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FAQs:
What is Lymphedema?
Lymphedema is defined as high-protein edema - an accumulation of water and protein in the tissues, caused by a decrease in the transport capacity of the lymphatic system. Lymphedema may be mild, moderate, or severe; most often, it affects the extremities, but can also be present in other body parts.
What is the Lymphatic System?
The Lymphatic System consists of tissues and organs that produce and store cells that fight disease and infection. They include the bone marrow, thymus, lymph nodes, and spleen, as well as the channels that carry lymph. There is a series of vessels and glands that comprise the lymph system and they are spread throughout the body similar to blood vessels. A disruption of the lymph system can eventually undermine its ability to drain fluid properly, resulting in excess fluid in parts of the body, which creates great risks of infection.
What is Lymphedema Massage Therapy?
Lymphatic drainage massage is a form of gentle massage that encourages the drainage of lymph nodes and the movement of lymph fluids around the body. It can help relieve symptoms of lymphedema.
The fluid in the lymphatic system helps remove waste and toxins from body tissues. Some health conditions can cause lymph fluid to build up.
Lymphatic drainage massages may benefit people with lymphedema, fibromyalgia, or other conditions.
What Causes Lymphedema?
Lymphedema is caused by a defect or damage within the lymphatic system. There are two types of Lymphedema: primary and secondary. Primary lymphedema is a genetic condition linked to a physical defect in the lymphatic nodes. Physical trauma that overloads the lymphatic system, such as infection, injury, or allergic reactions, can trigger primary lymphedema.
Secondary lymphedema is more common and occurs after a trauma involving the lymph nodes, such as breast, uterine, or prostate cancer, surgery, or cancer treatments. It can appear immediately or long after a medical procedure.
Another very common cause of lymphedema is Chronic Venous Insufficiency or Venous Stasis. The venous system can break down from chronic stress overload. This can cause the valves in the veins to collapse or get blocked while the water starts to accumulate, typically in the legs. The lymphatic system can initially handle the increased load, however, with time and repeated stress, the lymphatic system will give way, resulting in lymphedema.
During the first stages of chronic venous problems, a doctor may prescribe medication to control the problem. Once lymphedema sets in, the effectiveness of medication declines and a specialized lymphedema therapist should be consulted. Chronic venous problems may present with discoloration, typically a deep reddish-brown stain on the skin. Venous ulcers or wounds are common but usually respond well to treatment.
How Will the Swelling Go Down?
Complete Decongestive Therapy has been proven through research to be the most effective way to reduce swelling. This treatment includes a process for manual lymphatic drainage by a special unique massage to help the excess fluid drain out of the swollen limb or area. This therapy treatment also uses exercise to help move this fluid from your swollen tissue as well as some compression-type wraps to prevent the fluid from accumulating in the affected area.
When fluid has accumulated for a long period of time, the unique massage helps to thin out the fluid. The treatment provides a way to help move the excess fluid, via massage and exercise, to get your limbs functioning better. Compression wrapping also has been shown to be effective to prevent this fluid from sitting in your limb. The wraps change the pressure in the affected area to help keep the swelling from coming back.
What is a Lymphatic Therapist?
Lymphatic therapists, also known as edema therapists, are trained physiotherapists or medical masseurs with additional qualifications in the field of complex decongestive therapy (CDT). This therapy focuses on manual lymphatic drainage (MLD) followed by medical compression therapy for edema.
What Does a Lymphatic Therapist Do?
Lymphatic therapists perform manual lymphatic drainage as prescribed by your doctor. This very gentle type of massage uses special manipulation techniques to stimulate the absorption of accumulated fluid from the tissues into the lymphatic system. To ensure that the results of the manual lymphatic drainage are maintained, therapists usually wrap a lymphological compression bandage around the affected arm or leg afterward. If the arms or legs are already well decongested, therapy outcomes are ensured with a flat-knit medical compression stocking.
2 Main Types of Lymphedema
Yes, there are two types of lymphedema — primary and secondary.
Primary lymphedema comes from rare, inherited conditions that affect how your lymphatic system develops. Primary lymphedema affects about 1 in 100,000 people in the U.S. Lymphedema from these conditions can appear at these ages:
- Infancy: Infants may be born with Milroy’s disease, an inherited form of lymphedema.
