Breast Cancer Water Workout: Lymphedema

Water Workout for Breast Cancer : Lymphedema

October is breast cancer awareness month- the perfect opportunity to raise awareness for a condition that can occur with some breast cancer treatments: lymphedema. In this post, we will learn what lymphedema is, why we need to raise awareness, and how we can help treat this condition with a water workout for lymphedema.
What is lymphedema?

Lymphedema is a condition resulting in the accumulation of lymphatic fluid in surrounding tissues. The accumulation results in swelling- usually in appendages- can range from mild to severe. Lymphedema can be caused by several factors including hereditary and injury. Topically speaking, lymphedema can be caused disruption to the lymph nodes during breast cancer treatment. Lymph nodes can be disrupted by radiation therapy, surgery and complete node removal, which is sometimes necessary in treating breast cancer.
Why awareness?

Lymphedema is considered to be a rare occurrence, and few studies have been conducted on its occurrence. The numbers are hazy, but the common ground of most studies indicate as many as 30 percent of women who have had lymph nodes removed can develop lymphedema. Still, physicians and medical staff who practice in fields where this disease is uncommon may fail to correctly diagnose the condition due to the apparent lack of information regarding this disease.

How can water workouts help lymphedema patients?

First of all, water work can reduce swelling. Water also provides a comfortable and ideal setting for increased range of motion. Quite simply, water is freedom.

Sample water work for lymphedema patients

This is only intended to be a guide- not a prescription for exercise. A practitioner and/or certified aquatic therapist will have to determine what exercises are appropriate, how many sets, and when to provide rest periods and water breaks.

Total Time: 45 Minutes

This workout can be performed in shallow water or deep water. Buoyancy belts may be uncomfortable to wear following surgery, and deep water exercise can be more intense. It is best to progress to a deep water variation later in the recovery process.

1. Water Walking:

Remember to maintain strong vertical posture with ears over shoulders and shoulders over hips. Breath deeply, and combine your breathing patterns with your walking stride. Try the following set while walking forwards, then repeat walking backwards, finally repeat walking sideways.

1 minute – inhale for 2 steps, exhale for 2 steps
1 minute – inhale for 3 steps, exhale for 3 steps
1 minute – inhale for 4 steps, exhale for 4 steps
1 minute – inhale for 3 steps, exhale for 3 steps
1 minute – inhale for 2 steps, exhale for 2 steps

Wooden soldier style walking – Straighten your arms and legs, while keeping knees and elbows slightly belt as if mimicking a wooden soldier.

Bent knee march – Bring knees up in front to waist level as if marching in a band.
Slow march- March slower while pulling knees higher towards your chest.

2. Core muscle / Trunk exercises

Standing or suspended with legs apart at shoulder width. Keep your abdominal and lower back muscles

Side leans – Lean from side to side stretching the oblique muscles. Arms can be at your side, or reaching overhead for a more advanced stretch.

Hula Hoop – Gyrate the hips in a circular motion then change directions. Remember to keep core muscles steady.

Vertical abdominal crunch- Hold a water noodle or pair of aquatic barbells in front for support. Bend forward slightly as you contact your abdominal muscles. Remember to maintain a straight posture, do not hunch over.

Helicopter – With arms near the surface, rotate to one side in the comfort zone. Repeat motion to the other side, staying within that comfort zone.

3. Upper Body Stretching

Remember to breath deeply and maintain a strong foundation:

Neck turns – Tilt the head from side to side, or roll the neck in circles and reverse direction.
Tilts- Like side leans above, only holding the stretch.
Shoulders- Shrugs: Raising the rib cage and shoulders. Circles: circle shoulders in both directions.

4. Long Lever Moves

These exercises use leverage with waters resistance to workout the upper body and improve circulation. Use web gloves if properly conditioned at this point in the workout.
Arm circles from shoulders – With arms at sides just under the surface, circle the arms with the shoulders, and reverse direction

Arms at side – Abduction/adduction. Start with arms directly at the sides. Raise them to form the letter “T” with your body then lower them to form the letter “l” again.
Arms at surface – Adduction/abduction. Start in the “T” position, only this time bring arms in front of you as if clapping hands together.
Hands on shoulders – Contract arms to touch at the elbows, forming a V then return to starting position.
Surface bends – With arms at surface out at sides, bend at elbows bringing arms toward chest then back out.

Windshield wipers – Bend both arms in front of you while keeping your elbows close to your body. “Wipe” both arms back and forth.
Gates – Start in the same position as windshield wipers. Swing arms open like opening a gate then pull the gate closed again. Keep elbows at sides
Bicep curls – With arms at sides and elbows bent, alternate raising and lowering motion.
Wood Chopper – With both arms in front and hands touching each-other, pull down as if chopping wood.

Raise back to starting position
Fans – With arms just below the surface, pivot the wrist updwards and downwards as if fanning to cool off.
Goodbye – Hold arms directly in front and pivot wrist side to side as if waving goodbye.
Cheerios – One by one, rotate each finger in a circle and reverse rotation.
Thumb unders – Retract the thumbs towards their bases and hold stretch.

Light fist – Make a light fist with each hand as if crumpling up a handkerchief.
Play piano – Randomly wiggle fingers as if playing Beethoven’s 5th.

5. Static or active stretches

In the cooldown/strectching period, include calf, quads, hamstring, shoulder and back stretches.
This sample workout appears on the recently released Breast Cancer Recovery on Land and in Water by Naomi Aaronson, M.A., OTR/L, CHT, and Mary Essert, BA ATRIC (Aquatic Specialist).

Original Program Credits: “Water Exercise for Lymphedema”
UAMS Water Wellness Program
Kellie Coleman, MS, Fitness Coordinator

Naomi Aaronson, MA,OTR/L, CHT and Mary Essert B.A., ATRIC are the co-authors of a new interactive CD. Breast Cancer Recovery: On Land and In Water empowers breast cancer survivors to move forward towards wellness. Practitioners will learn how to work with clients on land and in water safely and effectively when at lymphedema risk. This CD is a 4 CEC course for many organizations. Copies are available through Mary Essert at,, or Naomi Aaronson at or through Fitness Learning Systems at Special Breast Cancer Month Price of only $48.00 including shipping.