Swimming is widely recognized as a beneficial form of exercise for individuals managing lymphedema, a chronic condition causing swelling typically in the limbs. Lymphedema results from a failure in the lymphatic system, where lymph nodes or vessels are damaged or blocked, leading to a build-up of protein-rich fluid in the soft tissues. This fluid accumulation creates feelings of heaviness and tightness, often restricting movement. Aquatic exercise offers a unique therapeutic environment that addresses the physical need for compression and low-impact movement, providing a safe and effective way to manage the condition.
The Hydrostatic Advantage of Water Immersion
The primary mechanism that makes swimming advantageous for lymphedema management is hydrostatic pressure. When the body is submerged, the water exerts a natural, external pressure that mimics the effect of a continuous compression garment. This external compression helps push accumulated lymphatic fluid out of the tissues and back into the circulatory system for drainage.
Hydrostatic pressure increases proportionally with depth, creating a natural pressure gradient across the submerged limb. This encourages fluid to move from the extremities (where pressure is highest) toward the central body cavity (where pressure is lower). This gradient is crucial for facilitating the return of lymph fluid toward the trunk where it can be processed.
Submerging to the neck also causes pressure across the chest wall, which enhances deep breathing mechanics. Deeper breathing stimulates the thoracic duct, one of the largest lymph vessels, aiding in the overall pumping of lymph fluid.
Low-Impact Movement and Muscle Pump Activation
Beyond the external compression provided by the water, swimming activates internal mechanisms crucial for lymphatic health. Since the lymphatic system lacks a central pump, it relies on muscle contractions and physical activity to propel fluid through the vessels. Swimming and water walking utilize the natural resistance of the water to gently strengthen muscles.
The repetitive muscle contractions activate the “muscle pump” effect, which squeezes the lymph vessels and encourages fluid to flow out of the affected areas. Because water provides buoyancy, it significantly reduces the gravitational load and strain on joints, which is beneficial for limbs burdened by swelling. This low-impact environment allows individuals to perform a greater range of motion and exercise longer than they might on land, promoting sustained lymphatic movement.
Essential Safety Measures and Hygiene Practices
Individuals with lymphedema are at an elevated risk of developing cellulitis, a serious bacterial skin infection that can worsen the condition. Meticulous hygiene and safety precautions are necessary when swimming to prevent bacteria from entering the body. Before entering the water, the affected limb must be thoroughly inspected for any cuts, scrapes, insect bites, or abrasions, as any break in the skin integrity can allow bacteria to enter. If any open wounds are present, swimming should be avoided until the skin is fully healed to minimize infection risk.
After swimming, whether in a chlorinated pool or saltwater, it is important to shower immediately using a mild, fragrance-free cleanser to remove any chemical or salt residues. The affected skin, particularly between the toes and in skin folds, should be dried completely using a soft towel. Moisture can create a favorable environment for bacterial or fungal growth.
Avoiding extreme water temperatures is also advisable, as very warm water can cause vasodilation, which may increase swelling in the limb. Pools maintained at a comfortably warm temperature, such as around 88 degrees Fahrenheit, are generally well-tolerated for therapeutic exercise. Regular skin care, including moisturizing, helps maintain the skin barrier and reduces the chance of cracking or irritation that could lead to infection.
Integrating Swimming into a Comprehensive Treatment Plan
While swimming is highly beneficial, it should be viewed as one component within a broader lymphedema treatment strategy. Before starting any new exercise regimen, consult with a Certified Lymphedema Therapist (CLT). A CLT can provide a personalized exercise plan that considers the individual’s specific stage of lymphedema and overall physical condition.
Swimming complements other standard therapies, such as Manual Lymphatic Drainage (MLD) and Complete Decongestive Therapy (CDT), by helping to maintain the volume reduction achieved through these methods. The external pressure from the water typically makes wearing compression garments unnecessary while swimming. However, if a garment is worn, it must be rinsed thoroughly with fresh water afterward. Once the aquatic session is complete, patients should promptly re-apply their prescribed compression garments to maintain the benefits of the exercise.