- Puberty, during pregnancy or up until age 35: Meige’s disease (lymphedema praecox may affect people going through puberty or pregnancy and up until age 35.
- After age 35: A rare, late-onset lymphedema (lymphedema tarda) can cause lymphedema, with swelling limited to your legs.
Secondary lymphedema may happen if your lymphatic system is damaged from surgery, trauma or radiation therapy. It is most common in people who’ve had breast cancer treatment. That said, not everyone who has breast cancer treatment develops lymphedema.
Stages of Lymphedema
There are several stages of Lymphedema, and each of them is very serious. These include Stage 0, Stage 1, Stage 2 and Stage 3. Let’s look at each of them a bit more closely.
Stage 0 - Also called Latency, this stage occurs when the lymphatic vessels are damaged but not visible.
Stage 1 - During this stage, the tissue in your body is at a non-pitting stage and bounces back after pressing. It looks normal but still is suffering from the condition. (spontaneously reversible)
Stage 2 - Is denoted by spongy tissue that is called ‘pitting.’ (spontaneously reversible)
Stage 3 - Swelling becomes irreversible in the areas affected and your tissue is unresponsive and hardened. In some cases, a surgery called “de-bulking” may be required, but this is not a proven treatment method.
Signs of Lymphoedema
The main signs and symptoms of lymphoedema are:
- swelling in your arm, leg, or other affected area — clothes, shoes or jewelry may seem tighter than usual
- a feeling of heaviness or tightness in the affected area
- aching and discomfort in the affected area
- not being able to fully move your affected limbs
- pitting of the skin (gently pushing on your skin leaves an indent)
- a toughening or thickening of the skin
Many people find that the swelling gets worse:
- through the day — and then gets better overnight
- in the heat
- with overuse of the limb
- with prolonged inactivity
Goals of Lymphedema Therapy
The goals of lymphedema therapy are:
- To reduce the swelling of the affected body part
- Improve function and strength
- Reduce the chance of secondary complications
- Provide education on managing the condition and preventing future recurrences
Treatment Options for Lymphedema
Complex Decongestive Therapy (CDT) is the most common and doctoral-recommended treatment for lymphedema. It has four components:
1. MLD ( manual lymphatic drainage) – the massage therapist uses special techniques to move fluid into working lymph nodes, where they are then drained. It is crucial that this is done by a fully trained lymphedema therapist and not just a regular therapist. The therapist needs a thorough knowledge of the lymphatic system for this to work. Remember that patients who have a history of heart disease, deep vein thrombosis, or kidney disease may not be suitable for MLD.
2. MLLB ( multilayer lymphedema bandaging) – muscles surrounding lymph vessels and nodes move the fluid through the lymphatic system. Unlike the circulation of blood, there is no pump (heart) for lymph fluids, so bandaging and compression garments support the muscles and encourage them to move fluid out of the affected body part. Patients will be taught how to apply their own bandages and compression garments correctly.
3. Exercise – light exercises can encourage the movement of the lymph fluid out of the limb.
4. Skin Care – taking good care of your skin reduces the risk of infections.
Types of Lymphatic Drainage Massage
There are four types of lymphatic drainage massage commonly used by massage therapists, physical therapists, and doctors. These include.
1. Vodder. This foundational technique uses various sweeping motions around the area the therapist is treating.
2. Foldi. An extension of the Vodder technique, Foldi requires the massage therapist to alternate between circular hand motions and moments of relaxation.
3. Casley-Smith. This approach to lymphatic massage also involves circular hand motions, mainly using the sides and palms of the hands.
4. Leduc. This technique relies on hand motions to collect lymph fluid before redirecting it for reabsorption into the larger lymphatic system.
Benefits of Lymphatic Drainage Massage
All these techniques function on the same principle. They all use gentle movements to stretch the skin in the direction of lymph flow. The methods must start at the part of the limb nearest to the torso and move outward. The procedure will typically last between 15 to 60 minutes.
