Lymphedema = Pain = More Pain = Avoidance = Get Educated = Get Fit
National Lymphedema Network – Educating Patients
Part 3b of 3b
Exercise and Compression Garments:
Lymphedema Remedial Exercise as a part of CDT
requires compression garments or bandages.3-5 There are no studies
on the use of compression garments when performing stretching or
flexibility exercise alone.
Our visiting young cousin from Norway
rode her first recumbent trike in Silverdale and wore “What is
COPD” tee shirt while she was here.
My young cousin, Malin from Norway is included here because
Obstructive Pulmonary Disease) began in 1997 for me and led into my
long ride into medical conditions – one after the other and my
gathering weight attracted lymphedema as surely as fresh bread and
butter sticks to peanut butter and strawberry
“The NLN Medical Advisory
Committee (MAC) recommends using the guidelines for aerobic and
resistance exercise to guide use of compression during flexibility
exercise since flexibility exercises may be combined with other
forms of exercise.
The amount and type of compression for exercise should be decided
with input from a professional knowledgeable about lymphedema.
There is no strong evidence basis for the use of compression
garments during exercise; however, most experts in the field of
lymphedema advise the use of compression during vigorous exercise
for people with a confirmed diagnosis of lymphedema.
Melissa showing me the latest fast,
protective lower leg support
Center for Orthopedic
& Lymphatic Physical Therapy in Port Orchard,
recently showed me a new and easy way to add support stockings…easy
except for we Tub’ettes.
“One study suggested that individuals with lymphedema who do
resistance exercise without compression may increase
20 Resistance exercise may reduce limb volume when used as an
adjunct to compression therapy in people with confirmed
8 One study showed that aerobic and weight-lifting exercise was
safely performed without compression in women at risk for breast
9 That study showed patients who developed lymphedema could
continue to exercise with compression garments. Compression
garments should be measured by an individual trained and
experienced in fitting compression garments for lymphedema and
should be at least Class I compression for upper extremity. Higher
classes may be required for more severe lymphedema and for lower
Custom sized, each leg. This pair is
old…notice the crinkles below the rubber dotted band. The
replacement compression stockings are black.
This pair is about one year old.
I throw the stockings in a little zippered mesh cloth bag and into
the washer on a short cycle, regular soap, extra rinse – cold water
and smooth out and let them hang to dry.
I prefer the toe less stocking so my toes don’t get scrunched up
and have two different kinds. The little rubbery tips around the
tops of both help them from sliding on down my leg and cutting off
circulation. Ask your
“A hand piece (gauntlet or glove) is recommended when exercising
with a sleeve to avoid causing or exacerbating hand
Definition of Individuals At Risk for
Individuals at risk for lymphedema have not displayed signs and
symptoms of lymphedema but may have sustained damage to their
lymphatic systems through surgical lymph node removal or radiation
Additionally, individuals at risk may have surgical incisions in
the vicinity of lymph transport vessels.
Individuals who have family members with hereditary lymphedema may
also be at risk.
An individual’s risk of lymphedema may change over time depending
on factors such as weight gain, age, and changes in medical
It is the position of the NLN that:•
is a part of a healthy lifestyle and is essential for effective
Before starting any exercise program, individuals should be cleared
for the program of activity by their physician.•
(also known as Remedial
Exercises) are specific rhythmic muscle and breathing exercises
used as a part of lymphedema treatment in Phase I and Phase
Therapy (see the NLN Position Paper on Diagnosis and
In Phase II lymphedema
maintenance, these exercises can be combined with or integrated
into a regular exercise program.•
After intensive treatment with CDT, the person with lymphedema
should work with the certified lymphedema therapist or qualified
lymphedema specialist provider (MD, NP) to adapt their remedial
exercises into their fitness and weight management program at the
time they are moving from Phase I (treatment phase) to Phase II
Individuals with or at risk for lymphedema can and should perform
aerobic and resistance exercise in a safe
The individual with or at risk for lymphedema may benefit from
working with an Exercise
Physiologist and/or Personal Trainer. The person
with lymphedema should inquire if the trainer or exercise
physiologist has experience working with lymphedema and other
medical conditions. Certification for personal trainers varies.
