Exercise for lower limb lymphedema: From “what” to “how-to”
ABSTRACT:
Exercise is now recognized as an important component of lymphedema self-management, but most existing evidence has focused on upper extremity lymphedema after breast cancer. This article discusses how recent consensus recommendations for lower limb lymphedema can be translated into practical, individualized exercise strategies. McNeely explains that exercise can increase fluid movement into tissues, creating heaviness, throbbing, and distress when lymphatic clearance is compromised. Lower limb lymphedema presents additional challenges because of gravity, limb size and weight asymmetry, altered biomechanics, fragile skin, garment friction, and cellulitis risk. The article outlines four practical areas for adapting exercise: navigating compromised lymph flow, counteracting gravity, considering movement mechanics, and protecting the skin. Strategies include resistance training, lymphedema-specific warm-ups, proximal-to-distal exercise sequencing, active rest, leg elevation, aquatic or recumbent exercise, single-limb strengthening, movement-efficiency training, and skin checks before and after exercise.
How to cite: McNeely, M. Pathways. 2026;15(4): 15-17. https://doi.org/10.70472/YWDX3607
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