The massage consists of precise, skillful gestures that deftly sweep stagnant ‘waste’ towards the lymph nodes, which makes it easier for your body to eliminate the toxins – and fast. But make no mistake: it takes an expert to carry out these techniques properly, so it’s always recommended that you seek a professional to give your lymphatic system a boost. This also isn’t like your usual massage, which works to loosen knots and tension; it combines firm pressure with a specific set of motions to unlock a raft of other tangible body benefits. So, what are the benefits of lymphatic drainage massage?
1. Debloats and depuffs
Fluid retention can happen to us all. Whether around your belly or your legs, ‘water weight’ can result in puffiness and bloating that your lymphatic system may need help to clear. A lymphatic drainage massage helps to ease all that fluid away, pushing it toward the lymph nodes where it can be eliminated. This is one of many reasons you may leave your treatment feeling lighter and more energized. If you suffer from heavy legs, this is a big benefit.
2. Breaks down cellulite and fat cells
Your practitioner can target cellulite during your lymphatic drainage massage, using a clever technique that, over time, may contribute to the smoothing of dimpled skin. This manual process also aims to break down fat cells, with some people reporting that it’s helped them to lose weight faster.
3. Gives skin a glow
Massaged skin often glows because the manual gestures give your blood circulation a boost, but we haven’t just seen boosted radiance on limbs, legs, and decolletage. Some of our lymphatic drainage clients notice the skin on their face also looks more luminous – again, as a result of stimulated blood flow.
4. Helps with post-injury swelling
When you have an injury – say from working out hard in the gym – you might find the area doesn’t circulate fluids as well, which causes extra swelling. Excess puffiness may be a sign that your lymphatic system isn’t working quite as it should, so a lymphatic drainage massage could be needed to help drain some of the swellings away.
5. Optimises results after liposuction
If you’ve undergone liposuction or a body-sculpting treatment (such as CoolSculpting or EMSculpt Neo), booking in for MLD post-procedure can help to enhance the contoured results. Talk to your surgeon or practitioner first, as they may advise some downtime before you go for a massage. However, in many cases, you can visit soon after your procedure.
6. Eases tension in the body
Last but not least, a lymphatic drainage massage can be truly relaxing. The sweeping gestures and the increase of lymph flow often works wonders at easing tension throughout your body. So, if you’re feeling pent-up, you can lie back and allow your practitioner to ease away stresses, all while receiving the benefits above.
Negative Effects of Massage Therapy on Lymphedema
Most massage strokes cause an increase in arterial blood flow (active hyperemia) in skin areas where such techniques are applied. Active hyperemia is accompanied by an increase in blood capillary pressure and a subsequent increase in the ultrafiltration of water in the area of the blood capillaries. This process results in more water accumulating in the interstitial spaces. Water represents a lymphatic load. Due to mechanical insufficiency, the lymphatic system will not be able to manage this additional water load. If massage therapy to lymphedematous tissues, an increase in swelling may result.
Additionally, superficial lymphatics are extremely vulnerable to external pressure. Traditional massage techniques can cause focal damage to anchoring filaments and the endothelial lining of lymph vessels.2 This possible damage to lymphatics, and the potential increase in arterial blood flow, must be avoided.
How to Find a Massage Therapist
Like choosing other healthcare professionals, it's essential to be a conscious consumer when selecting a massage therapist. Ask your primary care provider or someone else you trust to recommend a reputable business or therapist.
Don't be afraid to ask a potential massage therapist questions such as:
- Are you licensed, certified, or registered?
- What are your training and experience?
- How many massage therapy sessions do you think I'll need?
- What's the cost, and is it covered by health insurance?
A skilled therapist has a vast toolbox of techniques that can be incorporated based on your needs, and he or she will respond and modify these techniques based on your feedback. Massage therapy is safe and effective for people of all ages. It's not only a feel-good way to indulge or pamper yourself. It's a powerful tool to help you take charge of your health and well-being, whether you have a specific health condition or are looking for a stress reliever.
Sources:
The content herein is provided for general informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Medical information changes constantly, and therefore the content on this website should not be assumed to be current, complete or exhaustive. Always seek the advice of your doctor before starting or changing treatment. If you think you may have a medical emergency, please call your doctor or 9-1-1 (in the United States) immediately.