Hydrotherapy & Aquatic Equipment for Lymphedema

Overview of Lymphedema

Lymphedema is a condition in which the lymphatic system becomes overactive. 

This can cause swelling, leading to difficulty moving the affected limb. It usually occurs after surgery or traumatic injury, but it can also happen by itself, without an apparent cause.

According to the Better Health Channel, it is estimated that around 300,000 Australians suffer from Lymphedema at any given time.

Lymphedema causes pain, decreased mobility, and impaired function of an extremity, usually in the arms and legs. The condition is where the lymphatic system becomes overactive, causing swelling in a limb. Lymphedema is a chronic condition that affects the lymphatic system and is displayed in the body's tissues and organs. 

The cause of Lymphedema varies depending on the patient, with many different factors involved, including:

• Surgeries 

• Cancer treatment 

• Carpal tunnel syndrome

• Infections like HIV and lymphoma

• Autoimmune disorders like lupus or scleroderma, 

• Pregnancy complications such as preeclampsia

• Radiation therapy 

Of course, this is not a substantive list. There can be many other medical factors that cause the condition or no predetermined underlying primary cause.

What is Lymphedema?

Lymphedema develops when the lymphatic system becomes overactive and causes swelling and a thickening of the skin in the extremities, most commonly in the hands, feet, arms, and legs. 

Although there is no known cause of lymphedema, it can affect people of all ages and both genders. It's most commonly seen in women after pregnancy, childbirth, or after treatment and surgeries in those who have suffered from breast cancer. Lymphedema can also occur by itself without any apparent cause. 

The swollen limbs feel heavy and may be painful to move.  When the extremities swell, it is an indication that there is fluid that has leaked from the lymphatic drainage system into the tissues of the body, which causes pooling and swelling in the affected areas, either bilaterally or in one specific region.  Once the fluid has collected and pooled within the surface tissues of the dermis, there is nowhere for the fluid to escape, so it can continually gather until the skin holding it in becomes weak enough for it to flow through its barrier, which causes constantly wet skin, sores and painful and swollen areas.

Who is more likely to suffer from lymphedema?

Primary lymphedema is a rare condition and affects about 1 in every 6,000 people on average. Having primary lymphedema often means that there is no known cause of the condition and no other medical condition is contributing to it. Lymphoedema can also occur secondary to other infections or conditions, which is far more common, and this secondary condition is prevalent for those people who:

• Have undergone radiotherapy or surgeries relating to cancer

• Have diabetes-related neuropathy 

• Have suffered trauma on a limb during surgery or an accident.

• Those people who are obese

• Have a disability where the limb affected does not have much or any function

• Suffer from inflammation of the limb, which triggers lymphedema

• Those people who have had a significant injury to the affected area.

• Have complications in pregnancy

Symptoms of Lymphedema

Lymphedema occurs when fluid builds up beneath the skin, usually in one or more areas of your body.  

It can be challenging to fit into clothes, and jewellery may feel tight. 

Without treatment, it will get worse over time until you're unable to wear any clothing at all because of how swollen your affected areas are.

Symptoms of Lymphedema include:

• Swelling

• Pain

• Decreased mobility 

• Impaired function

• You have a feeling that your arm or leg has "gone to sleep," and you are unable to move it freely

• Your skin may be thicker and harder to the touch

• Redness and/or discolouration in your skin.

Lymphedema symptoms can vary from person to person, both in physical symptoms and the severity of those symptoms. As the condition changes, the treatment and therapy may also change in line with the prevalence of the symptoms by a medical professional upon regular reviews.

Water Therapy & Lymphedema

Studies show that water resistance combined with muscle movements generates a natural massage that helps drain the entire lymphatic system. Land based exercises don't give the same type of resistance and can often increase swelling due to the impact on joints and muscles.

Hydrostatic Pressure & Compression

When an individual is submerged in the water, they are presented with hydrostatic pressure, which is the pressure that water naturally exerts. As water is denser than air, it exerts more pressure on our bodies when we are submerged in it. It compresses your skin, muscles, and joints. It has two powerful main effects on the whole body: 

1) it pushes the fluids from the extremities through to the venous and lymphatic systems and heads towards the central cavity: which means your blood circulation and flow is increased; and 

2) the heart and lungs are required to work harder because the chest cavity is more compressed, increasing the work of deep breathing.

Water acts as a compression garment for the entire body and deepens muscle pumps, which stimulates the lymphatic drainage of the limbs. You do not need to wear compression garments in the pool. Water compresses the skin, muscles, and joints when submerged in it. It also makes you work harder because of increased pressure on your chest. The lungs then work harder too due to an increased air intake, which causes more compressed air intake during exercise. With this increase in heart-pumping power over water density comes better blood flow.

The instances of deep breathing brought on by the natural water pressure on the chest stimulate the pumping in the thoracic duct, which is the largest of the two lymph ducts in the lymphatic system. 

As the lungs go from inhaling to exhaling, there is a clear switch in intra-abdominal pressure. This creates a vacuum-like effect and moves sluggish lymph fluid up the thoracic duct and into the venous system.

After frequent water cycling many lymphedema sufferers report that they no longer need to wear compression stockings. However, please check in with your medical team first.

Lymphatic Drainage

Aqua cycling is technique that has proven to be effective in assisting in lymphatic drainage of the legs. When you're in the water, your body weighs less than it does when you are on land. This dehydration occurs faster, which triggers our bodies to work even more challenging. This resistance against the weight of water leads to an effect like manual lymphatic drainage therapy (which helps boost circulation). 

The combination of deep muscle movements while pedaling and pressure from being submerged against results in the negative feedback loop between vascular contraction and lymph flow increases as well as increased blood flow through capillary beds.

