Exercise with leg lymphedema

Exercise with leg lymphedema

Fitness article: exercise with lymphedema of the leg…

I am writing this article from two perspectives, as an experienced fitness trainer/strength trainer who has been dealing with health issues for many years and as a patient who suffers from lymphedema of the leg on a daily basis. I have been able to maintain my lymphedema fairly well, but that is because I have read extensively on the subject, listened to my doctors, and have extensive knowledge regarding exercise. I think about it every day, almost every moment, because it requires great effort to maintain 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 gymnastics and fitness trainer who worked out daily to a bedridden man after my surgery because the lymph nodes were removed along with the cancer. My life has changed drastically, but I got back to work and learned to nurture it as quickly as possible. Several doctors told me that I would be bedridden for the rest of my life and would never work again. That was 1991.

What is lymphedema? Here is the definition from the National Lymphedema Network...

"Lymphedema is an accumulation of lymphatic fluid in the interstitial tissue that causes swelling, most commonly in the arms and/or legs and occasionally in other parts of the body. Lymphedema can occur when lymphatic vessels are absent or impaired (primary), or when lymphatic vessels are damaged or lymph nodes are removed (secondary).

When the impairment becomes so severe that lymph fluid exceeds lymph transport capacity, an abnormal amount of protein-rich fluid collects in the tissues of the affected area. If left untreated, this stagnant, protein-rich fluid not only results in an increase in the size and number of tissue channels, but also reduces oxygen availability in the transport system, impairs wound healing, and provides a culture medium for bacteria that can lead to lymphangitis (infection).”

What types of exercises can a lymphedema patient do? This depends on the patient and whether they have medical clearance to train. After exercise, swimming is the best exercise to reduce swelling in the legs because the person is moving horizontally and makes a movement without impact. The next best exercise for a person with leg lymphedema is riding a recumbent bike. It is also shock-free, it is a steady movement and the legs are slightly raised.

If the patient is otherwise in good physical condition and has the lymphedema under control (as much as possible), they can use the elliptical trainer. That is, if they can tolerate it from a fitness and medical perspective. Make sure the lymphedema patient has their doctor's permission to perform an exercise, especially an intense exercise like the elliptical trainer. Keep the person with lymphedema away from the treadmill. Walking and running cause leg swelling to become MUCH worse because of the high impact they have. Imagine someone puts ice cream in an ice cream cone and then wraps it up. The swelling becomes dense, packed if not cared for properly. The heavier it is, the harder it is to deal with it.

In my experience, it can take an hour of leg elevation before the swelling even goes down, and several days or weeks for it to completely subside. People with lymphedema should wear their compression stocking if prescribed by their doctor and sleep with their legs elevated every night unless their doctor tells them otherwise. It's important to keep moving and only perform low-impact exercises. For example, squats are often better than lunges for someone with lymphedema. The walking lunge is a striking exercise. DO NOT encourage a person with leg lymphedema to participate in exercise classes that include hitting exercises. When in good shape, spin classes maintain circulation and help lose or maintain a healthy body weight. It's all about keeping the body moving without any punching exercises.

Remember that the lymphedema is from a recent surgery and the patient must be cleared to start exercising because if he starts exercising before the doctors allow him to exercise, he will cause problems with the lymphatic system. My doctors told me that if I started exercising too early, the swelling from the surgery would never go down and that I 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 any longer. I needed to get back into exercise because it was what I enjoyed and it was my life. It was extremely difficult for me not to be able to train my legs because of a lifetime spent in the gym. Again, ensure the lymphedema patient is FULL medically cleared to exercise.

Here's something a lot of people don't know. If a person with lymphedema is not moving and does not have a compression stocking on their leg, they must keep their legs elevated to prevent swelling. Something as simple as standing in line at the grocery store can cause enough swelling to keep a person in bed the next day. The swelling literally starts in less than a minute when you stand still or sit without your leg raised. It is really a challenge to keep the leg from swelling every minute of the day and those around lymphedema patients need to be patient and considerate.

There is a lot of information about lymphedema. It is either primary or secondary. For example, secondary lymphedema would be caused by cancer surgery. Mine is secondary because my lymph nodes were removed from my thigh during my cancer surgery on one leg. If lymphedema is not controlled, elephantitis can occur. Yes, it is a real illness and it is very serious. There are support groups for lymphedema in the USA. The National Lymphedema Network has a wealth of information.

Let me know how I can help you...

Karen Goeller, CSCS

Inspired by Karen Goeller