Swelling and edema in the legs and the rest of the body can occur for various reasons. The most common conditions that cause swelling are venous insufficiency, lymphedema, and lipedema. Blood comes from your heart and is pumped throughout your body through arteries. The blood then returns to the heart through the veins, or some clear fluid from the blood, called lymph fluid, returns through the lymphatic vessels. Swelling can be caused by congestion or backup of the veins or the lymphatic vessels.
These vessels in your body that move fluid rely on the muscles to help that process. When muscles activate, they act as a pump. Muscles contract around the veins and lymphatic vessels, stimulating and supporting blood or lymphatic fluid to flow through. However, swelling and fluid or blood congestion can occur without movement and using your muscles.
Exercise and movement are vital treatments for the management of swelling and edema, but let’s discuss how exercise benefits each swelling and edema condition and how they may differ.
Lipedema Exercise Benefits
Lipedema is a chronic, progressive condition that causes an increase in body fat distribution to areas of the body. This fat tissue, called adipose tissue, then holds fluid inside, causing swelling.
Pain in the legs or body is a common symptom of lipedema due to the accumulation of fat and fluid. This pain can make it challenging to be active or participate in exercise. However, exercise can significantly improve pain symptoms, as well as swelling, when done regularly. Exercise can help to create an anti-inflammatory effect on the body and has been shown to lower inflammation in a limb or area of the body with lipedema.
Lipedema exercise should focus on low-impact and gentle movements to avoid too much pressure and strain on the joints and the body. According to the American Academy of Orthopedic Surgeons, for every 1lb of weight on the body, it equals 4-6 lbs on your knees and joints. Lipedema fat tissue, typically seen primarily on the lower body, can lead to significant joint pain over time. Exercises in a pool, like swimming, water walking, or water aerobics, can take up to 80% of one’s body weight off the joints, making them an excellent option for those with lipedema.
Doctors often encourage diet and exercise for the treatment and management of lipedema. Still, when someone is dieting to try and lose weight, it’s essential to include strength training in a workout regime to avoid muscle loss or weakness. Strength training two times a week has been recommended as a guideline for healthy exercise by the American College of Sports Medicine.
Exercise for Vein Issues
Veins are vessels in the body that return the blood to the heart. A common condition caused by vein issues is chronic venous insufficiency. Problems with the veins and venous insufficiency lead to swelling and edema in the lower legs and feet.
The veins are a part of the cardiovascular system, controlled mainly by the heart. However, the muscles in the body also play a role in the activation of veins to help promote blood flow.
Exercises focusing on the leg muscles can benefit from edema and swelling caused by chronic venous insufficiency. Activities like walking, biking, and swimming provide the muscle activation needed to support the veins and improve circulation.
Strength exercises that focus on the ankle and calf muscles are shown to play a role in reducing swelling caused by vein dysfunction. This body area is furthest from the heart, and the veins must work hard to move blood up against gravity. So along with elevation, exercises can boost the veins in support.
Exercising for Lymphedema
Lymphedema is a progressive condition that doesn’t currently have a cure. It involves a dysfunction or issue with the lymphatic vessels or lymph nodes, causing congestion and a backflow of lymphatic fluid in an area of the body.
The lymphatic vessels are one-way vessels that run from the feet, hands, and other areas toward the heart. The vessels have small valves inside to help avoid backflow, but they do not have a muscle lining the walls to cause them to contract or pump. They rely entirely on the muscles to stimulate them.
All movement and exercise can be beneficial for lymphedema. Lymphedema exercises are often taught to be done in a sequence that pumps the muscles, like how manual lymphatic drainage is done. For example, exercises for pelvic and leg lymphedema would be done in the following order:
- Core exercises
- Hip exercises
- Thigh exercises
- Lower Leg exercises
- Foot and ankle exercises
This is done to help clear the congested area, and then the exercises are reversed to encourage the movement of the remaining fluid:
- Foot and ankle exercises
- Lower Leg exercises
- Thigh exercises
- Hip exercises
- Core exercises
Lymphedema therapists and healthcare providers have commonly taught lymphedema exercises to be gentle. Still, there is a growing awareness of the importance of strength training and aerobic exercise for the lymphatic system.
Fibrosis is a common side effect of lymphedema. It’s an increase in collagen tissue, which causes a thickening and hardening of tissue in the area with lymphedema. This fibrosis can embed into muscle tissue and may cause weakness. To help prevent this, strength training should be added to an exercise program to benefit those with lymphedema.
Specific Exercise Options for Swelling
Exercise is considered one of the main treatment options for swelling and edema related to all conditions, including lipedema, vein issues, and lymphedema. Now that we understand how exercise can affect these conditions, how does one know which activity is the best? Stay tuned for part 2, where we dive deeper into which workouts and exercise types are helpful or hurtful for swelling and edema.
References:
Donahue PMC, Crescenzi R, Petersen KJ, Garza M, Patel N, Lee C, Chen SC, Donahue MJ. Physical Therapy in Women with Early Stage Lipedema: Potential Impact of Multimodal Manual Therapy, Compression, Exercise, and Education Interventions. Lymphat Res Biol. 2022 Aug;20(4):382-390. doi: 10.1089/lrb.2021.0039. Epub 2021 Nov 8. PMID: 34748408; PMCID: PMC9422785.
American Academy of Orthopedic Surgeons. The Impact of Obesity on Bone and Joint Health. 2015. https://www.aaos.org.
American College of Sports Medicine. Physical Activity Guidelines. https://www.acsm.org/education-resources/trending-topics-resources/physical-activity-guidelines
