Lymphedema Exercises to Avoid: Understanding What’s Safe and What’s Not
Lymphedema can make it challenging to navigate everyday activities, let alone create an effective exercise routine. Exercise is generally encouraged for people with lymphedema because it supports the lymphatic system, improves circulation, and helps with muscle strength, which can reduce strain on affected areas. However, certain exercises can worsen lymphedema symptoms or place unnecessary strain on the lymphatic system. Knowing which exercises to avoid is as essential as knowing which ones to include.
Exercises that should typically be avoided by individuals with lymphedema, the risks involved, and alternatives that are safer and more supportive of lymphatic health are presented below. It’s very important not to overwhelm the overall transport capacity of the lymphatic system. Doing too much exercise at one time can overload the system and cause a backup of lymphatic fluid in your body.
Why Exercise Matters for Lymphedema – and Why Caution is Key
The lymphatic system is responsible for draining excess fluids and waste products from tissues. In people with lymphedema, this system is compromised, leading to fluid buildup and swelling, especially in the arms and legs. While movement is essential to stimulate lymphatic flow, certain activities can worsen lymphedema by:
- Increasing lymph production: Strenuous exercise can boost lymph production and cause more fluid accumulation in affected areas.
- Causing injury: Some high-intensity exercises place excessive strain on the lymphatic system, increasing the risk of injury or worsening inflammation.
- Triggering inflammation: High-impact exercises or heavy lifting can irritate soft tissues, potentially leading to inflammation, which can make lymphedema worse.
For these reasons, it’s critical to identify exercises that could aggravate lymphedema. Let’s look at some specific activities to avoid.
1. Heavy Weightlifting
Why to Avoid: Weightlifting with heavy loads can put a lot of pressure on the lymphatic vessels and surrounding tissues, potentially worsening lymphedema symptoms. Heavy lifting can also lead to increased muscle strain, which may lead to inflammation and more fluid buildup in affected areas.
Safer Alternative: Focus on light resistance training using resistance bands or light hand weights (1-3 pounds) under the guidance of a lymphedema specialist. This allows for muscle strengthening without excessive strain on the lymphatic system.
2. High-Intensity Interval Training (HIIT)
Why to Avoid: HIIT exercises involve intense bursts of activity followed by short recovery periods. This type of training can lead to rapid spikes in blood flow and heart rate, which can cause increased lymph fluid production, especially in areas affected by lymphedema. The stress from the quick, high-energy movements can also strain the lymphatic system.
Safer Alternative: Choose moderate-paced cardio exercises like brisk walking, swimming, aquatic exercise classes, or cycling, as these activities provide cardiovascular benefits without causing excessive strain on the lymphatic system.
3. Jumping and Plyometrics
Why to Avoid: Exercises that involve jumping, like box jumps, jump squats, or any plyometric exercises, create a lot of impact on the joints and tissues. This can lead to inflammation and strain in the muscles and lymphatic vessels, potentially worsening swelling in the affected areas.
Safer Alternative: Low-impact exercises, such as water aerobics or gentle stair-stepping, help improve mobility without the intense impact of jumping. Water exercises, in particular, have the added benefit of gentle compression from the water, which can aid lymphatic flow.
4. Running or Jogging on Hard Surfaces
Why to Avoid: Running or jogging on hard surfaces, such as concrete or asphalt, can cause a lot of jarring impact through the legs, hips, and spine. This can lead to irritation of the lymphatic vessels, increased swelling, and even joint discomfort, especially in individuals with leg lymphedema.
Safer Alternative: Opt for walking on soft surfaces like grass, dirt paths, or a cushioned treadmill. If jogging or running is important, consider using an elliptical machine or a stationary bike to reduce impact while still getting a cardio workout.
5. Hot Yoga and High-Heat Workouts
Why to Avoid: Workouts performed in high-heat environments, like hot yoga, can lead to excessive sweating, which causes the body to release more fluid. This can increase the lymph fluid in the affected areas, resulting in greater swelling and discomfort for people with lymphedema. Also excessive heat should be avoided in people with lymphedema.
Safer Alternative: Gentle yoga or stretching in a cool environment is a safer option. Focus on flexibility and relaxation exercises, as these can still help with mobility and lymphatic health without the added strain of heat.
