By Guest Blogger Pernille Henriksen

In primary school we had to attend swimming lessons. I hated it.
I was afraid of the dark end of the pool, getting water in my nose, not being able to swim as fast as the others, not getting all the badges and certificates which was required for a good little swimmer.
Later as my lymphedema developed, I was aware of my leg that stood out. That people would stare at me. I struggled to deal with the stocking – on or off? Wondering how I could “discreetly” battle with putting the stocking on in the changing room at the pool while sweating and people stealing a look. At the beach I was worried I would be stung by a jelly fish, walk on something sharp, get sand in the stocking, not have shade for my leg.
Swimming is one of the most beneficial types of exercises “lymphies” can do and yet I kept shying away. Denying myself the freedom of a compression free leg and the power of the water.
At one point, sometime back in 2017 I jumped.
What I realised was, that it was all in my head. Once I was in the water nobody can see me nor my leg and with a good plan, I could address all the “dangerous things that can happen”. I have made it possible for me to enjoy.
I have collated some tips that hopefully can get you swimming….
- “Strut your stuff”
- just raise your head and walk purposefully. You have the right to be in that pool or on that beach just like any other person. If you are bothered about the looks – look back. Be confident. Even if you are not, then pretend. “Fake it till you make it”. As you build up your confidence it becomes easier.
- Other people at the pool
- ask in the reception when you can expect less people. It might be the late nights or early Sundays that are better than lunch times. Go and have a look at your preferred time slot to check out the amount of people in the pool and if they have seating areas for parents during swimming class. This was the biggest hurdle I had to pass.
- Temperature
- check the temperature of the pool. Some pools have warmer water than others. Especially if you are just looking to walk in the water then it is often in the children’s pool which can be hotter. My leg is not happy with warm water and humidity.
- Classes
- if you are not a confident swimmer then check out Aqua Zumba, Aqua Biking, Aqua Jogging, Aqua Aerobics. They might have classes for elderly, those with physical disabilities and who need a ramp or support to get people in the pool. Again, check which pool they do it in and the temperature of the water and the area as well.
- alternatively, is to use a program like Fluidrunning.
- Pool size
- check the lanes where you will swim to see how many people can swim in one lane. I prefer a pool where the lanes are wider as I am conscious of people kicking me or scratching me. Some lanes might be dedicated to faster swimmers so since I am a slow swimmer that decreases the number of lanes available to me.
- my leg prefers deep pools but if you like to be able to stand then check the depth of the pool.
- Toys
- check if the pool has kickboards and belts you can borrow or if you can/should bring your own. It just makes it a little more fun if you can interchange swimming with some aqua jogging.
- Program
- I am still not a great swimmer, but I do one lane breast and then return on the back with legs splashing for about 30-40 min. I aqua jog with a belt for 10-15 min. And I do different leg exercises bending, kicking to the side and front. I also just got fins that I use with a kick board. I swim for 1 hour in total. This is a program that works well for me.
- Outfit
- spend some time choosing the right swimsuit. It can be a one piece or two piece (for a woman) or a loose or tight model, long legs, or speedos for a man…there are many options. You can get little tops and shorts/skirts or swim dresses to hide scars or body parts you want to cover up. Or swimsuits that holds prosthesis securely in place. You can get swimsuits with zippers to help get it on. It gives you confidence if you feel better, if the fit is better, if it accentuates your shape and skin colour. If you want to swim for exercise, I recommend a dedicated brand that is more figure hugging and has a fabric that is more chlorine resistant and can be washed often without fading in colour. While if you just want to dip in and out then go all in for sequins and ruffles if that is your thing.
- Accessories in the pool
- swim cap (mandatory where I swim), goggles, flip flops, bath robe in microfiber to cover up from the pool to the changing rooms, a “pad” to stand on for changing, gloves for donning compression. A plastic bag for all the wet items.
- Accessories at the beach
- beach shoes, extra towels (or wash cloths to dry in between the toes for leg lymphedema), fresh water to rinse in case there is no showers, aloe vera gel, zipper bags to keep sand out of your compression.
- Compression?
- This is a big one and you should find what works best for you. Personally, I swim without compression as my leg gets a wonderful drainage. I can see how the skin literally lifts itself to allow for better drainage. When I have showered, I dry my leg and toes well. I then apply aloe vera gel as it dries quickly and gives instant hydration. I use an old(er) stocking and then either double up or change when I come home. Changing rooms are usually quite hot and I found that my skin still sweats a while after the shower, making it difficult to put the stocking on. The more I struggle the worse it gets. So, this solves it. Remember your gloves or donning device.
I now swim 2-3 times a week for 1 hour. I am so satisfied with the results for my leg but also the rest of my body – the arms, core and back. I do have some intermittent swelling in my stomach and buttock, and it seems that especially the core benefits from the swimming. I have grown several centimetres in confidence. I no longer fear going to the beach as I love swimming in the sea, and I can finally participate in this lovely family experience. I have found that it is in fact all down to good planning and my “strut the stuff” attitude.
I finally turned into a mermaid…..
Still not convinced?
A study (Gianesini 2017) involving 16 patients (12 female and 4 male) with bilateral chronic swelling investigated the effectiveness of an exercise protocol in water.
All the patients underwent a protocol of five sessions of physical exercises specifically conceived inside a pool. Volumetry, subcutaneous thickness, ankle range of motion and symptomatology were assessed as outcome measures. One week after the end of the protocol, the average reduction in lower limb volume was 303.13 ± 69.72 ml and 334.38 ± 62.50 ml in the right and left legs, respectively. Ankle range of motion and feeling of heaviness significantly improved.
The authors concluded that a specifically designed aquatic protocol is able to positively impact chronic leg swelling offering a first line rehab for this medical condition.
And for breast cancer related lymphedema? “Because the scientific data are beginning to show breast cancer patients can safely make improvements to injured muscle and cardiovascular function through aerobic and resistance exercise, swimming (which provides both) can be incorporated into the fitness regimen.” (Pittinger, E. S. et al. 2013) Read more here: https://journals.lww.com/nsca-scj/fulltext/2013/12000/Swimming_as_Exercise_Prescription_for_Breast.7.aspx
Join me in the running group for more inspiration on how to exercise with lymphedema.