Lymphedema-Caroline Shubert-Exercise
Exercise and Lymphedema

What type of physical exercises should I do to help prevent or manage my lymphedema?

  • Your body works better when you have daily physical activity.

  • This is still true when you have lymphedema. But, you need to do your activities in ways that will not hurt your arm(s) or leg(s) that had lymph nodes removed or damaged.

  • The therapist or rehabilitation specialist can help you find activities that fit your daily physical needs or exercises to help make your arm(s) and leg(s) less likely to have problems with lymphedema.

  • Exercise helps the muscles contract and this helps get the lymphatic fluid moving.

  • Deep breathing and drinking water also helps to get the lymphatic liquids moving.

  • Your daily life may include activities that are just as beneficial as any of the exercises described below.
    • Picking up a baby
    • Cleaning fish or game
    • Lifting a ream / package of paper for the office machines
    • Raking dry pine leaves to help as a fire starter in the fire place
    • Walking up and down stairs at home or at work
    • Walking up and down hills outside
    • Putting groceries away
    • Shoveling snow or mud
    • Dancing or teaching others traditional dances

  • Here are some general guidelines (talk with your provider about how they can be changed to fit your physical condition):
GENERAL Instructions:
  • Start your physical activity / exercise program under the supervision of a healthcare provider or therapist who is experienced working with lymphedema patients. This person will help you personalize the activities to reduce the likelihood of you injuring yourself or making the lymphedema worse.
  • Do physical activity (such as gardening, cleaning the house, walking, swimming, or other exercises) only while your arm is wrapped or while wearing a compression sleeve.

Caroline Shubert
(Fish River Inupiaq)
Dx 1988 Breast Cancer


play video

"The three of us would go for walks in the neighborhood. I would deliberatley swing my arms to try to get back the mobility and movement in my arms. I had exercises: walking your finger tips up the wall, I had to do that... Once I get them up there push down you know. Um, I spent a lot of time doing exercises, um and going for walks, I like the out of doors. After I was cleared to fly, I went up to the village. And mother was there. And the fish were running and it was so difficult because I had been cut from one side of the body to the other, the incision was healing, but I, I had very little strength in my arms. Hans and my brother, Johnny, would lift the fish up on to the table. Sometimes I could only cut two or three salmon and then I would have to go back and lie down. There is a lot of insulation across the area, and I found that even in the warmest weather I would get very, very cold."

to play Video Vignette - click audio only

  • Wear loose clothing with wide waist bands and wrists and ankle cuffs
  • Sit or stand tall and straight with good posture while doing your activities.
  • Take turns doing activities that use the muscles and then relax that group of muscles.
  • Keep muscles not involved in the activity relaxed.
  • In general, use slow, controlled movements while doing your activities
  • Do your activities once or twice a day, 5 - 10 repetitions depending on how fit and strong you are or to follow your therapist's or provider's directions.
Don't do:
  • Anything that causes pain or cramping, unless your therapist needs you to do something uncomfortable for a while.
  • Fast, rapid, forceful movements.
Warm-up exercises:To watch an Exercise Video - click the
  • Ask your provider before you do "any" exercises

    • These exercises can be done standing or sitting.

  • Introduction
  • Start and end the activities with good slow deep breathing. Breathe in through your nose; breathe out through your mouth. If you have trouble standing, you can do many of the exercises while sitting down. But if you feel strong enough, try to do them standing.
  • Start and end the activities with stretching and relaxing your muscles. The length of time you stretch and relax your body should be as long of a time as you spent doing the activity.
  • Neck rotation.
    • Face the east. Turn your head to the right (south) then to the left (north). To this 5 to 10 times, depending on how tight or comfortable the movement feels for you.
    • Tip your head slowly so that your right ear stretches to touch your right shoulder. Keep your shoulders lowered and relaxed. Slowly tip your head to stretch your left ear to try to touch your left shoulder. Linda B calls the head lean, "Dr. Johns"

  • Chin tucks. Keep your chin level. Gently and slowly pull your head and neck back on your shoulders (with the chin level). Gently and slowly push your head and neck forward (still keeping the chin level). Repeat between 5 to 10 times.
  • Shoulder blade squeezes: squeeze shoulder blades together behind you. Hold for 5 seconds, and then relax. Repeat 5 to 10 times. If you are pretty strong and fit, you can do neck rotations while squeezing the shoulder blades. Remember to keep the shoulders lowered.
  • Shoulder shrug. Shrug (lift and squeeze the shoulders up toward your ears) and breathe in. Lower the shoulders slowly and exhale. Linda B calls the shoulder shrug, the "don't know" (inhale) and "oh well" (exhale)
  • Shoulder Rotation:
    • Rotate one shoulder forwards, alternating left and right sides. Linda B calls the one shoulder rotation backwards, "Snaggin". Pair up to the person next to you and do the shoulder facing them. Do it 5 to 10 times. Now pair up with the person on the other side of you and "snag them" Again, 5 to 10 times.
    • Rotate one shoulder forwards. Similar to "snagging" but is called the "Bettie Boop"
    • Do in both shoulders at the same time forwards. This is "shoulders going around the world". Repeat 5 - 10 times. Do both shoulders backwards, "Superman turning back time". Do 5-10 times.

