practising these exercises every day, which can easily be done at home, and taking these recommendations into account.
Exercises to prevent lymphoedema
The lymphatic system has two basic functions: fluid removal and immune defence. Oedema can occur following the removal of axillary breast tissue, and the body is then less able to fight off infection in the upper limb. It is therefore necessary to maintain good lymphatic drainage with specific exercises in order to prevent the onset of oedema and to take all possible precautions to prevent serious infections.
Introduction to the physiotherapy protocol for the prevention of lymphoedema and shoulder complications following breast cancer surgery.
Exercises: Presentation of the recommended exercises
The exercises should be performed during admission, 48 hours after surgery. They should be practised twice a day, carefully, for 10 days.
Exercises: Exercises for lymphatic drainage
We recommend doing the exercises daily for life after the 10 days post-surgery.
Recommendations and advice for preventing lymphoedema in the limb operated on
- Do not take your blood pressure in the arm operated on. The limb may swell from the pressure of the device.
- Avoid having blood taken unless absolutely necessary. The rubber tourniquet may cause injury when pressed on the arm.
- Do not undergo a lymphogram or other vascular scans unless absolutely necessary.
- Avoid acupuncture in the affected arm. Avoid vaccines or shots.
- Be careful not to injure the arm during a manicure.
- Make sure small wounds heal, even if they do not seem significant, as all open wounds can lead to infection.
- Take care to avoid scratches from cats or other animals and dog bites. Should they occur, treat them immediately because they can cause serious infections.
- In the garden, take care around thorny plants (use padded gloves).
- Wear gloves while performing certain tasks (cleaning fish, washing dishes, etc.).
- Do not strain by making excessive overhead arm movements or carrying heavy objects.
- Avoid sudden movements, e.g. on the bus, walking the dog, and avoid repetitive work which is likely to place stress on the hand or arm.
- Clapping can cause swelling; simulate it instead.
- Use a thimble while sewing or wear leather gloves.
- Avoid insect bites or treat them immediately to avoid scratching them.
- Do not put your arm in very hot water. Avoid excessive temperatures (smoke, stove, electric blanket, infrared light, sunlight, UVA, sauna, paraffin, clay).
- Do not wear tight-fitting clothes or clothing that restricts the forearm or arm. Do not wear rings, bracelets or watches.
- Avoid rough or strong massages.
- Apply gentle moisturisers. It is very important to keep the skin hydrated, especially around the elbows.
- Do not shave armpits with a blade, or use hot or cold wax on them (use an electric razor and shave gently without irritating).
- Try to lead a life as normal as possible.
- Try to do the specific exercises shown to you by the physiotherapist every day to maintain good mobility and good drainage in the arm.
- It is important to do other types of exercise (long walks, some kind of dance, yoga). This will help you maintain a good physical and mental state.
- Swimming is an excellent exercise to improve quality of life, but it is not advisable to do so during chemotherapy or radiotherapy because it can cause skin problems.
- When travelling by air it is important to move the arm from time to time or support it with a cushion in a slightly elevated position.
- You can perform all types of work, without ever exerting strain. If signs of oedema (swelling) develop, seek medical attention.
Part of the programme consists of monthly sessions on healthcare education to prevent lymphoedema. These sessions will feature a presentation of the topic, followed by a seminar in which those attending can make comments or ask for advice. These sessions were originally meant only for hospital patients but, because they deal with healthcare and prevention, they are now open to all.
The sessions are usually held once a mon