Exercise and Physical Activity with a Vascular Access Device

Physical activity is beneficial for almost everyone, including most patients with vascular access devices. Staying active helps maintain strength, improve mood, support immune function, reduce fatigue, and aid recovery. The goal is to find what you can do safely — not to focus entirely on what you cannot.

This guide explains activity guidelines by device type and helps you find a sustainable approach to staying active during treatment.

Why Activity Matters During IV Therapy

Research consistently shows that physical activity — even light activity — during cancer treatment, prolonged infection treatment, and other IV-dependent conditions:

• Reduces treatment-related fatigue
• Improves mood and reduces anxiety and depression
• Helps maintain muscle mass and functional strength
• Supports cardiovascular health
• May reduce the risk of blood clots (DVT)
• Improves sleep quality
• Enhances quality of life

The question is not whether to stay active, but how to do it safely with your specific device.

General Principles for All Devices

Pain is a signal: Stop any activity that causes pain at your catheter site, along the arm with the device, or in the chest. Report it to your care team.

Protect the site from water: No swimming or submersion for any patient with an external catheter exit site (PICC, midline, tunneled catheter, accessed port). This is a firm restriction.

Protect against direct trauma: Avoid activities where the catheter, exit site, or dressing could be hit, snagged, or pulled.

Tell your care team: If you want to return to a specific sport or activity not mentioned here, ask your vascular access nurse or physician. They can advise based on your specific device and condition.

Activity by Device Type

Peripheral IV (PIV)

When not infusing: No specific activity restrictions from the IV itself. The IV is typically in place for only a few days; resume normal activities.

During an infusion:

• Keep the infused arm relatively still — bending the elbow of the infusion arm can trigger pump alarms (occlusion)
• Light walking and gentle movement are fine
• Vigorous upper arm activity with the IV arm is not appropriate during active infusion
• Avoid blood pressure cuffs on the IV arm

Midline Catheter

Midlines allow more activity than PICCs in general, but some care is warranted:

Permitted:

• Normal daily activities, walking, light exercise
• Driving and most routine activities
• Gentle stretching and yoga (avoiding aggressive reaches or poses that apply tension to the upper arm)

Restrict:

• Heavy lifting with the midline arm (over approximately 10 lbs / 4.5 kg repeatedly)
• High-resistance upper arm exercise (bicep curls, rowing, pull-ups)
• Swimming, submersion, or water sports
• Contact sports or activities with direct arm impact risk

PICC Line

The PICC has the most activity restrictions among external catheters. The catheter tip sits near the heart; significant upper arm muscle activity can potentially shift the catheter or cause problems.

Permitted:

• Walking at any pace — excellent exercise; highly encouraged
• Cycling (stationary or outdoor — wear a long sleeve over the dressing in windy/dirty conditions)
• Lower body strength exercises (squats, lunges, leg press)
• Light upper body work with the non-PICC arm
• Yoga with modifications (avoid poses that heavily load or stretch the PICC arm)
• Golf — discuss specific swing mechanics with your team if the PICC is in the dominant arm
• Most activities of daily living

Restrict:

• Lifting heavy objects repeatedly with the PICC arm (general guidance: avoid repeatedly lifting over 10 lbs / 4.5 kg with the PICC arm)
• Upper body gym work targeting the PICC arm (bicep curls, shoulder press, overhead activities, chin-ups, push-ups placing weight on the PICC arm)
• Aggressive or repetitive overhead reaching (e.g., painting a ceiling, overhead shelf work) with the PICC arm
• Stretching the PICC arm forcefully behind the back
• Swimming, pools, hot tubs, open water — not permitted
• Contact sports with risk of blow to the PICC arm or dressing dislodgement

Why these restrictions? The concern is that vigorous upper arm muscle contractions increase intramuscular pressure and venous return in a way that can stress the PICC and, in some cases, contribute to thrombosis. Light to moderate activity is not only safe but encouraged.

