MANUAL LYMPH DRAINAGE

Manual Lymph Drainage (MLD) is a gentle slow repetitive technique performed on skin. It’s profound but subtle effects on the body have been scientifically proven to assist lymph flow and aid in drainage of tissues.  Its’ main effects are to decongest tissues of waste products, alleviate pain, have a calming effect on the body and indirectly it may affect the immune system as bacteria and allergens are transported to lymph nodes where they can be neutralized.

Benefits

MLD is beneficial for a range of conditions such as:

  • Orthopaedic & Musculoskeletal Conditions (Fractures, Dislocations, Haematomas, Sports Injuries)
  • Pre & Post Surgery (Joint Replacement, Cancer, Plastic & Reconstructive, Scar Treatment)
  • Neurological Conditions (Migraine, Concussion, Stroke, Headache)
  • Chronic Inflammations (Sinusitis, Rhinitis, Bronchitis, Acne, Rosacea, Arthritis, Complex Regional Pain Syndrome, RSI)
  • Circulatory Problems (Venous Ulcers, Swollen Limbs)
  • Lymphoedema /Lipoedema

Pre & Post Surgery Benefits

Enhances recovery so that you can return to normal activities sooner.

MLD preoperatively decongests the tissues of excess fluid and waste products to improve the health of the tissues and relaxes the body in preparation for surgery.

Post-surgery it drains local swelling created by inflammation and removes cell debris which causes bruising. The gentle rhythmic technique of MLD blocks pain messages, and through decongestion relieves pressure and tension on pain receptors in the tissues further reducing pain. Scars become, smaller, softer and less visible. Regular MLD can reduce discolouration, itching, tension, encourage flattening of the scar, blood vessel growth and eliminate fibrosis. MLD also stimulates the formation of new lymph vessels.

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LYMPHOEDEMA

Lymphoedema is a swelling in the tissues in one or more parts of the body caused by a build – up of fluid and proteins and is a sign that the Lymphatic System is not working properly.

What Causes Lymphoedema?

This can be the result of a Primary Lymphoedema caused by congenital conditions resulting in a poorly formed Lymphatic System. Swelling is typically seen in the lower extremities. 1 in 6,000 people develop Primary Lymphoedema.

The most common cause of Lymphoedema is called Secondary Lymphoedema and may develop after any type of surgery or cancer treatment, where there has been damage to the lymphatic system, removal and / or radiation to lymph nodes. Secondary Lymphoedema may also occur in conjunction with traumatic injuries, Venous Disease, Infections such as Cellulitis, Immobility and Obesity. According to the Centres for Disease Control and Prevention (CDC) the incidence amongst cancer survivors is between 20-40%. Swelling after the treatment for Breast cancer may be seen in the arm or chest on the operated side. In Prostate, Uterine and Pelvic cancer, it may develop in one or both legs and the pelvis. Lymphoedema can also occur after Malignant Melanoma, Sarcoma and Head and Neck Cancers.

Unfortunately the risk of developing Lymphoedema does not reduce with time but is a lifelong risk.

How Can Lymphoedema Be Treated?

Lymphoedema is a Chronic Progressive Condition with a number of stages from mild to severe. Treatment is most effective in the early stages.  In the early stages symptoms may include heaviness with or without swelling, aching, tightness in the tissues, reduced range of movement and sometimes pain. People may notice that clothing and Jewellery have become tight. Symptoms in a limb or body part may increase as the day progresses but then reduce overnight. Symptoms can increase with over use, prolonged inactivity or heat.  As the condition progresses skin begins to thicken and tissues become firm. Early intervention is recommended to reduce symptoms and its progression.

Lymphoedema Therapy

Management of Lymphoedema is known as Combined or Complex Decongestive Therapy (CDT) and consists of Manual Lymph Drainage (MLD), Compression Bandages/Garments, Exercise and Skin Care and is divided into an intensive and maintenance stage. The aim is to reduce symptoms by increasing Lymph flow from congested areas, reducing tissue changes and the risk of infection whilst improving range of movement and quality of life. Laser Therapy and Lymphatic Taping are incorporated as required. CDT is also beneficial for Lymphoedemas of mixed origin such as Phlebolymphoedema (Chronic Venous-Lymphatic Insufficiency/oedema) and Lipolymphoedema (Combination of Lipoedema and Lymphoedema).

Manual Lymph Drainage

This is to clear the backlog of lymph, help the lymphatic system to work better and redirect lymph to nearby healthy lymph vessels. This is a light technique but firmer techniques are also used to help soften tissues that have become firm.

