Another theme which is quite common with persons with lymphoedema is that they have been told to avoid exercise, carrying heavy goods to household chores such as ironing. Hopefully the following will give a little insight in the physiology of the lymphatic system and how exercise can be beneficial to a person with lymphoedema.
The lymphatic system comprises of lymph vessels, nodes, organs, capillaries and lymph, it is a network of vessels throughout the body. The lymphatic system facilitates the removal of extracellular fluid and soluble proteins from the interstitial space into the blood. Transportation of lymph is uni-directional and it can be likened to a ‘one way street’and is propelled through the lymphatic system by internal and external factors.
SO WHAT ARE THESE FACTORS?
For the lymphatic system to function it relies on pressure to generate lymph flow. The initial lymphatic vessels act as simple conduits transporting lymph in response to local tissue changes. It is not until the lymph enters the lymphatic collectors which spontaneously contract, that propulsion of lymph flow occurs.
Important external contributors to lymph flow are the musculoskeletal and cardiovascular systems owing to their close proximity with the lymphatic system vessels. Muscle contractions, respiration (especially deep diaphragm breathing) and blood flow all aid in the lymph flow. When the muscle contracts, it creates a gentle pressure to the surrounding areas (tissue, vessels, lymph) and it is this contraction that aids the flow of lymph.
How I explain this to my clients is that blood is ‘pumped’ around the body via the heart. The lymphatic system doesn’t have a pump and relies on the contractability of the vessels to move the lymph. So if we can encourage the affected limb to contract, and if we can do this through gentle exercise, then this in turn will aid the flow of lymph.
I am also a big fan of deep abdominal breathing as there are many lymphatic structures in this region. If you have done yoga, it is the same technique! Just inhale deeply through your nose to the bottom of your belly and slowly exhale through your nose bringing your belly button towards your spine. Do this for 5-10 mins a day.
A study conducted by Cormie et al.,(2013) and Fong et al.,(2014) found that doing upper body resistance or taichi exercises did not increase the swelling or feeling of discomfort in the lymphoedemous limb.
Cormie, P., Galvao,D., Spry, N., Newton, R., (2013). Neither heavy nor light load resistance exercise acutely exacerbates lymphoedema in breast cancer survivor. Integrative Cancer Therapies (125,423 -432.
Fong, S., Ng, S., Luk, W., Chung, J., Ho, J., Ying, M., Ma, A., (2014). Effects of Qigong exercise on upper limb lymphoedema and blood flow in survivors of breast cancer – A pilot study. Integrative Cancer Therapies (13 1, 54-61.