Tunneled Catheter (Hickman/Broviac/Groshong)

Similar to PICC restrictions during the healing phase; somewhat more liberal once fully healed:

First 4–6 weeks after placement (cuff healing):

• Follow guidance equivalent to PICC restrictions
• No activities that stretch, pull, or apply tension to the exit site or tunnel area
• No heavy lifting

After cuff fully healed:

• Most daily activities and moderate exercise are permitted
• Walking, cycling, lower body exercise — unrestricted
• Light to moderate upper body work is generally fine
• Avoid heavy repetitive resistance work on the catheter side
• Swimming remains restricted (exit site cannot be submerged)
• Contact sports — discuss with care team

Implanted Port (not accessed / no needle in place)

The implanted port allows the greatest activity freedom of all central access devices when not in use. With no external tubing or dressing:

Permitted (when not accessed):

• Swimming in pools, ocean, lakes — fully permitted
• All forms of exercise including high-intensity cardio and strength training
• Contact sports (note: a direct, hard blow to the port chest area should be avoided; most normal contact is fine)
• Yoga, pilates, stretching without restriction
• Water sports
• Essentially normal physical activity

Discuss with care team if:

• You participate in full-contact sports where the port could sustain a direct, hard impact (hockey, combat sports, football with significant tackling)
• You plan deep-sea diving or activities with significant pressure changes
• You have persistent discomfort from a shoulder strap or harness over the port

When the port is accessed (needle in place, receiving an infusion):

• Restrict vigorous arm movement on the port side
• Avoid getting the access site wet
• No activities that could dislodge the needle or dressing

Dialysis Access (AV Fistula / AV Graft)

The fistula/graft arm has specific and permanent restrictions:

• No blood pressure cuffs ever on the access arm
• No compression (tight sleeves, watches, accessories)
• No heavy resistance exercise with the access arm (may promote vascular changes)
• Swimming is generally permitted once the fistula is mature and post-needle sites have fully healed — ask your dialysis team
• Avoid sleeping on the access arm

Returning to Exercise After Catheter Placement

After any catheter is placed, you may need a brief period of reduced activity at the insertion site:

Swimming: A Special Consideration

Swimming is one of the most common questions from patients with vascular access devices.

Physical Therapy and Rehabilitation

If you are receiving physical therapy during a period of vascular access use:

• Tell your physical therapist about your device before any session begins.
• Your PT should avoid:
  • Applying resistance or manual techniques to the PICC arm that would stress the insertion site
  • Blood pressure cuffs on the PICC or fistula arm
  • Vigorous manual therapy directly over any catheter insertion or exit site
• Many PT exercises can be modified to accommodate a PICC or catheter while still achieving therapeutic goals.

Benefits of Staying Active: A Note for Discouraged Patients

If your condition or treatment has significantly reduced your activity level, it can feel demoralizing to think about exercise at all. A few key points:

Start where you are. Even 10 minutes of gentle walking once daily is meaningful. There is no minimum threshold to benefit.

Some is much better than none. You do not need to maintain your pre-illness fitness level to benefit from activity during treatment. Any increase in activity over being completely sedentary is positive.

Activity is not the same as exercise. Walking to the kitchen, taking the stairs, doing light housework — all count.

Listen to your body. Some days you will have energy and others you will not. Rest when you need to. Do not push through severe fatigue, chest pain, or significant shortness of breath.

Ask for help. A physical therapist or exercise physiologist who specializes in cancer rehabilitation or medically complex patients can design a program that fits your specific situation.

Related Guides in This Series

• Going Home with a PICC Line
• Going Home with an Implanted Port
• Living Well with Long-Term IV Therapy
• Travel with a Vascular Access Device
• Skin Care Around Your Catheter Site

This guide is for educational purposes. Activity restrictions are individualized — always follow the specific guidance of your vascular access nurse, physician, and physical therapist for your situation.