• Sit on the floor or on a chair, keeping your back, neck and head straight.
• Breath in slowly, feeling your abdominal wall (the area around your stomach) pushing out. The diaphragm – the large muscle underneath your lungs – automatically moves down and your breath gets more room. To make the effect even deeper, put your hands on your ribs and imagine pushing them apart with your breath.
• Breathe out slowly. Relax your neck and chest muscles, lower your ribs and, at the end of the breath, pull in your stomach.
• You can repeat this exercise as many times as you wish.
• Arm and shoulder exercises: Exercising the arms and shoulders can improve blood circulation and encourage the healthy lymph nodes to work harder.

 

Things to avoid:

 

• Jerky, heavy stretching and swinging movements. The reason: if your lymph nodes are damaged by radiotherapy, their tissue has lost a lot of its protective elasticity. Jerky movements can tear blood vessels and nerves.
• Pain. If you feel pain, stop. The reason: our lymphatic system is designed to protect us from infection by foreign bodies. Pain tells the lymph node that there is an injury. The lymphatic vessels then contract in order to give the tissue surrounding the wound the chance of eliminating potentially harmful pollutants. Your goal is to minimise the build-up of lymphatic fluid, but our lymphatic system can potentially react to any pain because it does not identify that the wound causes the pain and tension.

 

Important: Before you start any form of exercise after breast cancer surgery, talk to your doctor or physiotherapist to find out what exercise is best for you and how soon after surgery you should start. Always wear your compression garment or bandages during the exercises if you already have lymphoedema. These will help you get the best results as they are designed to encourage lymph fluid drainage.

 

Gentle exercises for arms and shoulders

 

These five simple exercises have been recommended by breast cancer care specialists. They can be repeated 5–10 times.

 

1. Shoulder Rolls

• Sit on a chair with your back straight.
• Raise both shoulders and then allow them to drop slowly as low as possible.
• From this position, roll both shoulders forwards, and then backwards.
• Move the shoulders in a circle, one at a time. Allow your arms to hang relaxed.

 

2. The Butterfly

• Sit on a chair with your back straight.
• Fold your hands around your neck so that your elbows are pointing forward.
• Slowly turn your elbows as far to the side as possible. As soon as you feel any tension, release the stretch.

 

3. Picture Frames

• Stand up straight.
• Grasp your elbows with the opposite hand in front of your body.
• Keeping your hands on your elbows, raise them as high as comfortable above your head. Hold them in this position briefly, then lower them again.

 

4. The Elephant

• Stand up straight.
• Hold your left wrist with your right hand.
• Stretch your left arm out and raise it gently up to shoulder height.
• Hold the stretch for a moment with the left hand open.
• Repeat the exercise with your right arm.

 

5. The “O”

• Stand up straight.
• Stretch your arms forward.
• Fold your hands over each other and slowly lift them over your head, and then lower them.

 

Don’t forget to take a rest – plan breaks during your exercises. This way, your muscles and lymph nodes will have time to recover and you will not feel any strain.

 

• Breast Cancer Care: Treatments for lymphoedema
• Breast Cancer Care: Living with lymphoedema, downloadable pdf
• Macmillan Cancer Care: Lymphoedema information and support