How Lifting Weights May Help Lymphedema

woman lifting weights
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The burden of undergoing breast cancer surgery and/or radiation is enough—yet some women also develop lymphedema, an uncomfortable swelling of an arm after that may occur after surgery, lymph node removal, or radiation.

The good news is that women can take an active role in reducing lymphedema symptoms through proper exercise and lifting weights. Let's examine what lymphedema is, and the science behind how weight lifting may improve the discomfort that stems from this condition.

Understanding Lymphedema

Lymphedema is caused by the removal of axillary lymph nodes during breast cancer surgery, or by damage to those nodes or other lymphatic vessels during radiation treatments. Excess lymph fluid can build up in areas where lymph nodes and lymph vessels are no longer present to help carry the fluid to other parts of the body.

Lymphedema symptoms can include swelling and pain in your arm, chest, and breast area. It may also include a change in skin color and texture, a feeling of heaviness, and difficulty using your fingers for daily tasks. The symptoms vary from person to person.

Most often, lymphedema develops gradually fairly soon after surgery or radiation. But in some people, it may begin even months or years later. Some surgeons have reported lymphedema to develop 50 years after a mastectomy.

Studies on Weight Lifting and Lymphedema

Current research suggests that weight lifting may help reduce or prevent lymphedema.

For instance, a 2009 study done at Lund University in Sweden in Physiotherapy Theory and Practice found that when people with breast cancer 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.

A 2014 study again using pole walking also tested the cardiovascular effects of an 8-week program. In addition to a reduction in the amount of fluid in the affected arm and increased strength, the participants had significant decreases in their heart rate.

In addition, in one 2005 study in Lymphology, a small group of women with lymphedema 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, another 2009 study published in the New England Journal of Medicine examined 141 people with breast cancer complicated by lymphedema who had taken part in an exercise program. While half of the people were careful not to overuse their arms, the other half engaged in 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 the 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 fewer lymphedema symptoms than the women who protected their arms. The women who lifted weights, not surprisingly, also had more strength.

Finally, a review of studies published in 2016 looked at the effect of high-intensity resistance exercise on lymphedema. There has been concern and controversy over this type of exercise in the past as it was feared that resistance training significant enough to improve strength could actually trigger (or worse) lymphedema. There is now sufficient evidence to dismiss this concern, and it appears resistance training to gain strength is safe from a lymphedema triggering standpoint.

The Role of Weight Lifting in Improved Lymphedema Symptoms

Researchers believe 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.

In addition, 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.

How to Get Started

If you're interested in trying some exercises, some simple gentle arm lymphedema exercises are a good place to start. Before you do any exercise, however, it's important to talk to your doctor. You will likely have some limitations after surgery and/or radiation, and it's important to take this time to fully heal before stressing your incision or traumatized muscles.

Some cancer centers have physical therapists who specialize in managing people with lymphedema. Even if you do not have any symptoms, be sure to talk to your surgeon or oncologist. Not only can a good physical therapist help design an exercise program which could help with lymphedema safely, but he can help to educate you on how to avoid developing lymphedema if possible and take baseline measurements of the circumference of your arm.

It's important to note that if you talk to people who had breast cancer in the past, they may discourage exercise. For a long time, it was thought that exercise could exacerbate rather than improve lymphedema symptoms. The tide is changing, but those who remember practices of the past may leave you feeling anxious about exercise, but it shouldn't deter you from finding a lymphedema physical therapy or Physical Medicine and Rehabilitation physician to assist you in developing a program. Some cancer centers are now Star-certified for cancer rehabilitation, meaning that they are following guidelines set out to help cancer survivors thrive in their new normal both physically and emotionally.

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Article Sources

  1. Jönsson C, Johansson K. The effects of pole walking on arm lymphedema and cardiovascular fitness in women treated for breast cancer: a pilot and feasibility study. Physiother Theory Pract. 2014;30(4):236-42. doi:10.3109/09593985.2013.848961

  2. Schmitz KH, Ahmed RL, Troxel A, et al. Weight lifting in women with breast-cancer-related lymphedema. N Engl J Med. 2009;361(7):664-73. doi:10.1056/NEJMoa0810118

  3. Nelson NL. Breast Cancer-Related Lymphedema and Resistance Exercise: A Systematic Review. J Strength Cond Res. 2016;30(9):2656-65. doi:10.1519/JSC.0000000000001355

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