Patients who are unsure of about the qualifications of a community
exercise practitioner should work with a certified lymphedema
therapist or health care provider to assist them in finding a
community exercise program or professional.•
In general, individuals with a confirmed diagnosis of lymphedema
should utilize compression garments or compression bandages during
Individuals at risk for lymphedema may or may not utilize
compression garments during exercise; this is an individual
decision to be made with guidance from a care provider and/or
therapist based on risk, activity, and conditioning
Individuals at risk for lymphedema will benefit from most forms of
exercise tailored to their individual needs.
Individuals at risk for or with a confirmed diagnosis of lymphedema
should avoid repetitive overuse of the affected part.
Sudden increase in an individual’s usual exercise duration or
intensity may trigger or worsen lymphedema. It is likely that a
program of slowly progressive exercise for the affected body part
will decrease the potential for common daily activities to result
Exercise should be started gradually, increased cautiously, and
stopped for pain, increased swelling, or
The risks of exercise for the individual with or at risk for
lymphedema must be balanced against the risks of deconditioning
that undoubtedly results from not exercising. A deconditioned body
part with or at risk for lymphedema can do progressively less
without risk of overuse. As a result, exercise is recommended for
those with and at risk for lymphedema.
The NLN cannot specifically determine the safety
of exercise for any individual. The guidelines in this Position
Paper provide general principles, but do not substitute for medical
evaluation and recommendations from a health care professional. It
is the responsibility of all individuals with or at risk for
lymphedema to consult with their health care provider regarding
their own specific needs.
1. Tidhar D, Katz-Leurer M. Aqua lymphatic therapy in women who
suffer from breast cancer treatment related lymphedema: a
randomized controlled study. Support Care Cancer.
AL, Piller NB, Carati CJ. The effect of gentle arm exercise and
deep breathing on secondary arm lymphedema.Lymphol.
M, Weindorf S, Lasinski B, Boris G. Lymphedema reduction by
noninvasive complex lymphedema therapy.
Oncol (Williston Park). 1994;8(9):95-106; discussion
E, Földi M, Weissleder H. Conservative treatment of lymphoedema of
M, Földi E, eds-in-chief. Foldi’s Textbook of Lymphology for
Physicians and Lymphedema Therapists,
2nd ed. Munchen, Germany:Urban & Fischer; 2006.
A, Mendes VV, de Almeida Dias R, do Amaral E Silva B, da Costa
Leite Ferreira MG, Fabro EA.
Incidence and risk factors for axillary web syndrome after breast
cancer surgery [published online ahead of print October 17,
Breast Cancer Res Treat. doi:10.1007/s10549-011-1805-7.
W, Rob KA. Physiotherapy management of axillary web syndrome
following breast cancer treatment: discussing the use of soft
NLN • 116 New Montgomery Street, Suite 235 • San Francisco, CA
Tel: 415-908-3681 • Fax: 415-908-3813
Infoline: 1-800-541-3259 • Email: email@example.com
Several years ago, I called Harrison Medical Center and
asked if non-cancer patients with lymphedema could attend their
support group meetings. At that time, it was limited to
Yesterday I called
the following number to be certain it was still up to date.
It is and the closest Lymphedema Support Group I know
If anyone knows of
more, let me know – I can post it here.
Kitsap County Closest Support Group
Northwest Lymphedema Center
Kent, WA (24.11 miles *
Meeting times: Date varies Phone:
I’d like to be part of a support group of fatties who NEED to lose
weight for their health’s sake – with or without current medical
issues. No dues – a scale and occasionally health professionals
willing to talk to us – to educate us – to motivate us – guest
I have been told that I’m not a good candidate for bariatric
surgery…so, before I push that particular button – is there anyone
beside me, who wants to be part of an obese/tubby support group to
work together for weight loss and good health?
To lose weight through good nutrition and exercise is my
We are dying of too much fat, fellow Tubby Ones.
Will you join me in our battle to shed the fat and live healthy?
Let me know…
Thanks for reading… Sharon O’Hara firstname.lastname@example.org
Kitsap County Library System
has educational Lymphedema books for the layperson – just