22 Jul Live Well With Lymphedema
Do you experience tired, heavy legs at the end of the day? Have you experienced a surgery or trauma and have swelling that won’t go away ever since that time period? Do you experience swelling that can’t otherwise be explained? If the answer is yes to any of these questions, you may have a condition called lymphedema. In this article, we will define what lymphedema is, how lymphedema is treated, available resources to learn more about this condition, and how to live well with lymphedema!
What Is Lymphedema?
Lymphedema is defined as a mechanical breakdown or disruption to the lymphatic system and/or lymph nodes that causes swelling in one or more parts of the body (1). People living with lymphedema experience swelling and discomfort in their arms, legs, chest or abdomen, and face or neck. Common signs and symptoms of lymphedema include:
- Feelings of ‘fullness’ or ‘heaviness’ in one or more body areas
- Skin tightness
- Less flexibility in the joints
- Feelings of clothing being tighter in one arm or leg
- Your jewelry or shoes fitting tighter than usual
- Obvious swelling in a limb
Our lymphatic system serves as the ‘waste filtration’ mechanism of the body and plays a large role in our immune function. This system is essential in keeping us healthy and illness-free. Damage to this system can happen in a variety of ways – trauma and accidents, infections, cancers, surgery, and in rare cases, it can be a hereditary condition. There are two types of lymphedema:
- Primary lymphedema: Also called hereditary lymphedema; swelling can manifest either at birth (Milroy’s disease) or later on in life.
- Secondary lymphedema: The most common type of lymphedema; most often happens from cancer or surgery.
Live Well With Lymphedema: Treatment Options
No matter what type of lymphedema you experience, there are a variety of treatments available that can assist you in optimizing how to live well with lymphedema. The gold standard treatment for lymphedema is Complete Decongestive Therapy, also known as CDT. This type of therapy is meant to ‘decongest’, or remove swelling from the affected limb, and is most often provided by a Certified Lymphedema Therapist (CLT). Treatment you will receive may include (2, 3):
- Manual Lymphatic Drainage – A specialized, light touch ‘massage’ that is meant to move fluid away from a swollen limb.
- Compression Bandaging – Bandages that are applied to the limb that help keep fluid from collecting
- Skin and Nail Care – It is common to experience skin dryness and broken, soft nails with lymphedema. Treatment is aimed at keeping these areas as healthy as possible to improve healing.
- Compression Garments – An essential part of treatment where you would be specially fit for stockings or sleeves for the affected area. This ensures long term maintenance and control of the swelling
- Decongestive Exercise – There are many types of physical activity and exercises that you can do to help improve circulation as well as help move fluid out of the affected limb. These can include walking programs, swimming, biking, light resistive exercises, yoga, range of motion exercises, or deep breathing.
Below, we will provide a couple of examples of decongestive exercises that are excellent for living well with lymphedema:
Live Well With Lymphedema: Shoulder Rolls
- HOW: Begin in a seated position with your hands by your side. While maintaining arm position, slowly make big backward followed by forward circles with your shoulders and shoulder blades.
- FEEL: This should feel like a nice shoulder and shoulder blade movement. Think about making smooth, big circles in both directions. You should feel your shoulder blade muscles controlling the movement.
- COMPENSATION: Keep the rest of your body including your head and neck still as you perform this exercise.
Live Well With Lymphedema: Ankle Pumps With Feet Elevated
Getting the legs elevated above the heart and getting the muscle pump action going with ankle pumps is an excellent way to improve foot/ankle swelling and live well with lymphedema!
Live Well With Lymphedema: Seated Cat/Cow
You may be surprised, but getting our trunk and spine moving can help with lymphedema anywhere in our body! This paired with diaphragmatic breathing (which we cover below) are two great exercises to begin with!
Live Well With Lymphedema: Seated March
You want to start proximally before distally! Getting the hips moving is just as important as getting distal segments moving to help with lymphedema. Typically you go proximal –> distal –> proximal in terms of exercise order, so don’t be afraid to do these twice!
Live Well With Lymphedema: Diaphragmatic Breathing
- HOW: To perform this exercise, you can either be in a seated or supine (laying flat on back with knees extended), or hooklying position (laying on your back with your knees bent). You will want to start by placing one hand on your chest and the other hand on your abdomen. You will then breathe in through your nose, and use your diaphragm as the primary inspiratory (breathing in) muscle to help you execute this breathing technique correctly. Once you have completed the inspiration portion of the full breath, you will passively expire (blow out the air) from your chest and lungs, and then repeat this sequence. The feel bullet below will go into more detail of what you should feel for with your hands and body during this exercise.
- FEEL: You should be feeling the entirety of this breathing in motion starting from your abdomen, NOT YOUR CHEST! To receive some great feedback, it helps to have the hands-on your chest and abdomen, so you can feel your bottom hand moving with your abdomen when breathing in while your top hand remains relaxed against your chest.
