Lymphedema – Also called lymphatic obstruction is swelling in an arm or leg caused by a lymphatic system blockage.

The condition is caused by a blockage in the lymphatic system, part of the immune and circulatory systems.  Lymphedema is most commonly caused by lymph node removal or damage due to cancer treatment.

The main symptom is swelling in an arm or leg that may be accompanied by pain or discomfort.  Exercise, wrapping, lymphatic drainage massage, and compression can help.

Symptoms

Requires a medical diagnosis.  The main symptom is swelling in an arm or leg that may be accompanied by pain or discomfort.

Pain areas: in the arms or legs or skin

Skin: dimpled skin like an orange peel or rashes

Also common: swelling in extremities, swollen lymph nodes, or water retention.

Treatments

Treatment consists of devices and therapy
Exercise, wrapping, lymphatic drainage massages, and compression

Devices
Elastic bandage: Stretchy bandages used to wrap sprains and strains.  Provides support and compression during recovery.

Compression stockings: Elastic hosiery that squeeze blood up the legs to prevent swelling and blood clots.

Self-care

Physical exercise: Aerobic activity for 20-30 minutes 5 days a week improves cardiovascular health. If injured, pursuing an activity that avoids the injured music.

Stretching: Stretching exercises can improve flexibility and improve physical function.

Moisturizer: Hydrates and protects skin from damage.

Specialists

Lymphatic Drainage Massage Therapist: Is a specially qualified practitioner trained in Lymphatic Drainage Massage.  Lymphatic Drainage Massage can help promote the circulation of lymph, reduce swelling, associated pain and discomfort.

Occupational Therapist: Improves daily living and work skills of patients.

Physical Medicine and Rehabilitation: Restores function and quality of life to those with physical disabilities.

Physical Therapist: Restores muscled strength and function through exercise.

Primary Care Provider (PCP): Prevents, diagnoses, and treat diseases.

Manual lymphatic drainage (MLD), also known as lymphatic massage or lymphatic drainage, is a gentle massage modality that addresses a buildup of lymph fluid in the extremities. This condition, called lymphedema, is caused by blockages in the lymphatic system. It’s often a side effect of cancer treatment, lymph node removal, infection in the lymph nodes, or pregnancy. Its first stage has a classic presentation called ‘pitted edema.’ If you press your finger into the affected area, it will live a temporary ‘pit’ instead of bouncing back. Its most severe stages, cause the effected limb to look engorged and leathery.

In a healthy body, contractions of lymph vessels and the movement of skeletal muscles circulates lymph, moving immune cells and collecting waste products. Lymph is swept to the lymph nodes and drains into the circulatory system for the body to process. The goal of MLD is to encourage the natural flow to lymph toward the lymph nodes and reduce fluid buildup.

Manual lymphatic drainage was originally developed in the 1930s by Drs. Emil and Estrid Vodder. While working with patients suffering from chronic colds, the Vodders noticed their patients frequently suffered from swollen lymph nodes. Not much was known about the lymphatic system in the thirties, and the Vodders dedicated their practice to studying lymph flow. They introduced their light, rhythmic drainage technique in 1936 and began teaching as a complementary therapy after World War II. The Vodder method is a school of MLD still used today.

How Does Manual Lymphatic Drainage Massage Work?

Lymph vessels are a mesh of tiny, thin-walled structures that are encouraged to drain under specific conditions. About 70 percent of them are located just below the skin. Lymphatic massage therapists focus on lymph flow and work with the action of these capillaries for maximum potential benefit.

Manual Lymphatic Drainage massage sessions are slow, gentle and rhythmic. The practitioner uses just enough pressure, about 1 to 4 ounces, to manipulate the skin and the lymph vessels just below it without pushing the vessels closed. The movements smoothly push and “stretch” the tissue to encourage fluid flow. The slow pace gives the fluid time to pass from vessel to vessel efficiently.

Benefits of Manual Lymphatic Drainage Massage

Lymphedema can have a significant impact on quality of life. Manual Lymphatic massage therapy on its own is meant to alleviate mild, or Stage 1, lymphedema. Because lymphedema can have a serious impact on other structures like blood vessels, clients seeking MLD should have a doctor’s approval before receiving treatments.