Buoyancy is a factor that aids in venous return and elimination of lymph fluid from the body. When on land, gravity pushes blood and lymph towards our feet because it's under us. 

When in water, buoyancy thrusts upward to counteract gravitational downward pull, making for more effortless blood flow to the heart and more efficient flushing out lymph fluid through the venous system where it exits back into one side of our circulatory system or another.

People suffering from lymphedema may find that traditional exercise is simply too painful and puts too much exertion on their affected limbs. This can cause someone to avoid activity or avoid it altogether due to the amount of pain and discomfort it brings.

Exercise, in general, is perfect for those who suffer from lymphatic issues as it can help move the fluid around and reduce pooling and pain from the condition.

Exercising in water can specifically help relieve any pressure caused by the body's weight and gravity. The buoyancy of water provides a different action from gravity which is beneficial for reducing stress on the affected areas during exercise.

Hydrotherapy exercises performed in the safety of a controlled pool environment can help those with lymphedema. 

It is a way of performing activities that they would not be able to do on land without feeling varying degrees of pain and discomfort, which are alleviated by water therapy.

Weight Control

Exercise, like water cycling, is not only good for your health- it allows you to increase the rate at which your body burns calories effectively.

It is entirely possible to burn up to 800 calories in an hour of pedalling on an aqua bike. This can improve body fat and overall circulation, improving symptoms of lymphedema and leg swelling - which is essential for those afflicted with lymphedema.

Aqua cycling, like most other exercises, assists in increasing the body's overall metabolic rate, which is the rate your body burns calories for energy. Since water has a naturally greater resistance than air, your body is forced to work harder. It, therefore, burns more calories than you might with land-based exercises. It is actually possible to burn up to 800 calories over 60 minutes on an aqua bike! 

This may lead to a significant reduction in body fat which is super important when related to lymphedema. 

It's been shown that reducing your body fat percentage helps to improve the circulation within your lymphatic system and reduces the symptoms of lymphedema in the legs.

Ease of Movement

Exercising in a pool can take away up to 90% of the pressure that is felt if the same exercise was to be performed on land; therefore, those who have associated mobility issues resulting from the lymphedema may be able to move more freely in the water as opposed to the restricted movement they may feel on land performing the same exercises.

The wonderful thing about aqua cycling is that it's accessible to anyone, even people who have reduced movement skills (for example, an overweight person) or who have a low fitness level. Unlike other forms of exercise like land-based running and traditional gym workouts, which require you to perform intense exercises for short periods of time before resting up for more challenging work later on in the day - not so much fun if your joints are already sore from days spent plodding around the track! 

Aqua cycling enables you to hit all parts of your body during each session; as such, it can be tailored to suit anyone by their personal ability. You can go at a leisurely pace or challenge yourself with interval training--whatever suits your fancy!

The greatest thing about aqua cycling is that it's incredibly accessible to anyone, even those with reduced movement abilities (overweight, age, joint problems) or those who have a lower level of fitness. 

The intensity of the sessions really depends on how hard you pedal, meaning you can go at a leisurely pace or challenge yourself with intense interval training.

This is specifically beneficial for lymphedema sufferers as it is often the restricted movements that prevent them from performing any exercise at all.

Improved Circulation

Although you want to exercise, you must do so the right way. 

Lymphatic drainage is a vital part of the therapy process. 

To stimulate your lymphatic system, decongestive exercises can be combined with cardiovascular activity such as walking and cycling. This is where muscle pump contractions will help flush out fluid deep within the body.

Reduced Pain

Hydrotherapy is a beneficial practice in treating chronic pain.

The heated water creates a pleasant environment to perform any exercise, reducing strain on the body. 

The exercises you perform in this warm and soothing pool help release endorphins that may help alleviate pain and promote a sense of wellbeing. 

These endorphins interact with your opioid receptors when exercising, creating an analgesic effect for patients as well as releasing extreme amounts of energy into cells.

Water Therapy Equipment & Lymphedema

An Aqua Bike is an excellent piece of aquatic equipment that can help alleviate the symptoms of Lymphedema. Studies have shown that water resistance combined with muscle movements generates a natural massage that helps drain the entire lymphatic system. Land-based exercises don't give the same type of resistance and can even increase swelling due to the impact on joints and muscles. 

A Hydrorider AquaBike is the best piece of equipment due to the speed generated from the Hydrorider flywheel. The enhanced speed improves the lymphatic draining. Faster and better results are seen with frequency. If you cannot attend classes, an aquabike for your home pool may be a good option. An AquaBike enables exercise with minimal pain and discomfort as it can:  

• Allow exercise and movement to have a reduced pain threshold

• Improve overall mobility in the affected extremities

• It helps avoid extreme pain associated with post-exercise

• Allows more unrestricted joint mobility on mobilizing

• Reduces stiffness within the affected limbs

However, an Aqua Treadmill can also be used as an option if mobility is significantly reduced. However, please note  benefits are more significant with the Hydrorider Aquabike; the speed enables faster and stronger lymphatic drainage.

An Aqua treadmill may help improve:

• The range and frequency of mobility

• Heart and lung strength 

• Blood flow and circulation

• Post-exercise pains by calming your whole body

• Sleep and rest

Lymphedema can be a debilitating condition, the swelling can cause pain and discomfort. Severe Lymphedema may also cause a reduction of mobility and function due to the severe swelling and pain, affecting an individual's overall quality of life. By participating in water therapy and using specialised hydrotherapy equipment like a Hydrorider AquaBike those suffering from Lymphedema can reduce the symptoms and improve their quality of life.

Note: Please seek medical advice before exercising & always train under the advice your medical specialist.