After breast surgery, sometimes a woman’s arm gets enlarged, a condition called lymphedema. Women are told to elevate the arm and/or wear a compression sleeve to reduce the swelling. They are also told to “be careful of the arm,” so as to not injure it, which could make the swelling worse. Weight lifting in particular has been on the “no-no” list.
But that advice can lead to underuse of the arm, which in turn can lead to muscle weakness. Then, when a women does lift the arm, injury—the very effect she was protecting against—may be more likely.
Women protecting their arm may avoid strenuous exercise in general, robbing them of the bone protection from exercise.
The recommendation to “not lift weights” is not based on clinical evidence; it is only well-intentioned advice.
Weight Lifting Not Dangerous, Study Shows
One hundred forty one women who had breast surgery and stable lymphedema were randomized into two groups. The experimental group has twice weekly exercise sessions that included whole body resistance training with increasing weight and repetitions. The women wore custom-fitted compression sleeves. They exercised in groups at first, then on their own. The control group had no special treatment. The study is described in the August 13, 2009 issue of the New England Journal of Medicine, volume 361, pages 664-73.
Investigators looked at results after a year. About 10% of women in each group, experimental and control, had an increase in lymphedema—in other words, no difference. But the weight lifting group had fewer symptoms and had improved strength. They also had fewer exacerbations (acute flare-ups).
There were no serious events within the study.
The study was funded by the National Cancer Institute and the National Center for Research Resources.
Lymphedema Results from Tissue Removal
Lymph is normal body juice that surrounds cells. It has its own circulation, from cells to lymph vessels, to lymph glands, to collecting vessels, back into blood. It is then oozed out as blood flows around cells, to repeat the cycle.
Cancer cells sometimes move (metastasize) through lymph glands. Breast cancer cells sometimes move to lymph nodes around the shoulder and armpit. Surgeons removing breast tissue may intentionally remove these lymph nodes. That interrupts the usual path of lymph flow from the arm. The lymph backs up and swells the arm (lymphedema).
Not Necessarily Generalizable
This study showed that weight lifting, if done in gradual, supervised steps, while wearing custom-fitted compression sleeves, is not particularly dangerous, and the improvement in strength may have benefits. Women with lymphedema should discuss their options with their physicians.
This study provides no information about whether weight lifting prevents lymphedema in women without lymphedema.
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