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Yoga exercises to get things moving again after surgery or cancer treatment

Reading time: 10 minutes

The lymphatic system includes lymph nodes that work to filter and destroy nasties from our lymph and contain white blood cells called lymphocytes that fight infection. These nodes are what we often refer to as “glands” that become swollen (active) when we are fighting an infection as they trap bacteria and viruses that they can’t destroy immediately. Although there are nodes throughout the body, they are mainly in the neck, armpits, groin and abdomen. 

Lymph nodes are connected by lymphatic vessels, and some of these vessels are very close to the surface of the skin. Sometimes lymph nodes have to be removed as part of cancer treatment, and when this occurs, there is a lifelong risk of lymphedema. 

The buildup of lymphatic fluid in the tissues of the limbs, neck and abdomen can be debilitating and painful and increase the risk of infection in affected areas. The one-way lymphatic system relies on muscular contraction, flexion and compression, respiration, arterial pulse pressure and the natural pull of gravity to maintain tissue fluid balance and promote lymphatic drainage. 

Yoga postures, dynamic movement and breathing techniques can all help with these processes. According to Cancer Research UK, “Research has found that exercise and movement can help to lower the risk of developing lymphoedema. Most of this evidence comes from research into lymphoedema and breast cancer.”1 

For instance, a research study found that “lymphatic flow is two to three times greater when we exercise than when the body is at rest,”2 and this helps us keep the fluid in our lymphatic system moving back towards our heart, which is the direction we want it moving in. 

We want to move slowly, building back strength safely and taking baby steps to build up the strength needed for more challenging poses. The sequences here will give you the opportunity to build back strength in a safe way. They can help reduce swelling in the legs, build back muscle strength to help the muscles “pump” fluid around the body and help you focus on deep breathing as a way of moving lymph fluid. 

We can squeeze areas of the body and then release them to create a tourniquet effect of compression into areas of lymph nodes. This is stimulating and helps movement.

Lymph is embedded in the fascia. Tightness in the fascia can prevent the movement of lymph, so releasing any stickiness in the fascia is important to allow more circulatory movement within the body. BKS Iyengar, the founder of Iyengar yoga, emphasized in his teaching that postures that open up the “armpits and leg pits” will help the lymph nodes do their work of filtering and removing toxins and harmful substances from the body.3 

If you are living with lymphedema, be mindful of doing too much weight-bearing activity before sufficient strength has been built. Start slow before transitioning to more challenging weight-bearing poses. You can move dynamically, coming in and out of poses, so that you can take the weight off your arms. 

You should stop if your arms feel heavy, achy or tired. As the lymphatic system is working less efficiently in people living with lymphedema, they are more susceptible to cellulitis, a sudden, noncontagious infection of the skin characterized by redness, swelling and heat.4

Warm-up exercises 

Start with your breathing. Full diaphragmatic breathing helps to massage the thoracic duct and aids lymph flow. This is easier to feel when lying on your back. 

  • Take your hands onto your belly and notice its natural movement. 
  • As you inhale, your belly rises/expands, and as you exhale, it falls/deflates. 
  • Inhale and see your belly rise and then, as you exhale, notice how it draws in and slightly up. Tuning into the internal movement of your breath encourages the movement of lymph towards your heart.

Mobilizing the small joints 

Mobilizing the small joints helps to move lymph from the periphery to the center. Your ankles and wrists can act like a pump. 

  • Flex and point your feet. 
  • Squeeze your hands into fists and release them. 
  • Circle your hands and feet in one direction as you breathe in, and then in the opposite direction as you breathe out. 
  • Bend your knees and bring your feet flat to the floor so your knees point up towards the ceiling. Interlace your fingers behind your head.
  • Inhale and open your elbows and knees so the soles of your feet come together. 
  • Exhale and squeeze your elbows and knees back to point towards the ceiling. 
  • Continue like this for four or five more breaths, creating a pump action in the groin, squeezing and opening the lymph nodes in the groin and those in the armpits (axilla).

 

Giving yourself a hug 

  • Still lying on your back, inhale and move your arms out to the sides and up to shoulder height. 
  • Stretch through your fingers, spreading them wide, then cross one arm over the other as if you are giving yourself a hug. 
  • With your arms still crossed, reach around with both hands as if you are trying to reach for the shoulder blade on the opposite side. If this feels like too much, then release and hold the sides of your arms instead. 
  • Press your elbows upwards and breathe in between your shoulder blades. We carry tension in our shoulders, so imagine you are trying to massage your body with your breath. 
  • Open your arms wide and then switch your arms so the opposite arm is on top, and repeat. 
  • Breathe five or six breaths in, drawing the breath between your shoulder blades.

