August 9, 2017
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 Water Based Exercises For Your Leg Lymphoedema.

Aug 2017

If “exercise is medicine” then exercise in water may be “good medicine” for lymphoedema. Walking, cycling, dancing, lifting weights, yoga, Pilates etc are all wonderful for you, but if you like water and you have lymphoedema, consider the following special characteristics of water based exercise.

  • When you exercise in a pool or in the sea, the pressure water exerts on your body (hydrostatic pressure) is comparable to the pressure exerted by most compression garments, so you do not have to wear your compression garments.
  • The buoyancy you experience in water lifts your body weight off stiff or painful low backs, hips and knees, giving you the comfort you need to move in all directions, making it a total body exercise.
  • The resistance you experience as you move against the water makes your muscles and your lungs work. They pump and propel your lymph fluid through the lymph system to the nodes for filtering, keeping you healthy.
  • People with lymphoedema who use water for exercise, report their lymphedema limb “feels softer” immediately afterwards. This softer lighter feeling both rewards and inspires them to return to the pool. Regular exercise is corelated with has many important health benefits.
  • There are pools galore in every county in Ireland and at an average cost of 7.50 Euro a session, they are excellent value. Pools open most days including weekends and holidays, rain, hail or snow. So while exercising 3 – 6 days a week is a big comitement it is achievable.
  • To locate and select a pool that suits your needs, visit www.swimireland.ie/ and click on “Get Swimming / Learn to swim / Find a pool”, and see their list of the 10 pools closest to you.
  • For those who also like exercising in the sea, they can plan snorkelling and scuba-diving trips with friends and family.

What is the best water temperatures:

Normal body temperature is 98.6°F (37°C). The ideal temperature for water based exercising for people with lymphoedema is 94°F (34°C) degrees or slightly cooler. This temperature feels comfortably warm, soothes nerve endings, relieves pain, relaxes tense muscles and softens fibrotic lymphoedema. Water temperatures above 94°F (34.4°C) degrees, should be avoided because heat may increase lymphoedema. Strenuous exercise may also generate too much heat and increase lymphoedema.

So, it is preferable to exercise in a relaxed moderate manner in water temperatures of 94°F (34°C) degrees or slightly less. When you are checking out the pools near you or planning a seaside holiday inquire about the water temperature, so it suits your needs.

Can everybody with lymphoedema exercise in water?

Each person is unique and factors like your general health, your age, your balance and agility plus the condition of your skin and nails will need to be reviewed with your doctor, before you get into a pool.

Also, pool surfaces can be slippery and require you have excellent balance and agility to walk safely from the locker to the pool. Some pools have disability access e.g. life guards, seated cubicles to change in, non-skid flooring, hoist chairs, steps and ladders and safety bars to hold onto. Discuss all of this with the pool staff when you are calling around or when you ‘go, look, see” to help you select the one that best meets your needs.

The length of a session of water based exercise.

As with all types of exercise, people with lymphoedema do best when they start gently and progress slowly and patiently. This slow and progressive approach is safest as it gives your body time to adapt physiologically and gives you time to get to know your body’s reaction. It is “best practice” to check your lymphoedema before and after exercise to see if it is less or more. Based on this reaction, you can decide how to progress your program. You may wish to start with 10-15 minute sessions for example, working up, over several weeks to 35 – 45 minute sessions and then 55 minute sessions. As with all new activities, if you have any health and safety concerns, discuss with your doctor before you start.

Examples of water based exercises for leg lymphoedema

Introduction: Each session includes a 5-minute warm up, a 5-exercise circuit, followed by a 5-minute cool down. The program is progressed over the weeks by increasing the number of circuits. 

Examples of 5 minutes warm ups:

  • Stand chest high in water. Using safety bars as needed, breath in and out deeply 3 – 5 times, roll your shoulders back and down 3-5 times, stretch the sides of your neck by gently bringing your right ear to the right shoulder then the left ear to the left shoulder 3 – 5 times each side. Relax your mind and body and move gently and rhythmically to warm up and loosen up the spine, shoulders, hips and knees, wrists and ankles. Feel the ball of your foot as it lifts you forward with each step.
  • Walk slowly and calmly back and forth across the pool, go forwards, then backwards and then sideways. Do one or two laps on your tip toes and then on your heels.

Examples of leg circuits:

  • Squat down and gently jump up and repeat 3-5 times
  • Lunge on the right and then alternate to the left 3 – 5 times
  • Jumping jacks with the arms out for balance 3 – 5 times
  • March in place knees up 3 – 5 times
  • Power walk across the pool, moving arms and legs 3-5 laps
  • Rest for 30 – 90 seconds
  • To progress, repeat the entire circuit.

Examples of 5 minutes cool downs:

  • Stand chest high in water. Breath in and out deeply x 3-5 times, roll your shoulders back and down 3-5 times, stretch the sides of your neck by gently bringing your right ear to the right shoulder then the left ear to the left shoulder x 3 – 5 times each side. Relax your mind and body, move gently and rhythmically to cool down and loosen up the spine, shoulders, hips and knees, wrists and ankles. Feel the ball of your foot as it lifts you forward with each step.
  • Walk slowly and calmly back and forth across the pool, go forwards, then backwards and then sideways. Do one or two laps on your tip toes and then on your heels.

In summary: Water based exercises may be ideal for the person with lymphoedema. Fortunately, pools are in abundance in Ireland, are open most days of the week and all year round. Water based activities are whole body activities. People with lymphoedema can; move in comfort in water, train and condition their muscles, joints, hearts and lungs, develop a fit and strong body. For the adventurous, when on holiday with friends and family, strong and fit people with lymphoedema can enjoy sea water exercise and go snorkelling and scuba diving.