Lymphedema is a condition of localized fluid retention and tissue swelling caused by a compromised lymphatic system. Common causes for lymphedema include the following:
- Lymph node removal and/or radiation therapy for cancer treatment
- Blood clots
- Varicose veins or venous insufficiencies
- Fractures and sprains
- Orthopedic trauma in addition to a history of lymph node removal and/or radiation
- Improperly formed lymphatic system related to congenital defects or degeneration
- Lipedema which over time can cause deterioration of the lymphatic vessels
- Congestive heart failure
Lymphedema therapy involves specialized care to reduce swelling called Complete Decongestive Therapy (CDT). CDT includes four basic components:
1) Compression applications: This may include compression garments such as sleeves, gloves, stockings or compression wraps using specialized bandaging supplies. Compression applications help to soften lymphedema so that it may move more easily through the lymphatic vessels and towards the heart.
2) Manual lymphatic drainage (MLD): MLD is a specialized manual therapy technique that softens swelling and gently stimulates the lymphatic vessels to contract and move the fluid toward the heart and out of the affected tissues.
3) Exercise: Increasing the heart rate and respiration along with compressive applications helps to stimulate the lymphatic vessels to pump harder, faster and evacuate the swelling. Exercising while bandaged helps to soften the lymphatic fluid and makes it easier to transport the fluid out of the swollen region. Exercise also helps reduce body fat which in excess can increase the risk of developing lymphedema1 and cause further deterioration of the lymphatic system2
4) Skin and nail care: People with lymphedema are at an increased risk of developing infections in the affected region. Proper skin and nail care can help reduce infections like cellulitis. In those at risk for lymphedema, cellulitis can occur years and decades after their medical treatment. This makes skin care education an essential component of therapy.
Not all physical therapists can safely treat lymphedema and proper management requires evaluation by a certified lymphedema physical therapist. Only a lymphedema specialist can determine when it is safe to return fluid from the body to the heart, lungs and kidneys. Our nationally certified lymphedema therapist will work closely with your physician to ensure your safety and overall health.
1. Sagen A, Karesen R, Risberg MA. Physical activity for the affected limb and arm lymphedema after breast cancer surgery. A prospective, randomized controlled trial with two years follow-up. Acta Oncologia, 2009. 48; 1102-1110. 2. Hespe GE, Kataru RP, Savetsky IL. Exercise training improves obesity-related lymphatic dysfunction. J Physiol, 2016. 594(15) 4267–4282
2. Hespe GE, Kataru RP, Savetsky IL. Exercise training improves obesity-related lymphatic dysfunction. J Physiol, 2016. 594(15) 4267–4282