  • Fist clenches: squeeze fists for 3 seconds, and then relax for 3 seconds. You can do this one in different positions, depending on how strong and flexible you are (and of course with the therapists or providers "okay"). The positions may include (standing straight up with good posture of course):
    • fists by your hips (you may grip all your fingers at the same time, or roll them in little finger in first, then ring finger, and so on)
    • fists waist high in front of your body (keep shoulders down and relaxed)
    • fists shoulder height in front of your body (very carefully, especially if you have not healed from your surgery) "Grip the staff from the healer" and "Release the staff to the healer
    • Fists shoulder height out to the sides of your body - keeping shoulders lowered and loose/relaxed (only do this if you have healed from your surgery). You can do this one rotating your wrists so that your fists are upright (vertical) or parallel with mother earth (horizontal). Horizontal with palms downward = "Dropping the chicken feed". You can rotate to the four directions doing this one (and several of the earlier ones too). "Offering the corn pollen" is horizontal with palms facing the sky
    • Fists above your neck or head - only if therapist and provider approve and your skin and body are healed from your surgery. Slowly and gently raise the arms as high as is comfortable for you. You may need to keep your arms bent. That is fine. Keep it comfortable so that you are not hurting yourself. Fists closed, the open to welcome the blessings from the Creator. "Thank you, Creator for another good day." You can do this one with arms in front of your body or to the sides of your body.

  • As your body gets stronger, you can combine some of these. Like hold the bucket with chicken feed with the left arm, reach in with the right to feed the chickens. Always using slow and gentle movements.
  • Shoulder touch. Make a fist with the right hand and touch it to the chest, or if you are stronger and more flexible, touch it to your left shoulder. This is the "I promise". You can make private promises or out loud promises. "I promise to do something good today for my community". "I promise to do something good today for my family". And then, "I promise to do something good today for my self". You can quietly decide what that "something" is to be. Then do this with the left hand in a fist and touch your left chest or shoulder. "Put on the back pack." Repeat 5 to 10 times.
  • Berry picking. Stretch out arm and lean forward (bend your knees a little). Clench your fist and bring to your mouth. Return your empty hand to your side. Stretch our arm and lean forward again (bend your knees a little). Clench your fist and bring to your shoulder put the berries in your gathering sack to bring some berries back to the family. Repeat 5 to 10 times. Then do the same movements using the other arm and fist.
  • Spider Woman. Stand (or sit) in front of the wall. Let your fingers slowing climb like a spider up the wall, then down.

    When you feel strong, Spider Woman can weave a web on the wall. Start with small circles for the beginning of her web and the circles gradually get larger and larger. Do this one hand at a time.

  • Climb from one world to the next. Kokopelli leads the way from the inner world up to the next world. (Or Raven leads from out of the home in Mother Earth to above the ground). You slowly reach up to grab the ladder rung with one arm and hand to pull yourself up. Repeat with the other arm and hand of pull yourself up.
  • Move through the bushes or swimming breast stroke. Bring both arms forward with palms together as pointing your way through dense brush and bushes. Slowly turn the palms outward and pull the arms around to the side (to push the bushes aside so that you can move forward). Lower your hands to your sides.
  • Twist the apple or light bulb change. Raise your arm above your head. Rotate your hand as if screwing in a light bulb or twisting the apple from the tree limb. Do with your other arm and hand. 5 -10 sides on each side.
  • Finger dexterity Place palms and fingers together. Pull the thumbs toward your chest then back to your palms. Then pull the index fingers toward your chest and back to the original position. Then the "live long and prosper" position and back to the original position. Then from the ring finger and the rest of the hand toward the chest and back to the original position. Last, do from the little finger and rotate whole praying hands to the chest and back to the original position.
  • Finger coordination. Open both palms facing skyward. Start with right hand and touch right thumb of palm of left open hand. Return to original open palm position. Next, move right index finger to touch middle finger of left hand. Return to original open pal position. Then move right little finger to touch left index finger. Repeat with the opposite hands and fingers. You can change which fingers you touch and use, but try to include all 10 at some time in the activity.

  • Hold the ball in your lap and squeeze the ball with both hands. Hold for 3 seconds and then relax. Repeat 5 to 10 times.
  • Roll the ball along your waist. Using both hands hold the ball at your waist and roll the ball to your left side (waist height). Keep your shoulders low and relaxed. Then slowly roll the ball to your right side (keeping in waist height throughout the roll).
  • Roll the ball on your thigh. Sitting down and using both hands, roll the ball length-wise down your thigh, then back up. Do this on both legs about 5 to 10 times.
  • Roll the ball around your thigh. Move your bottom to the front of the chair. Then using one hand roll the ball under your thigh and with the other hand continue rolling the ball back on top of your thigh (try to not drop the ball. Do this about 5 to 10 times. They repeat the activity with the other thigh. When you are feeling very strong and have good balance, stand up leaning on the wall (to help prevent you from falling down) and do the same activity standing up on one leg with the other leg and knee bent.

