Manual Lymphatic Drainage (MLD)
MLD uses a range of specialised and gentle rhythmic pumping techniques to move the skin in the direction of lymph flow. This stimulates the contraction of the lymphatic vessels thereby increasing lymph flow and thus the rate of removal of waste products, toxins and excess fluid from the body’s tissues.
As part of Combined Decongestive Therapy (CDT) for lymphoedema it is superb. The gentle technique assists in the removal of fluid from the affected limb by opening other lymphatic pathways within the body that will carry the excess fluid away.
No oils or powders are used so it is completely safe for those with sensitive skins. For pregnant women this is one of the safest massages available as absolutely nothing can be introduced to upset the developing foetus.
As a pre and then post operative treatment it is unparalleled in its ability to ease most of the tissue swelling associated with surgery and so speed the healing rate of damaged structures.
Used prophylactically following any surgery involving lymph node removal and/or radiotherapy treatment it can prevent secondary lymhoedema from developing.
It has spectacular results for congestion problems for example sinusitis, and has a pain relieving effect so can be used with recent trauma such as sports injuries. Patients find the techniques soothing and relaxing with no side effects.
Other conditions for which MLD is effective:
| • Scars |
• Traumatic oedema |
• Sinus congestion |
| • Burns |
• Strains |
• Tinnitus |
| • Ulceration wounds |
• Sprains |
• Menieres syndrome |
| • Venous stasis |
• Whiplash |
• Migraines |
| • Acne and Rosacea |
• Arthritic conditions |
• Constipation |
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Compression Therapy
This is an essential tool in the management of lymphoedema. It can maintain and enhance the results achieved by Manual Lymphatic Drainage (MLD) and keep the swelling down long term. Initially compression therapy may need to be used both day and night but once the limb stabilises a compression garment is usually only worn by day.
There are two types of compression therapy.
Compression Bandaging
This is done for a short period of time during an active management phase (1-3 weeks). It is useful in reducing limbs that are particularly large or hard. Bandages conform to the shape of the limb as swelling reduces.
Compression Garment
Compression garments are more practical than bandages and more comfortable to wear once the limb is a more normal size. They are made of an elastic fibre that allows for a non-bulky and natural limb contour.
Compression garments can be ready made or custom made, a therapist can advise on the best choice to ensure the best fit.
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Skin Care
Unfortunately lymphoedema and venous insufficiency predisposes to various skin problems. Good skin care is important and helps to ensure that the skin continues to act as a barrier against organisms and reduce the risk of infection.
Normal skin secretes sebum which keeps the skin soft and supple and inhibits the growth of bacteria. The skin of a lymhoedematous limb or a limb at risk of developing lymphoedema is prone to dryness causing the barrier mechanism of the skin to be weakened. Dry skin is prone to cracking which leads to an entry point for germs and thus the risk of infection.
Good skin care can help reduce the risk of developing cellulitis.
Hints to help the affected limb
• Keep the affected area clean by using a low PH lotion as an alternative to soap which tends to strip the skin of its protective layer of sebum
• Moisturise the skin using an additive and perfume free lotion.
Try to avoid,
• exposure to sun
• exposure to biting or stinging insects
• any form of skin puncture on the affected limb (piercing, vaccines)
• restricting lymph circulation (blood pressure cuffs, poor fitting elastic garments, tight bra straps, watches, rings etc)
• beware of opening an oven door and allowing the heat to flow onto the affected limb
Temperature extremes cause the lymphatic system an extra burden so beware of,
• extreme heat from saunas, whirlpools, hot weather
• frostbite or extreme cold
• heat treatments, hot packs, etc.
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Exercise Therapy
Exercise therapy is an important component in the management of lymphoedema.
Movement at a natural pace with as full a range of muscular and joint action as possible is extremely beneficial.
Exercises can be adapted for each individual, even for those who are chair or bed bound. Our therapists can help to devise an exercise programme tailored specifically to your needs.
Aqua therapy has proven very useful in the management of lymphoedema. It also very helpful for oedema associated with pregnancy. A full range of movements to be used in the pool can be taught.
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