Key lymphatic massage benefits can include:
• Reduction of swelling
• Improved range of motion
• Relief from swelling-induced discomfort
• Relief from feelings of stress, anxiety and depression
• Boosts in confidence

Utilizing Lymphatic Massage Techniques

Many lymphatic massage therapists offer MLD as a stand-alone session. These sessions typically last 60 to 90 minutes. In cases of acute lymphedema, such as following surgery, some clients may seek 30-minute sessions once a day for several weeks. These short sessions can also be combined with other modalities to form a complete treatment plan.

MLD is an excellent complementary therapy to incorporate to other massage sessions either as a matter of routine or as a 30-minute add-on treatment. Because it’s often caused by cancer, it can be offered alongside oncology massage. It can be tailored into pregnancy massage sessions or the sports massage of a young athlete with hereditary lymphedema.

Teaching clients self-care techniques is a common part of MLD sessions. Self-care can help extend the effectiveness of a professional session and help clients with chronic lymphedema regain a sense of control over their bodies.

Lymphatic Massage vs Complete Decongestive Therapy

Lymphatic massage is a mild therapy, and on its own is best for the first and mildest stages of lymphedema. For more advanced cases, a comprehensive technique called complete decongestive therapy (CDT) is often recommended.

CDT is an aggressive protocol of lymphatic massage, bandaging, compression garments, exercise, and self-care performed under a doctor’s supervision. It’s meant to wrestle lymphedema under control and then maintain the results. It’s split into two phases. Phase One lasts 3 to 6 weeks and involves controlling moderate to severe swelling. Phase Two is an ongoing self-care protocol tailored to maintain the results. Performing CDT requires in-depth, specialized training beyond that of manual lymph drainage techniques alone.

What is Post-op Lymphatic Massage Therapy

Post-Op Lymphatic Massage Therapy (POLMT) is a hands-on therapy that uses gentle manual pumping and drainage techniques to simulate a specific wave-like movement to stimulate fluid motion and aid in the recirculation of blood and lymph. These subtle manual maneuvers activate lymph and fluid circulation and stimulate the function of the immune system. Therapy includes infrared and ultrasound for less fluid retention, reduction of inflammation, and improves bladder control.

• Pre & Post-Op Surgery
• Liposuction
• Mommy Make Overs
• Tummy Tucks
• Breast Reconstruction
• BBL (Brazilian Butt Lift)
• Tissue Fibrosis
• Gynecomastia Surgery
• Vaser 360 Lipo
• Male BBL
• Pectoral Fat Transfer

Lymphatic Balancing MD Therapy has been shown to help:

• Super boost your immunity
• Release toxic fluid build-up
• Faster Recovery
• Decrease acute and chronic pain
• Reduce edema and lymphedema (primary, secondary, and post-surgical)
• Release muscle spasm and decrease joint pain
• Reduction symptoms of chronic fatigue syndrome
• Reduce symptoms of fibromyalgia
• Decrease headaches
• Induce deep relaxation to aid insomnia, stress, and loss of vitality
• Increase circulation for amputees
• Increase function after sports injuries

What is a Medical Therapeutic Massage?

Medical Massage will produce tangible results. Medical massage therapy treatment is planned out with a specific goal in mind, and your massage will factor into a larger treatment plan that is based around your health needs and goals. Sessions can be 30, 60, and 90 minutes. 30-minute sessions are focused on one area of the body. 60-to-90-minute sessions allows enough time to work over all the major areas of the body like the back, shoulders, legs, feet, arms, hands, and neck.

Medical Massage is a Complementary Therapy

Medical massage therapy should be seen as complementary to the work of your medical practitioner – you should always get a medical diagnosis for any health problem before you use massage therapy. You should also tell your doctor if you are using complementary alternative therapies, including medical massage. This will help him or her to understand and track your progress and any improvements in your overall health.

Benefits of Medical Massage

It can ease discomfort and pain on a number of medical issues that are either chronic (meaning they last a long time) or acute (a medical issue that has happened recently and can be cared for in the near future.)

