Asociación Galega de linfedema, lipedema, insuficiencia venosa crónica y otras patologías: WHAT SPORT TO CHOOSE WITH LYMPHEDEMA - SPORT INJURIES AND THEIR COMPLICATIONS - PREVENTIVE MEASURES - Organic Lymphatic Vascular Disease - Chronic Skin and Subcutaneous Tissues Impairment - Pediatric and Primary Lymphedema - Secondary Lymphedema

Physical activity and sport, regardless of age, background, or location, enhances physical condition and offers numerous benefits for physical, mental, and social well-being. Regular physical activity offers numerous benefits for both adults and children, it strengthens the heart, improves blood circulation and sugar levels, builds muscle mass, bone density, joint flexibility, helps maintain a healthy weight, and boosts overall well-being and quality of life. Likewise, insufficient physical activity is a major risk factor for chronic conditions like cardiovascular disease, osteoporosis, etc.

The diagnosis of lymphedema doesn’t have to mean giving up exercises and sports, in fact, recreational activities have physical and emotional benefits for people with lymphatic dysfunction. Many times they can even help slow the disease progression, even though there’s no normative guideline for exercise prescription from the perspective of reducing lymphatic dysfunction severity. The psychological Impact due to the visible swelling (disfigurement) and physical limitations associated with lymphedema (physical disability), can also lead to anxiety, depression, and social isolation. Impaired lymphatic function can pose certain risks, but with proper precautions, guidance, right adaptations or modifications, many sports and physical activities are accessible to people with different range of lymphedema stage levels.

WHAT ARE THE PHYSICAL LIMITATIONS AND RISKS IN LYMPHEDEMA?

Numerous scientific evidence regarding risk factors and injury complications in sport practice have been published, but there aren't studies specifically evaluating sport injuries in patients with impaired lymphatic function, therefore a “common-sense” approach should be adopted regarding sport injury preventative strategies and management in lymphatic vascular disease. Apart from the recognized risk of injuries related to various sport activities, it is clear that lymphedema carries an increased risk of developing severe complications, and therefore this fact should not be underestimated. Swelling in limbs due to lymphatic fluid build-up can cause pain, limited range of motion, and make individuals more susceptible to skin infections (infectious cellulitis). The physical limitations imposed by lymphatic dysfunction can make it difficult to engage in strenuous activities and maintain fitness levels. It is crucial to consult with a doctor or physical therapist before starting any exercise program to assess individual risks and benefits, as well as to monitor symptoms and adjust activity levels accordingly.

Lymphedema (Organic Lymphatic Vascular Disease) is due to impaired lymphatic drainage resulting in skin disease, characterized by persistent and progressive swelling, and abnormal thickening of the skin and subcutaneous connective tissue. lymphatic dysfunction is not just a localized swelling problem, but a condition that can affect multiple body systems, structures and functions, leading to a range of physical, physiological and psychosocial symptoms and complications. It is clear that no patient or their lymphedema is the same and neither is its progress. Some patients with limb lymphedema can easily do different degrees of physical activity, while others feel the strain and experience increased swelling with minimum effort. Research and planning are key to participating in physical activities, but it is essential to first consult with a healthcare provider to consider the sports and exercises options that can be done comfortably, safely, and with a limited risk and impact on the effected limbs.

WHAT ARE HIGH AND LOW IMPACT AND HIGH AND LOW CONTACT SPORTS

Depending on the amount of force exerted on the body, particularly the joints or the physical interaction between players, physical activity can be divided into high or low impact and contact sports and exercises.

High-Impact Sports are activities that put significant force on the body, involving running, jumping, landing, and rapid changes in speed and direction, and movements where both feet leave and then hit the ground, placing force and stress on the joints. This contributes significantly to a high risk of ankle sprains, knee injuries and falls, that can be harder to recover from. Even though proper technique and protective gear can help mitigate injuries, it doesn't eliminate all risks. Examples of intense high-impact physical activities are running, jumping activities, basketball, volleyball, tennis, gymnastics, etc. High-Contact Sports involve physical interaction between players, and potential high-impact collisions and increased risk of injury due to the nature of the sport. Examples of High-Contact physical activities are football, soccer, rugby, hockey, etc.

Low-Impact sports are activities that put less stress on the joints, as they keep at least one foot remaining on the ground during movement, making them suitable for people of all ages and fitness levels. When done safely and under guidance, they are good choices for maintaining cardiovascular health, improving range of motion and muscle strength, and promoting lymphatic flow without excessive strain or worsening lymphedema. Low-Contact sports minimize physical interaction between players. Examples of low-impact and contact sports and physical activities are walking, swimming, indoor/outdoor cycling, nordic walking, archery, bowling, golf, dancing, Pilates, aqua exercise , aerobics, gradual strength training, etc. There are also specific lymphedema exercises and activities (deep breathing exercises, posture work, gentle stretching and flexibility exercises, etc) that are designed to promote lymphatic drainage, which can be incorporated into a daily fitness routine.

WHAT ARE THE MAJOR INJURIES ASSOCIATED WITH SPORT?

All physical activity carries some risk of injury, although the risk varies greatly depending on the type, intensity, duration, environment, as well as individual pre-existing conditions. While most forms of exercise are generally safe, beneficial, and outweigh the risks, injuries can still occur, and it's important to be aware of potential risks and take steps to minimize them. The most common injuries associated with physical activity are musculoskeletal injuries, such as sprains, strains, and overuse injuries.

WHAT ARE THE MAJOR INJURIES IN HIGH-RISK SPORTS?

