Weight Lifting and Lymphedema

Photo credit: Candace di Carlo (Penn Current)

. . . . . . Kathryn H. Schmitz, Ph.D., MPH . . . . . . Photo credit: Candace di Carlo (Penn Current)

This is an extremely important topic, especially in light of some recent news coverage.  I (Amber) was going to do a little write-up on the matter, but just can’t put it better than Joe Zuther.  Here are his words as published in Lymphedema Today:

As some of you may know, an article published August 13, 2009 in the New England Journal of Medicine addressed the topic of weight lifting in women with breast cancer-related lymphedema. The article summarized an 18-month study performed by Dr. Kathryn Schmitz and colleagues in a controlled trial of twice weekly progressive weight lifting involving 141 breast cancer survivors with stable upper extremity lymphedema.

Shortly after this article was published, we received a large number of phone calls and email messages from patients and graduates of our lymphedema management certification courses asking us for clarification on some misleading and inaccurate statements that were made on the results of this study.

One of the more prominent questions we received from patients was: “If it is okay and safe for me to lift weights as this study suggests, is it okay then to lift heavy items at home or at work as well?”

The obvious answer to this question is “NO!”

This is not what this study suggested either, it is clearly a misunderstanding. As a result of these misconceptions, the National Lymphedema Network’s Medical Advisory Board asked Dr. Schmitz to address the many misleading statements that were made in the media about the results of her study. I am very glad to report that Dr. Schmitz answered the NLN’s call and her response was published in the April/June 2010 issue of the LymphLink. This response was necessary to clarify the results of this important study, and what they mean to patients living with lymphedema, or those individuals at risk of developing this condition.

For further clarification, here is the Academy of Lymphatic Studies’ statement on weight exercises:

Strength training can be beneficial for most lymphedema patients. An improved baseline of strength will allow daily tasks to be performed with less effort and possibly prevent muscular or ligament sprain or strain. Improved strength can prevent against overuse syndrome and restore intramuscular balance and normal biomechanics to the involved limb and surrounding joints. When beginning a resistance program, weights should be light, with higher repetitions, as opposed to choosing the heaviest weight the patient can only lift 1-3 times. Negative effects in terms of accumulation of fluid in the affected limb (or the limb at risk) are unlikely if exercises are performed with compression in place on the involved extremity.

Gradual progression is imperative when prescribing exercises, or recommending the return to activities for patients with lymphedema, or a limb at risk. Exercise programs should be comparable to the patient’s fitness level, while trying to accomplish an improved return of lymphatic fluid without adding further stress to an impaired lymphatic system. Please also see the Physical Activity and Lymphedema (PAL) Weight Training Guidelines published by Dr. Schmitz (Associate Professor University of Pennsylvania)

In some instances, individuals may not tolerate exercises that isolate the involved extremity, and the involved limb may respond adversely to these exercises. In these cases the patient may benefit from general, systemic activities such as light to moderate walking or biking. Walking and biking will stimulate diaphragmatic breathing, which will promote the return of lymph fluid to the blood circulation.

(This blog post was written by Joe Zuther for Lymphedema Today on the 19th of March 2010.  The blog can be found at http://networkedblogs.com/1o4Nu.)
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