Yoga and Its Impact on Lymph Flow

Practicing yoga to help activate flow through the lymphatic system

When most of us think of circulation, we attribute it to blood flow, weaving through our arteries and veins. Circulation also applies in the process of lymph fluid moving through our lymph nodes and vessels. As blood flows through capillaries, water, proteins, waste, and other materials can escape as they are not completely reabsorbed.[1] Our blood cardiovascular system could not function properly without our lymphatic system, as it helps to collect the escaped fluid between tissues and helps return it back to the blood.[2] We don’t think too much about the lymphatic system as it is not wholly defined by definitive arteries and veins, rather it is comprised of lymph nodes that contain disease-fighting immune cells as well as organs like the spleen and thymus that help fight off infections. The lymph nodes are connected by lymphatic vessels that are similar to veins with thin walls and contain valve structures. The lymph fluid is propelled in one direction back to the heart through contractions of both smooth muscles and skeletal muscles.[3] It will re-enter the blood circulation at the site of the veins. When problems arise in this fluid collection system, this can cause a type of swelling referred to as lymphedema.[4]

Lymphedema has several underlying causes, but two common ones are due to the removal of lymph nodes or an underlying infection.[4] Many of the removals of lymph nodes are from cancer surgeries. In breast cancer patients, lymph nodes are removed usually to help determine if the cancer has spread. While this can be beneficial for the surgery and lead to patient peace of mind in knowing whether the cancer has spread, it can also remove some lymph nodes that were important for the removal of interstitial fluids.

If the lymph nodes are not present and unable to aid in the removal and drainage of fluid, this can lead to an excess of fluid around the tissues and cause swelling and edema. While the increase in blood flow from exercise can lead to excess fluid leakage, certain forms of exercise can help alleviate swelling.[3] For an exercise treatment plan, aerobic training, flexibility training, and strength training all can improve lymphedema.[5-7] One such exercise that combines all three of these aspects is yoga.


Background on Yoga

Yoga can help with improving the lymphedema, as it can help with the muscular aspect of isometric muscular contractions to help improve the circulation and limb elevation.[9] In patients suffering from lymphedema of the legs, their condition can change the way they walk as well as lead to joint deformities. Yoga can help improve these problems, as yoga helps reduce the inactivity and aid in muscular strengthening.[10,11] For patients suffering from upper limb lymphedema due to breast cancer treatment, yoga has helped improve posture as well as strength.[12] Yoga has mental benefits too. Breast-cancer survivors noted that yoga helped not only improve their physical well-being but also their mental and social well-being.[13] Yoga helps in multiple ways that include the physical, emotional, and mental states.


Yoga Is Helpful for Lymph Flow

In the course of yoga flow, many of the muscle contractions involved in the practice are either static or dynamic poses. Static poses utilize isometric muscle contractions, where a pose is held for a period of time and the muscle generates force without changing length. The dynamic poses of yoga involve the extension and flexion of muscles in and out of static poses.[8] In an exercise study examining lymph clearance rate, participants had a higher clearance rate of lymph from legs during isometric contractions of extended legs than the clearance rate of flexed legs.[3]

Limb elevation is traditionally recommended to help improve lymphatic drainage and reduce lymph load received, but usually only at night due to concerns about limiting function and exercise.[4] Yoga can combine both limb elevation and muscular contractions to benefit from both options.


Yoga Poses

Here are several possible poses to include in your practice if you are suffering from leg swelling. 

Boat Pose

Boat pose in yoga helps improve lymph flow 

(Reproduced with permission: EkhartYoga.com)

Locust Pose

 Locust pose in yoga helps improve muscle contraction and lymph flow

(Reproduced with permission: EkhartYoga.com)

Supported Shoulder Stand Pose

Supported shoulder stand pose in yoga helps lymph flow drain fluid from legs 

(Reproduced with permission: EkhartYoga.com)

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  1. Bazigou E, Wilson JT, Moore JE. Primary and Secondary Lymphatic Valve Development: Molecular, Functional and Mechanical Insights. Microvasc Res.2014;96:38-45; PMID: 25086182 Link to research.
  2. Sherwood L. Human Physiology: From Cells to Systems. 8 ed: Cengage Learning; 2012.
  3. Havas E, Parviainen T, Vuorela J, et al. Lymph flow dynamics in exercising human skeletal muscle as detected by scintography. J Physiol.1997;504(Pt 1):233-239; PMID: 9350633 Link to research.
  4. Lymphedema - approach to the patient | DynaMed Plus. 2017; Link to research. Accessed July 28, 2017.
  5. Kerchner K, Fleischer A, Yosipovitch G. Lower extremity lymphedema update: pathophysiology, diagnosis, and treatment guidelines. J Am Acad Dermatol.2008;59(2):324-331; PMID: 18513827 Link to research.
  6. Rockson SG. Diagnosis and management of lymphatic vascular disease. J Am Coll Cardiol.2008;52(10):799-806; PMID: 18755341 Link to research.
  7. Lymphology ISo. The diagnosis and treatment of peripheral lymphedema: 2013 Consensus Document of the International Society of Lymphology. Lymphology.2013;46(1):1-11; PMID: 23930436 Link to research.
  8. Srinivasan T. Dynamic and static asana practices. Int J Yoga. Vol 92016:1-3.
  9. Tiedemann A, O'Rourke S, Sesto R, et al. A 12-week Iyengar yoga program improved balance and mobility in older community-dwelling people: a pilot randomized controlled trial. J Gerontol A Biol Sci Med Sci.2013;68(9):1068-1075; PMID: 23825035 Link to research.
  10. Aggithaya MG, Narahari SR, Ryan TJ. Yoga for correction of lymphedema's impairment of gait as an adjunct to lymphatic drainage: A pilot observational study. Int J Yoga.2015;8(1):54-61; PMID: 25558134 Link to research.
  11. Narahari SR, Aggithaya MG, Moffatt C, et al. Future Research Priorities for Morbidity Control of Lymphedema. Indian J Dermatol.2017;62(1):33-40; PMID: 28216723 Link to research.
  12. Loudon A, Barnett T, Piller N, et al. The effects of yoga on shoulder and spinal actions for women with breast cancer-related lymphoedema of the arm: A randomised controlled pilot study. BMC Complement Altern Med.2016;16:343; PMID: 27590865 Link to research.
  13. Loudon A, Barnett T, Williams A. Yoga, breast cancer-related lymphoedema and well-being: A descriptive report of women's participation in a clinical trial. J Clin Nurs.2017;10.1111/jocn.13819PMID: 28334470 Link to research.