These issues can include:

• Repetitive stress injuries from sitting or standing postures that are held for several hours a day.
• Migraines, cluster headaches, tension headaches or sinus headaches.
• Whiplash
• Temporomandibular joint and muscle disorder
• Strains and sprains (after inflammation has gone down).
• Low back pain
• Tendonitis
• Radiating pain
• Post-surgical scar tissue
• Frozen shoulder

What is lipedema?

Lipedema is a relatively common fat disorder that is often mistaken for simple obesity. Its clinical diagnosis is an adipose tissue disorder or a lipid metabolism disorder. A typical lipedema patient is a woman who struggles with large hips and legs, usually out of proportion to the rest of her body. Lipedema also appears in the upper arms. One of the hallmarks of the disease is that lipedema fat is relatively unresponsive to standard diet and exercise. These measures may lead to weight loss in other areas, but the size of the hips and legs remains disproportionately large.

Lipedema is a disorder of adipose tissue distinguished by five characteristics:
1) it can be inherited;
2) it occurs almost exclusively in women;
3) it can occur in women of all sizes, from the seriously underweight to the morbidly obese;
4) it involves the excess deposit and expansion of fat cells in an unusual and particular pattern – bilateral, symmetrical and usually from the waist to a distinct line just above the ankles; and
5) unlike the “normal” fat of obesity, lipedemic fat cannot be lost through standard diet and exercise.

Early tell-tale signs of Lipedema are the development of a cuff around the ankle where the fat distribution stops (the foot is usually normal size)’ extreme sensitivity, pain, swelling, and easy bruising.

In later stages of Lipedema, the leg typically develops s column-like shape, and the skin begins to pucker.

As the disease progresses, the skin begins to develop hanging folds, and in the final stages the fat distribution can become serve enough to greatly impede mobility.

In the final stages, the fat and fascia can impede the flow of lymph by constricting the lymphatic vessels. When this happens, a secondary condition know as Lymphedema develops, When a person has both Lipedema and Lymphedema, the condition is then called Lipo-Lymphedema.

4 Stages of Lipedema

Stage 1: Skin surface smooth, subcutaneous fat thickened, fat structure fine knotted

Stage 2: Skin surface uneven, fat structure coarsely knotted

Stage 3: Tissue additionally coarser and harder, large lobed deforming fat lobes

Stage 4: Additional severe lipolymphedema

4 Stages of Lymphedema

Lymphedema is a progressive disease and develops in stages which can be categorized according to severity.

• Stage 0: the Latency Stage. A subclinical state where swelling is not evident despite impaired lymph transport. …
• Stage 1: Mild Stage. …
• Stage 2: Moderate Stage. …
• Stage 3: Lymphostatic Elephantiasis (Severe Stage)

Stages

• Stage 1: Abnormal flow in the lymphatic system. No signs or symptoms.
• Stage 2: Accumulation of fluid with swelling. …
• Stage 3: Permanent swelling that does not resolve with elevation. …
• Stage 4: Elephantiasis (large, deformed limb), skin thickening with “wart-like” growth and extensive scarring.

Lymphedema and lipedema (also known as lipoedema) are two distinct medical disorders even though both involve swelling in the arms and legs. In short, Lymphedema is a disorder of the lymphatic system and is commonly caused by dysfunction in the flow of lymph fluid through the arms or legs. Lipedema in contrast, does not involve the lymphatic system, but it is a pathologic, mostly symmetric deposition of fat that most often affects the lower extremities and almost exclusively occurs in women.

Lymphedema

• A disorder of the lymphatic system
• Blockage of lymphatic drainage causes tissue inflammation/damage
• Usually occurs after cancer treatment, but can be spontaneous (congenital)
• Usually affects one arm including fingers; one leg including feet and toes.
• Often associated with severe infections (cellulitis)
• Should be treated by a certified lymphedema therapist
• Worsened by obesity
• Can be caused by morbid obesity

Lipedema

• A disorder involving pathologic fatty deposits in legs and sometimes arms
• May be successfully treated by a Lipedema plastic surgeon
• Occurs spontaneously but may affect multiple family members
• Usually affects both legs and/or both arms equally
• Fatty deposits usually are painful
• May result in walking/gait abnormality and skeletal issues over time
• May benefit from treatment by a certified lymphedema therapist (CLT)
• Worsened by obesity
• May or may not be associated with obesity
• May be associated with lymphedema as well, especially in the legs