Ever experienced puffy ankles, slightly swollen legs at the end of a day or after a flight? Do you sometimes find lymph drainage an issue? Then you’ve experienced the perfectly normal occurrence of oedema. However, over the summer I had a couple of clients come to see me who, whilst not why they had made the appointment, were actually suffering from quite a bit of oedema.
Oedema is the accumulation of fluid in the tissues, caused by failure of the lymphatic system to drain properly. The area is swollen, and there may be pain and heaviness. - Practical Pathology for the Massage Therapist by Su Fox p76
So here’s the thing. Our lymphatic system is one of the most incredible mechanisms within our bodies, yet it was only discovered in the seventeenth century (I love proof that our understanding of anatomy is constantly developing). It is our front line in defence, works tirelessly to keep us fit and well, but when we are ‘under the weather’ or really quite unwell, it could do with some support. But as with so much about our own bodies, it’s often confusing to know what we can / can’t / should / ought to do. So I’ve developed a DIY of self-care for oedema and lymphoedema.
Now, I don’t know about your school biology memories, but I don’t remember much talk about the lymphatic system at school, other than something to do with the immune system and white blood cells. So if you’d like more information on the anatomy side of things, I’ve got some a separate article of Lymph 101, including what the fuss is about oedema, the difference between this and lymphoedema, and what to look out for.
Oedema and lymphoedema can be greatly improved and effectively controlled with some simple exercises and ‘lifestyle tips’. However this does come with a major caveat:
If you have any of the 'red flags' outlined in the Lymph 101 article, or the cause of your swollen limb(s) has not been identified, it is really important that you get yourself checked out by a medical professional before undertaking any further self-care. I don't write this to scare you, but it is more important that if there are any doubts, it's always best to ask your medical team - they and you are the experts on your body.
However, once you are given the all clear or the swelling is something you are used to, if you occasionally suffer from puffy ankles, or are fundamentally fit and healthy, and happy just to crack on with helping yourself and your lymphatic system, here you go.
If you do not have sensitive, stretched or taut skin, a brilliant way to stimulate your lymphatic system is with skin brushing. A great article on this, along with a ‘how to’ video has been put together by Sue Hitzmann, Creator of MELT Method®.
Given that our muscles act as pumps for our lymphatic system, moving and exercising is a great way of getting the lymph moving. If you are wanting to undertake some exercise, it’s always a good idea to check with your GP particularly if you have been diagnosed with lymphedema, or any other condition which may put additional pressure on your lymphatic system.
Swimming is great place to start because the water will help to support your body weight and will encourage lymphatic drainage (even if you can’t swim, moving in water is hugely beneficial). Likewise, Yoga, Tai Chi and some Pilates classes will provide a gentle form of exercise with some relaxation - do please talk to the instructor before any class about your condition(s) and any limitations you may feel. Finally, if it hurts, stop and get it checked out by a medical professional.
A number of exercises can be done slowly, and gently, mostly while sitting down, so whether you are at home, in bed, in a meeting or on the bus, you know you can be doing something to help. The first thing I would suggest making sure you do though, is to activate your lymphatic system. This is really easy to do and comes back to the system’s role as part of the circulatory system - the primary ducts for returning lymph fluid to the circulatory are just below our collar bones, so by gently placing your fingertips below the middle of your collar bone and either lightly drawing down and in towards your breast plate, or by lightly tapping (think rain drops) on the area, your lymphatic system will be stimulated.
The next step is to slowly use your muscles to start to move your limbs, to pump the lymph back from your extremities to your trunk. How? Well let's work on the basis that the swollen limb is a hand or wrist. Throughout these exercises, breath slowly and deeply, preferably from your belly, and move slowly and with awareness.
- Stimulate your lymph by lightly tapping your breast bone below your collar bones for a few minutes
- Moving slowly, circle your shoulders forwards for several rotations, breathing slowly and deeply from your belly as you do this
- Moving slowly, circle your shoulders backwards for several rotations, again slowly breathing from the belly
- One at a time, pop one hand on the same shoulder and draw small forward circles with your elbow, slowly increasing in size. After a few rotations, change directions
- Repeat the elbow circles with the other arm
- Slowly bring one hand towards your shoulder then extend it outwards, in time with your breath. Complete this a few times and again swap sides
- Gently rotate your wrists, firstly inwards, then outwards
- Finally, slowly and gently clench your fist and then stretch it outwards a few times
- To finish, place your hands on your abdomen and breathe deeply for a few breaths
- Afterwards, if it is possible, keep your swollen limbs slightly elevated, above your heart for a few minutes
You can also do something similar with your legs, but I would suggest stimulating the upper body with the above exercise first.
Remember gravity is working against your lymphatic system, so clench your fist from time to time if you are walking, rest your arms on the arms of the chair when sitting for a while, wriggle your toes and practice ‘good toes, naughty toes’ (for those who didn’t do ballet as a tot, point your toes out long for good toes, then push your heels away and lift your toes to the ceiling for naughty toes).
- Avoid cuts, grazes, scratches and bites, and if any of these happen, clean the area properly and use an antiseptic solution immediately.
- Wear gloves in the garden and when doing the washing up
- Use an electric shaver when removing unwanted hair.
- Never allow the affected limb(s) to become sunburnt and keep the skin supple and moist - the Lymphedema Society recommend aqueous creams.
- Avoid tight clothing or jewellery
- Avoid putting heavy strain on the limbs, and if you are doing gentle exercise, such as swimming or yoga, your limb should not ache with tiredness, otherwise you’ve perhaps worked too hard.
Finally: Do not exercise or massage any area if you have an infection, cellulitis or a change in the appearance of your oedema or lymphoedema. If in any doubt, please get it checked out by a medical professional.