- COMPENSATION: You should NOT feel your chest muscles working harder than your diaphragm. If you feel that your top hand is moving with your chest as you breathe in rather than your bottom hand with your diaphragm, then you must stop and modify the way you are performing your diaphragmatic breathing technique.
For even more information on how to live well with lymphedema, check out this great video from Joachim Zuther, a guru in the field of lymphedema, discussing CDT and how therapists treat this condition.
[P]Rehab At Home Workouts will keep you moving and active from the comforts of your own home! No matter your fitness level, age, injuries, or available equipment – we have a workout for you! Lean more HERE
Live Well With Lymphedema: Available Resources
Learning how to live well with lymphedema can be emotionally difficult. It is normal to struggle with feelings of isolation and/or embarrassment, as well as fear of being out in public. You are not alone! There are many resources to educate yourself about how to live well with lymphedema as well as find a support system of other individuals who are also living with this condition. Here are a few resources to explore:
- Lymphatic Education and Research Network (LE&RN): Information for those seeking treatment options. Provides a wide variety of videos, links, and downloadable information. Learn more HERE
- Lymph Notes: Online resource for those who are living with or at risk for developing lymphedema. There is also information for friends, family, and caregivers for these individuals. Learn more HERE
- Lymphedema Blog: A ‘one-stop-shop’ resource for all things lymphedema, by Joachim Zuther, a pioneer in the field of lymphedema. Learn more HERE
- Lymphedema Network: How to find a great therapist (CLT) in your area! Learn more HERE
Considerations For General Lymphatic Health
There are a number of ways you can support your lymphatic system and keep it healthy on a day to day basis, to prevent conditions such as lymphedema and generalized illness from occurring (3)
- EXERCISE! Exercise is a powerful weapon in the fight against chronic disease. Before starting a new exercise program, you should ALWAYS get clearance from your doctor. Start slowly, and gradually increase your exercise over time for the best results.
For a great starting resource, check out our blog on bodyweight chair exercises that you can do right from home!
- HYDRATION: Drinking plenty of water (usually about 8 glasses a day for most individuals) helps to support our lymphatic system by hydrating our skin and tissues, as well as flushing away any harmful bacteria or toxins in our body.
- SLEEP: Sleep is restorative! Most adults require 7-8 hours of sleep a night for general health.
We have dedicated a [P]Rehab Guys Audio Experience podcast episode to the topic of sleep where online sleep coach Nick Lambe discusses common sleep issues and how to implement techniques to improve overall sleep and restoration.
- NUTRITION: Eating a well balanced, nutritious diet can help support many functions of health. Specifically for lymphatic health, avoiding high salt foods can help prevent swelling in the skin.
- PERFORM MANUAL LYMPH DRAINAGE: Manual lymph drainage is easy to perform on yourself and can help ‘decongest’ any areas that may be experiencing swelling or are at risk for swelling. Check out this video series from Klose Training that provides instructions for performing self-MLD.
- AVOIDING RISK FOR INFECTION: Lower your risk for infection by performing regular hand-washing, wearing gloves while gardening or doing housework, avoid sunburns by using sunblock or SPF, using skin cream to avoid dry, chapped skin, and protect yourself from insect bites.
It is completely possible to live a full, healthy, happy life, even with lymphedema. It is important to get the support and treatment you need, and be educated on how to live well with lymphedema. Recognizing signs and symptoms EARLY, and talking to your doctor about your condition will ultimately lead to the best outcomes when it comes to managing this condition. Do not be afraid to speak out if you see something happening in your body that doesn’t feel or look normal. There are many certified therapists that can help get you on track with proper treatment of your lymphedema. Live well and be healthy!
- (2009), Lymphedema. CA: A Cancer Journal for Clinicians, 59: 25-26. doi:10.3322/caac.20007 https://lymphnet.org/position-papers
- Grada AA, Phillips TJ. Lymphedema: Diagnostic workup and management. J Am Acad Dermatol. 2017;77(6):995‐1006. doi:10.1016/j.jaad.2017.03.021
- Zuther, Joachim E. Lymphedema Management: the comprehensive guide for practitioners. 3rd edition. 2013.
About The Author
Taryn Everett, PT, DPT, CLT, CF-L1, CNC
Taryn was born and raised in Maine and still resides there with her boyfriend and son. Taryn received her doctorate in Physical Therapy from Husson University in 2010, and also carries a Bachelors in Kinesiology and Human Movement Science. She is a Certified Lymphedema Therapist, a Certified Crossfit Level 1 Trainer, and a Certified Nutrition Coach. Taryn has extensive experience in many different realms of PT, from the young athlete to the geriatric patient. She has special interests in oncology care, dry needling, and Crossfit training. In her free time, Taryn enjoys working out, education, writing, and reading, and is very excited to be a part of The [P]Rehab team to educate others on the importance of health and wellness.