Shoulder Mobility Exercise for Lymphoedema
Lymphoedema is a build up of lymph fluid in particular parts of the body typically when there are problems with the lymphatic system. Lymphoedema can sometimes develop with cancer treatments and depending on your type of treatment you’re undergoing, there are some exercises and movements that can help ease the discomfort of lymphoedema and assist the movement of the lymph fluid around the body.
It is important to note that when engaging in exercises and movements not under the care of a qualified professional, you must be careful to move within your tolerance zone. This means:
Not causing pain or discomfort during the movement
Not “pushing past pain”
Avoiding exercises that increase redness, inflammation and swelling around the shoulder girdle.
As shown in the video, it is always encouraged to start with dynamic gentle movements such as shoulder shrugs and shoulder rolls. If it feels comfortable to do so, you can try to complete 10 repetitions and 2-3 sets should none of the above symptoms occur. You can start with small shoulder shrugs and circles to begin to allow the body to move slowly and then with more confidence, increase the range of movement. Some other gentle dynamic movements are knees to shoulders to overhead reaches. This is a nice progression to work overhead movements of the shoulder however it is important to start with a smaller range of movement such as only reaching above head height until it feels comfortable to reach overhead with straight arms. Similarly, if it feels right for your body, 10 repetitions over 2-3 sets is a good goal. The next mobility exercise, I have used the end of a broom stick for active assisted range of motion. Here, my left shoulder if working through new ranges of motion without requiring the muscles to get the shoulder into position. The right hand is guiding and encouraging the movement for the left shoulder. Try keep your shoulder as relaxed as possible and never push through an uncomfortable range.
The final two exercises are when we start to progress into isometric, eccentric and concentric movements. Isometric meaning; no change in an active muscle belly. Eccentric meaning; lengthening of an active muscle belly under load. Concentric meaning; shortening of the muscle belly under load. The first of the active exercises is isometric pectoralis presses. Use a ball or small pillow for some resistance. You should not be pressing 100% of your energy into the ball. Enough to give a gentle press to allow your body to feel the pectoralis major turn on (without discomfort). You can hold this for 3-5 seconds and repeat between 8-10 repetitions over 2-3 sets if comfortable to do so. The final exercise is eccentric and concentric control of the pectoralis major and minor muscles. Placing your right hand over the left wrist and as you lift your left arm up towards the diagonal, place a gentle pressure from the right hand. Here you’ll create enough tension in the pectoralis group as it lengthens under load. In reverse, as you switch the positioning of the right hand to under the wrist, the pectoralis group will gently shorten under load while the left arm presses against the right hand force. These exercises should be monitored carefully with the above symptoms to look out for. You can set a similar goal of 8-10 repetitions of 2-3 sets.
Should any of these symptoms occur, stop the exercise and consult with your doctor. The below exercises are a gentle guide to assist with mobility of the shoulder and move some of the lymph fluid away from the shoulder. Radiation or chemotherapy can play roles in the way the tissue can tolerate movements especially where there is scar tissue. Using the tolerance rule where you don’t push into movements where there is pain is a good guide to get you started. Once these movements do start to feel easier and your body is ready to progress, that’s where Clinical Pilates can be a great next step.
Optimal musculoskeletal performance is the goal with Clinical Pllates, regardless of what setting you’re working in. What is optimal musculoskeletal performance? It’s building strength, flexibility and endurance without risking injury. Clinical Pilates has a strong focus on core stability no matter what your injury, this includes pelvic and shoulder girdle stabilization, neutral alignment and breathing. Once an individual is able to understand and implement these fundamentals, greater progress is achieved in a holistic nature. Clinical Pilates assists to restore the natural curve in the spine, relieve tension and enhance self-confidence. It provides autonomy for clients for attending a session that creates positive changes to their health as well as creates a social presence outside of the home environment. When individuals are ready to progress to Clinical Pilates under the guidance of a Physiotherapist or Kinesiologist with associated Clinical Pilates training, they’ll also experience positive changes to their cardiovascular fitness. Clinical Pilates creates a social environment where the individual can allow themselves to have the confidence to work their body in a safe environment under the guidance of a qualified professional.