Knee scissors 

  • Lying on your back, bend your knees and draw them in towards you with your arms by your sides. Lift your legs and arms up to the ceiling. 
  • Inhale and circle your raised feet and hands in one direction. 
  • Exhale and change direction; circle your raised hands and feet the other way. 
  • Repeat these movements three or four times, stimulating the joints of your ankles and feet and the muscles in your arms and legs and allowing gravity to draw fluid back down your legs and arms towards your heart. 
  • Release your arms back down to the mat or floor and, as you inhale, separate your raised legs, making a wide V-position. 
  • As you exhale, cross your left leg over your right and bend your knees.
  • Inhale, uncross and take your feet and legs wide again. 
  • Exhale, cross your right leg over your left and bend your knees. 
  • Repeat three or four more times on each side.

Opening up lymph vessels in your neck

  • From lying on your back, transition to a sitting position. First, roll to the side that is more comfortable for you. You might want to keep a stronger arm on top so that you can use it to press into the floor and roll up to sit. Your head will be the last thing to come up. 
  • Come up to sit on a folded blanket or cushion so that when you cross your legs, your knees are positioned lower than the top of your pelvis. 
  • If you aren’t comfortable sitting cross-legged, then you might sit in a chair or extend your legs out in front of you. 
  • Check that your lower back isn’t rounding behind you but instead feels like it is traveling forward, keeping the natural curves of your spine. 
  • You should feel as if you can maintain this length of your spine even if you lift your hands away from the floor. If not, elevate your pelvis by sitting on more blankets. You can also support your legs with blankets, cushions or yoga blocks.
  • Turn your chin towards your right shoulder, then back to the center; then turn it towards your left shoulder and back to the center. Repeat these movements a few times.
  • Bring your right ear to your right shoulder, then your chin towards your chest, then your left ear to your left shoulder. 
  • Lifting your chin, bring your right ear to your right shoulder so you are gently circling your head without dropping it forward or back. 
  • Circle three times to the right, then change direction and circle three times to the left. This opens up the lymphatic vessels that lie close to the surface in the neck.

Sitting twist 

  • Inhale and reach your arms forward and up. Make fists with both hands. 
  • Exhale and bend your elbows like rugby goalposts, and turn to the right, opening your hands.
  • Inhale and turn back to the center, and reach your arms up and make fists again. 
  • Exhale and bend your elbows like goalposts again, but this time turn to the left, releasing the fists.
  • Repeat the above steps two or three more times on both sides. 
  • Come back to the center and change the cross of your legs. 
  • Inhale and reach your arms forward and up. Make fists with your hands. 
  • Exhale, bending your elbows and pressing your forearms back to open up your chest. Notice whether this makes your ribs poke out. Soften your ribs in and breathe into the back of your body. 
  • Inhale.

Armpit opener/side bend 

  • Remain seated cross-legged. 
  • Take your left hand to the back of your head, where your neck meets your skull, and lean to the right. 
  • Use your right hand to stroke from your left elbow to your armpit and across your chest towards your collarbone. This stimulates the lymphatic vessels that are close to the surface of the skin and gently guides the movement of lymph towards the heart.
  • Breathe into the left side of your body. Feel your breath expanding into the left side of your rib cage and all the way into your left armpit.
  • Drop your right ear towards your right shoulder and slowly lower your left arm to the left until you feel a stretch in the left side of your neck. 
  • Inhaling, bring your right arm over your head as if you want to touch your left ear. Use the strength of your arm to bring your head all the way back up to neutral. 
  • Repeat on the other side.