Compression Bandaging/ Garments

In the intensive CDT stage a multi- layer re-useable bandaging system is used which consists of a cotton layer, a foam bandage layer followed by short stretch compression bandages. The bandages are applied following MLD and remain on throughout the day and night. They are removed the following day to allow for showering or bathing. MLD is repeated and bandages reapplied. CDT is performed daily and generally lasts between 2 – 4 weeks or until the affected limb or area has been decongested as much as possible. Progress is checked by measuring limb volume. In the maintenance phase which follows the intensive phase, clients are fitted with medical compression garments which are generally worn all waking hours. Compression bandages and garments help to improve the pumping of the veins and lymph vessels, prevents lymph fluid from refilling in the limb, maintains any reductions gained during MLD and softens areas of firm tissue.

Exercise

Daily exercise when wearing compression bandages increases the uptake of lymph in the tissues and improves the pumping of the lymph vessels when the muscles contract and relax against the pressure exerted by the compression bandages. Appropriate methods of exercise will be discussed with you.

Skin care

Ensuring the skin is as healthy as possible reduces the risk of infection such as keeping skin well moisturised with a pH neutral non fragranced moisturiser and taking care to reduce the incidence of skin damage during certain activities.

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LIPOEDEMA

Lipodema is a chronic progressive disorder of adipose tissue which almost exclusively affects women. It is estimated that around 11% of the adult female population have Lipoedema. It generally presents as bilateral symmetrical accumulation of fatty tissue from the hips to the ankles whereby the lower body is disproportionately larger than the upper body however it may also occur in the arms. The feet and hands are not affected. Lipoedema is poorly recognised and can be misdiagnosed as obesity or Lymphoedema and often delays early management.

Symptoms

Symptoms include heaviness, tightness, easy bruising due to fragile blood capillaries with increased fluid accumulation in the legs as the day progresses. Tissues tend to be highly sensitive to pressure and touch. Exercise and dieting does not significantly reduce the excess adipose tissue.  Lipoedema can progress through various stages from a smooth nodular texture in early stages to an uneven appearance like “orange peel” and in later stages larger fatty lobules on the outer thighs and medial knee develop which can effect joints and mobility. The increase in adipose tissue may obstruct lymph flow leading to Lipolymphoedema and fluid will begin to accumulate in the feet.

What Causes Lipoedema?

The cause of Lipoedema is unknown however it is thought that it is associated with inflammation, hormonal disorders with it developing at either puberty, during pregnancy, at menopause or following gynaecological surgery. A hereditary component is also suspected as it can be seen in other female family members.

How Can Lipoedema Be Treated?

There is no cure for Lipoedema however it can be managed through conservative and surgical methods. Conservative treatment is aimed at easing symptoms of fluid accumulation, pain and reducing its progression by stimulating lymphatic flow.  It comprises Combined Decongestive Therapy (CDT – Manual Lymph Drainage, Compression Bandaging/Garments, Exercise and Skin Care) as in the treatment of Lymphoedema. Maintaining a healthy diet is important even although dieting does not reduce Lipoedema as additional weight in non-affected areas will make the symptoms of Lipoedema worse. Conservative measures of CDT do not reduce the excess adipose tissue and surgical methods using Tumescent Liposuction by Surgeons knowledgeable about Lipoedema and the Lymphatic System may be beneficial for some people in addition to the supportive measures of CDT post operatively.

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LYMPH TAPING

Lymph Taping is used in conjunction with MLD to stimulate fluid movement in the skin to reduce swelling post injury/ surgery and can also be used as part of the management for Lymphoedema, Lymphoedema of mixed origin and Lipoedema. Taping maintains the effects of MLD and continues to stimulate decongestion of tissues between sessions. It remains effective for as long as the tape is on the skin which is generally 5-7 days and tolerates showering and swimming.

Effects

Lymph Tape is a highly elastic latex free adhesive tape made of 100% cotton which allows it to work with the soft tissues of the body rather than restricting them.

It is applied to stretched skin and when the body returns to its’ resting position the recoil of the tape creates convolutions which lifts the epidermis of the skin. This creates space in the dermis where the initial lymph vessels, blood vessels and nerve receptors are found. Pressure in the tissues beneath the tape is less than areas where tape has not been applied and fluid moves from higher pressure areas towards the tape. Movement during daily activities and exercise moves the skin creating pressure differences beneath the tape. This has a micro massage effect stimulating transport of fluid and directing it away from swollen areas thus reducing pain and irritation.

LASER THERAPY

The LTU-904 is an infrared Low Level Laser used for muscular skeletal conditions, pain relief and Lymphoedema. Its invisible wavelength penetrates deeply into tissues and does not generate any heat making it suitable to use post injury or surgery and with Lymphoedema. It is used in conjunction with MLD and CDT.

Effects

The Laser energises cells such as Fibroblasts and Macrophages which are important in wound healing. Treated wounds show

  • Reduced scar formation
  • Reduced pain and inflammation
  • Increased collagen and reduced cellular substances
  • Increased epithelial activity
  • Increased capillary blood vessel formation.
  • In Lymphoedema the Laser can
    • Soften fibroses and scar tissue
    • Reduce limb volume over time
    • Improve symptoms of tightness, heaviness and pain

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