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In August the New England Journal of Medicine published a study comparing the effects of strength training on 141 breast cancer survivors who had lymphedema, a painful swelling of the arm. Half of them were told to continue doing any type of exercise that they normally did. The other half engaged in a gradual, progressive program of weight lifting. The surprising results were that the weight lifters had significantly fewer flare-ups than the control group. Traditionally, women have been advised against lifting anything heavier than 5-15 pounds and performing repetitive arm movements like scrubbing, pushing and pulling. While some women altered their lifestyles out of fear of triggering an episode, many others were not able to abide by the old restrictions because of their normal physical demands such as picking up a child, carrying a laptop, or doing housework. The weight lifters had fewer problems because they had better muscle tone and endurance. The program of progressive weightlifting exercises gradually increased the physical capacity of the affected arm in a controlled setting, making it less likely that daily activities that require upper body strength would overstress the impaired lymphatic system. The lymph system acts to regulate the balance of fluid in the limbs and fight infections. Lymphedema is a symptom of trauma to the system, which may become impaired if lymph nodes are damaged by radiation or surgically removed. When lymph cannot drain out of the arm, the build-up of fluid can cause swelling, tightness and heaviness in the limb resulting in a loss of arm function. The new study shows that weight lifting can actually improve this condition. In the study, the women worked out twice a week for one year. Fitness professionals established the proper starting weight for each participant based on her current level of strength and added more weight gradually every two weeks, provided there was no change in her symptoms. All of the women wore a compression sleeve around the limb at risk and were monitored periodically by a lymphedema specialist. The upper-body exercises included the seated row, chest press, lateral or front raises, biceps curls and triceps push-downs. Each exercise was performed for three sets of ten repetitions. No upper limit was set on the amount of weight a woman could lift. The exercises that target the shoulders and upper arms have the additional benefit of working the muscles in the path of alternative lymph drainage. As the muscles contract they pump the lymph fluid. The goal is to promote dilation of these channels to increase the flow without overtaxing the impaired lymph vessels. In addition to the upper body exercises, the women in the study also did a cardiovascular warm up, stretching, and abdominal, back and lower body exercises. Stretches should focus on the chest and shoulders, since tightness in the pectoral area and decreased shoulder mobility can both interfere with normal lymph drainage. It is important to restore full range of motion in these areas before starting to strengthen them. Not surprisingly, at the end of a year the women in the exercise group showed an increase in strength over the control group. More surprisingly, in that time only nine exercisers had a flare up as opposed to nineteen non-exercisers. Furthermore, the weight-lifters experienced fewer and less severe symptoms. Some of the additional stated benefits were improvements in mobility, balance and coordination. Safety Guidelines for Strength Training: 1) Always check with your doctor before becoming much more physically active than you are now. 2) If you have lymphedema, talk with your doctor to make sure that your lymphedema is stable (i.e. you haven’t had new problems in the last three months). 3) Wear a custom-fitted compression sleeve while exercising. 4) Consult with a certified exercise professional regarding proper weight lifting techniques. 5) Start slowly and progress gradually. Stop if you have pain, increased swelling or discomfort. 6) In the event of a flare up, have an evaluation by a lymphedema specialist and wait until the flare subsides before resuming lifting. Joan Pagano is certified in Health and Fitness Instruction by the American College of Sports Medicine (ACSM), a best-selling author and the owner of the Joan Pagano Fitness Group in New York City. For many years she served as Fitness Consultant to SHARE, a support group for women with breast and/or ovarian cancer. She is recognized by the fitness industry as an expert on fitness training guidelines for post-operative breast surgery. Joan is the author of Strength Training for Women (2004); Strength Training Deck (2006); 8 Weeks to a Younger Body (2007), 15-Minute Total Body Workout + DVD (2008) and 15-Minute Abs + DVD ( 2009). All titles published by DK Publishing For more info, please visit: Joan Pagano Fitness Subscribe to our FREE Ezine and be eligible for Health News, discounted products/services and coupons related to your Health. We publish 24/7. HealthNewsDigest.com We also create, produce and distribute tv/cable public service campaigns: HealthyTelevisionProductions Top of Page 
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