6. Squats and Lunges with Heavy Weights
Why to Avoid: Squats and lunges can be beneficial, but adding heavy weights to these movements can put excess pressure on the lymphatic system, especially in the lower limbs. For people with leg lymphedema, this additional pressure could aggravate swelling in the thighs, calves, or feet.
Safer Alternative: Perform bodyweight squats and lunges or use resistance bands instead of weights. This approach allows you to engage in strengthening exercises without overloading the legs, reducing the risk of exacerbating lymphedema symptoms.
7. Tennis, Basketball, and Other High-Impact Sports
Why to Avoid: High-impact sports that involve a lot of quick starts and stops, jumping, and lateral movements can create too much strain on the joints and lymphatic system. Tennis, basketball, and similar sports often lead to repetitive impact and jarring movements that may trigger inflammation and worsen lymphedema.
Safer Alternative: Consider gentler activities, such as swimming or cycling, which provide cardiovascular benefits without intense impact. Swimming is particularly advantageous because the water offers natural resistance and compression.
8. Sit-Ups and Crunches
Why to Avoid: Sit-ups and crunches, especially if done vigorously, can compress the abdomen and restrict the flow of lymphatic fluid, potentially exacerbating lymphedema in the lower body. These exercises may also increase intra-abdominal pressure, which can impede lymphatic drainage.
Safer Alternative: Try core-strengthening exercises that don’t involve spinal flexion, like standing core exercises, or modified planks (done with support from the knees). These exercises strengthen the core without excessive abdominal pressure.
Learning how to perform diaphragmatic breathing is also important as the diaphragm acts as a pump for the lymphatic system aiding in circulation of the fluid.
9. Push-Ups and Planks (for Arm Lymphedema)
Why to Avoid: If you have lymphedema in your arms, exercises like push-ups and planks can place a significant amount of weight on the arms, leading to fluid buildup and increased swelling. Supporting your weight through the arms in these exercises may overstress the lymphatic vessels.
Safer Alternative: Try wall push-ups, which reduce the weight load on the arms, or perform supported planks on the knees to ease pressure. You can also focus on seated arm exercises with light resistance bands for a safer way to build strength.
10. Rowing Machines and Rowing Exercises
Why to Avoid: Rowing exercises involve repetitive pulling movements, which can be strenuous on the upper body, particularly the shoulders and arms. This can exacerbate swelling for people with arm or shoulder lymphedema, especially if done with excessive force or high resistance.
Safer Alternative: For upper-body conditioning, use light resistance bands or perform seated arm exercises that don’t involve pulling. Gentle swimming strokes or water aerobics can also provide upper-body benefits with a natural compression effect from the water.
General Tips for Safe Exercise with Lymphedema
- Consult with a Lymphedema Specialist: Before starting any exercise routine, it’s essential to work with a lymphedema therapist or physical therapist familiar with the condition. They can provide personalized advice and modifications to keep you safe.
- Wear Compression Garments: If prescribed, wearing compression garments during exercise can help support lymph flow and prevent excessive swelling.
- Focus on Low-Impact Movements: Low-impact exercises, like swimming, walking, and gentle cycling, are generally safe and effective for people with lymphedema, providing cardiovascular benefits without excessive strain.
- Listen to Your Body: Stop any exercise if you notice pain, increased swelling, or fatigue in the affected area. Take breaks as needed and allow time for recovery.
- Stay Hydrated: Proper hydration is essential for supporting lymphatic function, and it’s especially important when you’re exercising.
- Avoid Overexertion: Even if a specific exercise feels safe, doing too much too quickly can lead to inflammation and aggravate lymphedema. Gradually build up your exercise duration and intensity.
Exercise can be a powerful tool in managing lymphedema, but it’s essential to approach it with care. High-impact or high-intensity exercises are often best avoided as they can overwhelm the system. Instead, focus on gentle, low-impact exercises that support lymph flow without overloading the lymphatic system. Working with a healthcare provider, choosing the right exercises, and staying mindful of your body’s responses can empower you to safely incorporate physical activity as part of your lymphedema management plan.
Dr. Elizabeth Baillie
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