Lymphedema and Exercise FAQs

Is it safe to exercise with lymphedema? Won't I swell more if I exercise?

Yes, exercise is safe with lymphedema as long as you pay attention to a few basic principles. If you have lymphedema, you should exercise while wearing your compression bandages or your compression garments.

Exercise should not increase swelling. In fact, research suggests that it may actually reduce swelling and improve your quality of life.

Will exercise make my lymphedema worse?

No. Research has shown us that in people with breast cancer related lymphedema, exercise is safe. In fact, people who participated in a supervised, slowly progressive weight-lifting program had a 50% reduction in the likelihood of lymphedema flares during the time of the study. When exercise is done correctly, muscle contractions act as a pump to improve fluid drainage.

Why should I wear compression when I exercise?

The compression garments, or bandages, increase the efficiency of the muscle pumps in moving the fluid from your limb(s), trunk, or face. Without the compression, the increased circulation and increased production of lymph fluid will collect in the areas that are lymphedematous, or swollen.

How do I begin to exercise?

First, get clearance from your healthcare provider that it is okay to begin exercising. It is recommended to start slowly and then progress gradually. Start by doing gentle range-of-motion exercises.  Then, you can progress to more resistance training. It can also help to see a physical therapist who can tailor an exercise program that is individualized for you and your goals.

Your exercise should be:

• Low intensity.
• Pain free.
• Within the guidelines for any surgical procedures you may have had.
• Done while wearing compression bandages or garments.
• Fun.

What kind of exercises should I do?

Your exercise program should include the following:

• Stretching/Mobility: To increase the range of motion at joints that are tight.
• Strengthening/Resistance Training: To improve muscle performance and strength.
• Cardiovascular/Aerobic Training: To improve the efficiency of the heart, lungs, and muscles.

How can I start my own exercise program?

• Think about what your goals are. Then, decide what is most important for you to get back to doing or to be able to do again. For example:
  • If you were a runner, you want to begin with walking first.
  • If you want to be able to lift your arm up so you can reach into the cabinet, then you want to begin with stretching exercises to improve your range of motion.
  • If you want to be able to lift and carry your grocery bags like you did before, then you want to begin with a gradual resistance program.
• Start out with low levels of exercise and gradually increase the intensity and length of time of your exercise as you get stronger and more conditioned.
  • You should be able to complete the exercise without being short of breath, overly fatigued, or sore.
  • Start slowly and gradually build your physical fitness.
    • For example, start wherever you are! If you can only tolerate 5 minutes of exercise, then that is totally okay! Any form of movement is good for you!
    • You can start with 1-2 days per week for 10 minutes and then progress to 3-4 days per week for 15-20 minutes. Then, you can progress to 5 days a week for 30 minutes. Figure out what works best for you!
    • Plan for rest and recovery days.
• Major organizations like the American College of Sports Medicine (ACSM) and the American Cancer Society (ACS) outline the following baseline exercise targets:
  • Aerobic Exercise: 150 to 300 minutes of moderate-intensity activity (like brisk walking, cycling, or light swimming) or 75 to 150 minutes of vigorous-intensity activity per week.
  • Strength Training: Muscle-strengthening exercises involving major muscle groups at least 2 days a week.
• Mix up your exercise routine! For example:
  • Try strength and flexibility training every other day.
  • Do cardio/aerobic exercise on the days you don't do strength and flexibility.
  • Add deep breathing, meditation, posture/yoga, and stretching into your exercise.
• Plan to exercise when it works best for you. 
  • For example, if you are a morning person, then plan to exercise in the morning.
  • If you know you have a busy day, then do not worry about exercising, and exercise the next day.
• Find an exercise buddy who can help you and keep you motivated.

What should I expect to feel once I start exercising?

Regular exercise benefits both your physical and mental health. While improvements in strength, flexibility, and endurance may not happen overnight, you will likely begin to notice that everyday activities become a little easier. For example, getting dressed in the morning may require less effort, climbing stairs may leave you feeling less short of breath or fatigued, and you may even notice an increase in your overall energy level.

When beginning a new exercise program, it is normal to experience some muscle fatigue and mild soreness. This discomfort should improve within a few days as your body adapts to the new activity. Listen to your body and avoid pushing yourself to the point of excessive fatigue or muscle failure.

Some muscle soreness is expected and is a normal part of becoming stronger. However, persistent swelling, significant pain, or symptoms that worsen after exercise may mean that you have done too much. If swelling or pain lasts for more than a few days or continues to worsen, stop the activity and contact your healthcare provider.

Remember, consistency is more important than intensity. Small amounts of exercise performed regularly will lead to greater long-term improvements than doing too much at once.

Do I need more information or help starting an exercise program?

That is up to you! Some people prefer to start an exercise program under the guidance of a physical therapist or exercise professional. A physical therapist will create an evidence-based exercise program that is appropriate for your level of conditioning. If you have any concerns about starting an exercise program on your own, talk to your healthcare provider about a referral to a physical therapist or work with a qualified exercise professional.

Are there special therapists or exercise professionals who work with people with lymphedema?

Yes! Physical therapists and other providers treat people with lymphedema.

Physical Therapists with specialized training are specifically called Certified Lymphedema Therapists (CLT). If a physical therapist has this type of training, they will have CLT after his/her name. These therapists have to complete a minimum 135-hour certification course in Complete Decongestive Therapy (CDT). This curriculum includes Manual Lymphatic Drainage (MLD), compression bandaging, skin care, and decongestive exercises. It is recommended that when calling a physical therapy location, you ask if the physical therapist is a certified lymphedema therapist. Other reputable training for physical therapists includes the Academy of Lymphatic Studies, Norton School of Lymphatic Therapy, Klose Training, and International Lymphedema & Wound Training Institute.

Your physician may work closely with a certified lymphedema therapist. So, ask your doctor for a referral. If he/she is not aware of a local physical therapist, use this resource to find a LANA Certified Lymphedema Therapist.

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