Lymphedema of the legs
(Remember to wear your leg sleeve(s) before you do any of these exercises and have your provider or therapist tell you which ones are okay for you to do).

  • Sit in a chair and place a dry wash cloth on the floor. Use bare feet, one at a time to move the toes to gather the wash cloth into a ball or bunch. Try to grip the wash cloth with your toes and lift it off the ground about 3 inches. Do the same activity with the other bare foot.
  • Place small ball (like a foam ball or tennis ball) on the floor and sit in the chair. With bare feet using one foot at a time, roll the ball forward, then back towards the chair. Then roll the ball to the right, and back towards the chair. Then to the left and back towards the chair. When you feel strong, do the same activity with your hands holding the chair close to your knees and tuck your chin to your chest. Use both feet to roll the ball.
  • Sit in a hard solid chair (not a soft cushion) and tuck your chin to your chest. Slowly and gently lift the right foot up and straight in front of your body. Slowly lower the foot to the ground. Do 5 to 10 times. Next do the same activity with the left foot.
  • Do the next activity using different objects, like a pillow, a bath towel rolled up, or a small container of sealed oat cereal. Sit in a hard solid chair and tuck your chin to your chest. Place a light object between your knees. Slowly raise your knees and the object upward and hold the position 3-5 seconds. Then lower your knees and the object to the ground.
  • Place a solid chair in front of you, and then lie on your back in front of the chair so that your calves rest on the seat of the chair. Place the palms of your hands flat on the floor next to your hips. Raise your head so that your chin is close to your chest. Try to straighten the right leg up in the air (or in a position that is comfortable for you). Lower the leg back to the resting position in the chair. Do 5 to 10 times. Then do the same activity with the left leg. If you are very strong and your provider or therapist says it is okay to do, do the same activity with both legs at the same time. You must keep your chin tucked close to your chest to help protect your low back from straining.
  • Lying on your back with the knees bent and your feet flat on the floor. Place the palms of your hands flat on the floor next to your hips. Lift your head so that your chin is close to your chest. Slowly and gently straighten your right leg out so that your foot is a few inches above the floor. Hold in that position for 3 to 5 seconds. Bend your knee and lower the foot flat on the floor. If you feel strong, you can try putting your foot at different heights from the floor. Do the activity with both legs. If you feel very strong, you can try to do both legs at the same time. But check with your provider or therapist before you try to do this.


Canned food upper body exercises.

.8 ounces,
23 grams
6 ounces,
170 grams
10 3/4 ounces,
305 grams
1 pound,
453 grams

18 ounces,
510 grams
1 pound 12 ounces,
754 grams
5 pounds,
2.27 kilograms

  • You may use different sizes and weights of cans depending on how strong you feel. Hold the can of food (whatever weight you are comfortable with - so you may start out with a can of soup, then later with a large can of tomatoes). Or you may find it easier to use a light, but larger container, like the oatmeal carton.
  • Sit if you are more comfortable. Stand if you feel strong. Hold your elbows firmly against the side of your body. Hold the can of food so that it is parallel with the ground and you are holding the round ends of the can or object. Slowly curl the object towards your chest keeping your elbows against your sides (don't let your elbows move with the activity), then lower to waist height. Repeat 5-10 times. Do more repetitions as you feel stronger and stronger, or increase the weight of the object you are using.
  • Using two cans. If the arm that has had lymphedema is weaker, use a lower weight can in that hand. Stack one can on top of the other. Hold the higher of the two cans in the position in front of you, then stack the other can on top of it. Again hold the higher can in the same position and stack the other can on top of it.
  • When you feel stronger and with the permission of your provider or therapist, you can use a longer object to get more movement. You can be creative in what you choose to use for the longer object. It may be a staff, a broom, an arrow, a flute, a pipe, or any other object you feel comfortable holding and moving.

  • Hold the long object vertically (sitting or standing) and walk your hands on top of one another to climb to the top of the object and then down to the bottom of the object.

    "Fatter" objects (like the flute) use fingers differently than tinier objects (like the arrow).

  • Hold the long object in the middle with both hands about 6 inches apart. Rotate the long object alternately like a kayak paddle. You can also use a rolled up towel (length wise) for this activity. Pull the towel taunt so that it is stretched out. Now just rotate it like a figure 8 directly in front of your body. Then pull the lower part as though you are paddling through water.
Body rotation.
  • Hold the long object close to its ends out in front of you so that it is parallel with the ground. Slowly turn your body with the object to the right hold the position for 3 to 5 seconds, then rotate to the left, again, hold the position for 3 to 5 seconds.



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