After having surgery for breast cancer, a woman is usually told to protect her surgery-side arm: avoid lifting, blood pressure cuffs, needles, and exercise. Doctors were concerned that overuse of that arm would bring on lymphedema, a condition that most women would willingly avoid.
Arm lymphedema -- considered chronic and incurable -- is caused by the removal of axillary lymph nodes, or by damage to those nodes during radiation treatments. Excess lymph fluid can build up in areas where lymph nodes are no longer working efficiently.
Lymphedema symptoms can include swelling and pain in your hand and arm, a change in skin color and texture, a feeling of heaviness, and difficulty using your fingers for daily tasks.
Research Supports Arm Exercise to Relieve Arm Lymphedema
In 2005, guidelines published by the National Lymphedema Network stated that strength training "poses the greatest risk to individuals with lymphedema." But now those guidelines are being challenged.
Clinical trials and studies are now delivering a blow to the old idea that exercise, and strength training in particular, worsens arm lymphedema. Current research suggests that you pump a little iron in order to reduce or prevent arm swelling.
A study done at Lund University in Sweden found that when breast cancer patients did a regular program of light free weights, water exercise, and pole walking, they experienced relief from their symptoms. Routine lifting of one-pound weights helped with muscle tone, arm strength, and bone density.
At Flinders University in Australia, 38 women learned to combine deep breathing with arm exercise for 10 minutes every morning and evening. They did this program for one month, and found that their arm swelling went down. In addition, their lymphedema symptoms were much milder than before starting regular exercise. These women said that their arms felt better for 24 hours, one week, and even one month after the end of the study.
Finally, a study published in the New England Journal of Medicine looked at 141 breast cancer patients with lymphedema who had taken part in an exercise program. While half of the patients were careful not to overuse their arms, the other half was doing progressive weight lifting. All of the women in the study had lost one breast, had relatively healthy body weight, and had been out of breast cancer treatment for at least one year. Certified lymphedema therapists monitored the women's arms, and fitness professionals working at the YMCA taught 90-minute classes that met twice a week. During classes, the women followed a routine of warm-ups, abdominal and back exercises, and weight-lifting exercises. They did weight lifting with all the major muscle groups, very slowly increasing the weights that were used. No upper limit was set for the weight to be lifted, and instructors worked to monitor safety and comfort of the participants, as well as keep an eye out for lymphedema flare-ups.
Researchers were surprised to find that the group that lifted weights had significantly less lymphedema symptoms than the women who protected their arms.
How Exercise Helps With Arm Lymphedema
Researchers think that arm muscle contractions may help move lymph fluid back to veins in your armpit and neck, so it can rejoin your blood circulation. When the lymph fluid goes back into circulation, your arm lymphedema should improve. You can try some simple gentle exercises to help the proteins in your lymph fluid be reabsorbed, and your arm lymphedema symptoms to diminish or disappear.
Be sure to discuss your exercise plans with your doctor before you start. Gentle weight lifting can raise your self-esteem, give you a feeling of control, improve muscle tone and bone density. So strike a blow against arm lymphedema -- pick up some weights and get your arms back in good shape.
The Effect Of Gentle Arm Exercise And Deep Breathing On Secondary Arm Lymphedema. A.L. Moseley, N.B. Piller, C.J. Carati. Lymphology, 38 (2005) 136-145.
Exercise and Arm Lymphedema. Karin Johansson, RPT, LT, Lymphedema Unit, Lund University Hospital, Dr. Med. Sci, Dep. of Health Science, Lund University, Sweden. Physiotherapy Theory Practice, 2009 Apr; 25(3):165-73.
Weight lifting in women with breast-cancer-related lymphedema. Schmitz KH, Ahmed RL, Troxel A, Cheville A, Smith R, Lewis-Grant L, Bryan CJ, Williams-Smith CT, Greene QP. N Engl J Med. 2009 Aug 13;361(7):710-1.