Different sports have different types of risks and injury patterns, some contact intensity sports directly correlate with a high rate of high-impact collisions and injuries. There are several sports injuries that are known for their complexity and potential for long-term consequences, such as ACL tears, lacerations, concussions, fractures (particularly those involving multiple bones, surrounding tissues, and nerve or blood vessel damage), spinal injuries, rhabdomyolysis, etc.

WHAT ARE THE COMPLICATIONS RELATED TO FRACTURES?

Complications from sports-related fractures occurring in a high functioning population include acute issues like nerve and blood vessel damage, compartment syndrome, infection from open fractures, as well as delayed problems such as malunion (improper healing), avascular necrosis, joint damage, and complex regional pain syndrome. High-risk stress fractures, common in athletes, have a higher chance of requiring surgical intervention, and can potentially lead to permanent damage.

WHAT ARE THE COMPLICATIONS RELATED TO FRACTURES IN LYMPHEDEMA?

If a fracture occurs in a limb affected by lymphedema, the situation can be complicated by the difficulty of lymphatic drainage. In lymphedema, the risk of infection is higher than in people without lymphatic dysfunction, and a fracture can complicate recovery and cause additional inflammation, which could delay proper healing of the fracture, both in the bones and soft tissues. It is important to avoid Cellulitis, characterized by redness, swelling, pain, and warmth in the affected area, which can spread quickly to more serious complications like sepsis. Although exercise is beneficial for lymphedema, scrapes, cuts, and burns, no matter how small, can take longer to heal and become an entry point for bacteria, potentially causing inflammation, pain, and even serious infections if not managed properly. It is crucial to seek immediate medical attention to treat both the fracture and lymphedema, and prevent complications.

By addressing lymphedema injuries early and effectively, it is possible to optimize fracture healing and improve outcomes for individuals with both a broken leg and lymphedema. Effective management often requires a team approach, involving physicians and certified lymphedema therapists. Treatment plans should be tailored to the individual's needs and the severity of the lymphatic dysfunction.

Before starting any exercise program or sport, it's crucial to always consult with a doctor specializing in lymphedema or a certified lymphedema therapist for personalized advice. Each case is different and the situation of each patient must be analysed individually. Patients also need to be educated about the importance of adhering to risk prevention strategies to prevent severe complications.

WHAT SPORTS SHOULD BE AVOIDED IN LYMPHEDEMA?

As well as for the general population, certain types of physical activities should be approached with caution, modified, or avoided altogether. While exercise is generally encouraged for managing lymphedema, activities to be cautious with or avoided in lower and upper limb oedema, are those that can cause excessive strain, fatigue, pain, injury, and trauma to the affected limb and lymphatic system.

It is important to remember that lymphedema is a chronic condition and that proper skin care and infection prevention are essential to avoid complications. Accumulated lymphatic fluid (lymphatic stasis) can hinder the body's ability to fight infection, and wounds may take longer to heal. Specific concerns related to lymphedema are injuries, even minor ones can be problematic due to the impaired lymphatic system's reduced ability to manage fluid and fight infection. Skin infections like cellulitis (dermatolymphangioadenitis ) are a common complication, as bacteria can easily enter through even small cuts or abrasions.

High-intensity, high-impact, and high-contact activities in the affected area can cause fluid to accumulate (Increased inflammation and swelling), and may exacerbate and worsen lymphedema, and should be done with supervision and appropriate precautions. Any activity that requires prolonged static positions, or that causes increased swelling, pain, and that can potentially cause infections, injuries, trauma, and lead to worsening symptoms should be avoided or modified.

WHAT ARE THE RECOMMENDATIONS TO MINIMIZING THE RISK OF INJURY?

Consult and get clearance with a healthcare professional (specialist doctor or certified lymphedema therapist) before starting any new sport or exercise routine.

Inform the healthcare provider to any signs of increased swelling, pain, or discomfort during or after exercise, to adjust the activity accordingly or stop the physical activity if needed.

Inform the healthcare provider to any signs of injury (cuts, scratches, burns, trauma). Non-healing sores or wounds in lymphedema can become chronic and difficult to heal.

Avoid contact sports or activities with high risk of injury and trauma that can lead to severe complications.

Avoid prolonged static positions.

Avoid overexertion that can strain muscles and potentially exacerbate lymphedema symptoms.

Avoid extreme climatic temperatures (lymphedematous tissue has a thinner barrier),

Avoid Skin breakdown due to swelling, and keep the oedematous skin clean and well-hydrated.

If recommended by your doctor, wear compression garments when practising physical activities to help manage swelling during exercise, use appropriate equipment (footwear and protective gear), practice proper warm-up and cool-down techniques, and gradual activity progression.

SUMMARY

Exercise and sports are healthy activities for the general population, and forms part of programs for the prevention and management of many diseases. People with lymphedema (Organic Lymphatic Vascular Disease) are encouraged to participate in sports and physical activities, particularly low-impact ones, so they can enjoy their benefits and maintain an active lifestyle. It is recommended to always consult with a healthcare professional (doctor or physical therapist specializing in lymphedema), before making choices and starting any new exercise program. The healthcare professional can assess the specific condition, and provide personalized recommendations and determine the appropriate and safe exercise plan. In this way, individuals with impaired lymphatic function can enjoy and safely participate in physical activities, minimize the risk of exacerbating their condition, and enhance their quality of life.

REFERENCES

domingo, 11 de enero de 2026

WHAT SPORT TO CHOOSE WITH LYMPHEDEMA - SPORT INJURIES AND THEIR COMPLICATIONS - PREVENTIVE MEASURES - Organic Lymphatic Vascular Disease - Chronic Skin and Subcutaneous Tissues Impairment - Pediatric and Primary Lymphedema - Secondary Lymphedema - Awareness Campaign