Lymph Drainage Exercises for Lower Extremity (The James)

Lymph Drainage Exercises for Lower Extremity (The James)


Decongestive exercises are important to do to help manage your lymphedema, especially in the early phase of treatment. The exercises should be done in the following order: trunk, neck, shoulder, legs. Do 3 to 5 repetitions of each exercise. You may choose to do more, but it is important to follow them in order. It does not have to be a strong muscle contraction to work; the idea is to simply contract the muscle. If you have problems with doing these exercises, talk to your physical therapist about the changes that can be made. Your bandages or stockings should be worn during the exercises. Exercises should be done with both the affected and non-affected limb.


Abdominal Breathing Exercises - Steps to Follow:

  1. Get comfortable and relax your neck and shoulders. You can sit or lie down. Place one hand on your upper chest and place the other hand on your belly button. Use your hands to feel the movements as you breathe in and out.
  2. Take a deep breath in through your nose and feel the hand on your stomach move out. Do not let your shoulders move up. The hand on your chest should not move.
  3. Breathe out slow and gentle through your mouth. Pucker your lips as if you were going to whistle or blow out a candle. The hand on your stomach should move in as you breathe out. Breathe out as long as you can until all the air is gone.
  4. To help keep the lymphatic system moving well, practice two breaths every hour using the steps for abdominal breathing exercises.


Pelvic Tilt

  • Lie on your back with knees slightly bent and feet flat. Using your stomach muscles “tilt” your pelvis and flatten your lower back into the floor or bed. Imagine pressing down on a penny with the small of your back and count to ten. Release and repeat.


Partial Sit Up with Breathing

  • Inhale by breathing into your belly. As you exhale, slightly lift your head and shoulders off the floor, reaching forward with your hands. Be careful not to strain your neck.


Neck Exercises

Neck Rotation

  • Turn your head slowly to the right as you inhale and count to five. Return to the center as you exhale. Repeat to the left.


Head Tilt

  • Gently move your right ear toward your right shoulder, hold for 5 seconds, and then slowly bring head back to the center. Repeat on other side.


Shoulder Exercises

Shoulder Shrug:

  • Lift both shoulders towards your ears as you inhale, exhale and return to relaxed position. Next, pull shoulders down as far as possible while inhaling, exhale and return to relaxed position.



Shoulder Rolls

  • Roll shoulders back making a continuous circle.


Leg Exercises


  • Lie with both legs straight. Slide one leg up bending the knee and slide it back down. Repeat with other leg.


Leg Falls

  • Bend both knees and keep your feet flat on the floor or bed. Keep one leg in place and slowly lower your other leg out to the side. Bring your leg back to center. Repeat with the other leg.


Leg Slides

  • Lie with both legs straight. Slide your leg out to the side and return it to the center. Keep your knees straight and pointing up during the exercise. Repeat with the other leg.


Ankle Exercises

Ankle Pumps

  • Move your foot up and down as if pushing down or letting up on a gas pedal in a car. Repeat 10 times. Repeat with other foot.

Ankle Inversion / Eversion

  • Move your foot side to side. Repeat 10 times.


Toe Curls/Toe Splays

• Curl toes under, then spread toes apart.

You may want to end your exercise session with more abdominal breathing. It may also be a good idea to continue lying down and elevate your leg on a pillow while relaxing for a few minutes.



© January 27, 2022. The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute.

This handout is for informational purposes only. Talk with your doctor or health care team if you have any questions about your care.