Groin opening and closing 

  • Come onto all fours. You can fold a blanket under your knees for more support. Your shoulders should be either over your wrists or slightly behind them. (I find slightly behind them an easier angle for the wrists that creates less pressure on the mat). 
  • Press the floor away from you. Feel that your spine feels long. You shouldn’t be collapsing anywhere as you lift away from the floor. This is the Child’s Pose.
  • Extend your left leg back, and as you do so, notice whether you collapse on the right side. 
  • Hug your right outer thigh into your pelvis and lightly tone your belly so you support your lower back. 
  • Lift your left leg as you inhale. Lift from your inner thigh so your hips stay facing the floor. 
  • Then, as you’re bending your left knee, take it out towards your left arm. 
  • Exhale, circle your knee as you bring it to the mat or floor and press yourself back towards the Child’s Pose. 
  • Repeat four more times on the left side. 
  • Change sides and repeat five times on the right side. 
  • From all fours, come up to stand. This sequence opens up the groin on both sides, creating some space, and then squeezes it to come back into the Child’s Pose. This change in pressure helps to stimulate the movement of lymphatic fluid like a pump.

Eagle Chair 

  • Place your feet a comfortable hip-distance apart so your feet are under your hip sockets. For more support, you can always place yoga blocks outside of your feet.
  • Bend your knees so you sit back into an imaginary chair. If that feels too low or challenging, sit back onto an imaginary bar stool instead, and extend your arms out in line with your shoulders. 
  • Inhale.
  • Exhale and cross your left leg over your right and your right arm over your left into a big giant bear hug.
  • Inhale, open your arms and uncross your legs. 
  • Exhale, cross your right leg over your left, and your left arm over your right, again into a big bear hug. 
  • Inhale, open your arms, uncross your legs and come back to the center. 
  • Repeat two or three more times on each side. 
  • For more challenge, you can stay in the Eagle Chair Pose with the bear hug for four or five breaths before changing sides. For less challenge, keep your hands on your hips so you can just focus on your legs.

Dynamic warrior I 

  • Keeping your feet hip-distance apart, step your right foot back. Bend your left knee, checking that it doesn’t go forward of your ankle and is tracking your middle toes. Keep your left knee bent and catch hold of the opposite elbow with the opposite hand. 
  • Inhale and take your arms over your head as if taking off a shirt. 
  • Exhale and straighten your legs, release your elbows and lower your arms down. 
  • Inhale, bending your right knee, catch opposite elbows and take your arms over your head as if taking off a shirt again. 
  • Exhale, straightening your legs, and lower your arms. 
  • Repeat these steps four or five more times on both sides, moving with your breath.

Warrior II with archer twist 

  • Step your feet wide apart, turn your left toes out, lift your right heel and turn it slightly out. 
  • Starting with your arms down by your sides, press down evenly into both feet so you feel equal weight in the front and back foot. 
  • Elevate your arms in line with your shoulders or explore how it feels to take your arms up slightly higher than shoulder level. 
  • Inhale and look back at your right hand. 
  • Exhale and bring your right hand towards your left hand, turning your upper body to the left. 
  • Inhale and, starting at the wrist or forearm, stroke your left hand along your right arm and collarbone and bring your arm back to where you started. This stroking stimulates the lymph vessels in your arm and encourages the movement of lymph back towards your heart. 
  • Exhale and sweep your right hand towards the left. 
  • Inhale and stroke your right hand along your left arm and collarbone and back to the start. 
  • Repeat three more times. 
  • Straighten your legs and turn your left toes in and right toes out. Lift up your left heel and turn it slightly out and repeat the archer twist on the left side four or five times. 
  • Turn your toes in and step your feet back together.

Viparita karani 

This pose is calming for the nervous system, and it turns the body upside down so gives it a break from its normal functioning of having to pump blood back up towards the heart. It can help to encourage movement of fluids towards the center of the body to relieve swelling of the feet and ankles. 

  • Place two folded blankets near a wall. 
  • Sit with your outer hip on the blankets so you are close to the wall. 
  • Use your hands behind you on the floor to support you as you roll your sacrum onto the blankets and your legs up the wall. 
  • Push your hands into the floor to get your hips closer to the wall. 
  • Gently lower your head and shoulders backwards to the floor, keeping your hips close to the wall so that your legs don’t lean but are supported and you feel your thighbones descending down into your pelvis. 
  • Stay like this for five minutes.

 

References

1 

Cancer Research UK, “Lowering Your Risk of Lymphoedema,” Aug 12, 2019.  www.cancerresearchuk.org 

2 

Sports Med, 2005; 35(6): 461–713 

3

Lois Steinberg, Iyengar Yoga Cancer Book (Parvati Publications, 2013)

4

Lymphoedema Support Network, “About Cellulitis,” June, 2019. www.lymphoedema.org 

 

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Article Topics: Lymph, Lymphatic system
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