This blog post is from our My Ovacome forum and was originally written in February 2020.

As well as the specific treatment techniques we’ve talked about in previous posts, there are things you can do day to day to manage the symptoms of lymphoedema and reduce the risks of infection. As in our other posts, we’ll be focusing on lymphoedema in the legs because this most commonly affects people diagnosed with ovarian cancer.

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Exercise

Moving around and exercising are an important way to help with lymphoedema. Unlike blood, which is pumped round the body by the heart, lymph fluid doesn’t have a pump to move it around. Instead, the movements of the muscles surrounding the lymph vessels help the lymph to flow and drain away. Exercise can also help you to maintain a healthy weight, improve joint health and develop good posture, which are also beneficial if you have lymphoedema.

Your lymphoedema specialist will advise you about the exercises that are suitable for you. Generally, slow stretching movements and deep breathing exercises are most helpful for moving the lymph through the body. Walking, swimming, stretching and yoga can be beneficial.

If you’re thinking of going back to exercise that you enjoyed before your diagnosis, or trying something new, ask your doctor or lymphoedema therapist for advice. Most kinds of exercise are generally thought to be safe to do with lymphoedema, but avoid anything with a high risk of muscle strain or skin damage. It’s generally safest to start slowly and gently and build up gradually as you feel able.

You can watch a video about exercises for arm and leg lymphoedema and an exercise class for leg lymphoedema that you can follow.

If you wear a compression garment for your lymphoedema, it’s important to wear it when you exercise. If this is uncomfortable for you, or if your skin gets red and hot when you wear it, speak to your lymphoedema therapist for advice. If you become more breathless or uncomfortable than expected, or if the swelling gets worse, during exercise, stop straight away and get medical advice.

Why not join our weekly online gentle exercise class for people with ovarian cancer? Find out more and sign up here.

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Daily activities

As well as exercise, staying generally active such as walking around, housework and gardening can also help to reduce the symptoms of lymphoedema. Some activities may be difficult at first because of the swelling. If it’s safe and comfortable, you should continue to use the affected limb but avoid anything too strenuous such as lifting heavy shopping that could injure the muscles in the area and wear gloves and long sleeves for gardening to avoid scratches.

Skin care

Lymphoedema can also cause skin changes. The skin may feel tight, stretched and fragile, or it can get thicker, drier and redder. Sometimes lymph fluid can leak through the skin. Lymphoedema also increases the risk of a skin infection called cellulitis, which causes red, hot a painful skin and sometimes swollen or painful glands (https://www.nhs.uk/conditions/cellulitis/). It’s therefore important to take care of your skin by keeping it clean, using moisturiser and protecting it from injury.

Wash the skin at least once a day, dry it gently, especially between the toes, use moisturiser and check for signs of injury or infection. If your foot is affected, use surgical spirit or alcohol wipes between your toes to prevent fungal infections such as athlete’s foot.

Specialist moisturisers aren’t usually necessary, unless the skin is particularly dry or scaly. Your lymphoedema specialist or pharmacist can advise you, or you can ask your doctor to prescribe a suitable product. When applying moisturiser, make sure that the last stroke is in the same direction as the hair growth to avoid blocking the hair follicle (folliculitis). You can find a video of a specialist lymphoedema physiotherapist advising a patient with lymphoedema about skincare here.

Infection can get into the skin through cuts and burns or if the skin is fragile, especially if lymph fluid is leaking through the skin. It’s therefore important to take extra care to protect the skin, for example by avoiding sunburn (see our post on our the My Ovacome forum about sun care for more information) and using an electric shaver rather than a razor or wax for hair removal.

Tell any healthcare professionals treating you about your lymphoedema so that they can avoid injections or other procedures on the affected area. You can also get a lymphoedema alert bracelet from the Lymphoedema Support Network (020 7351 4480).

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Infection

If your skin does get injured, use antiseptic and keep an eye on the skin for signs of infection. Signs of infection include a high temperature, flu-like symptoms and feeling generally unwell. You may also notice that your skin is red, hot, swollen or painful.

If you have lymphoedema and show any of these signs of infection, stop wearing your compression garment and seek medical advice straight away. Infection can often be treated effectively with a course of antibiotics, but it can get worse quickly so it’s important to start treatment as soon as possible. Find out more information about reducing the risk of infection with lymphoedema and how it’s managed.

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Avoiding extra strain

Most lifestyle management of lymphoedema aims to keep pressure off the affected area and help to stop the lymph from pooling in the tissues. For example, you should avoid tight clothing and jewellery that could restrict the flow of lymph away from the affected area.

It’s helpful to avoid sitting or standing still for long periods and sitting with your legs down or crossed. When you are sitting, if possible put your feet up with support behind the knee to promote the flow of lymph back towards the body. You can also do gentle exercises in your chair such as bending and stretching your ankle and knee. Try to stand up at least once an hour.

If you do need to stand for a long time, you can do exercises such as slowly rising up onto your toes and lowering back down, rocking back and forth from your toes to your heel and shifting your weight from one foot to the other. Your lymphoedema specialist will be able to give you specific advice about exercises that would be beneficial for you.

When travelling for long periods, wear your compression garment, especially on planes. You should stand up regularly if you can, walk around and do gentle stretching exercises. Many airlines provide instructions on helpful exercises. There is more information about this in our My Ovacome forum post on travelling following an ovarian cancer diagnosis.

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You can find more information about exercise, skincare and lifestyle management of lymphoedema through:

Lymphoedema Support Network

Macmillan

Cancer Research UK

If you would like to share your experiences of exercise, skincare or lifestyle with lymphoedema or have any tips, please comment on this post. If you would like information or support, please contact our Support Line on 0800 008 7054 or email [email protected].