2020. 2. 20. 06:01ㆍ카테고리 없음
Lymphatic System Overview - Maureen AbsonMany experts believe that MLD techniques may be effective for releasing trigger pointsManual lymph drainage (MLD) is a gentle manual treatment technique initially developed in the 1930’s by Danish Drs. This trigger point therapy blog is intended to be used for information purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell. MessagePlease note, comments must be approved before they are published. Recent ArticlesOct 22, 2019Oct 16, 2019Oct 16, 2019Oct 14, 2019Oct 13, 2019Oct 12, 2019 Categories.
Movement of Lymph Fluid in Lymph VesselsThe common denominator of all strokes is the resting and working phase. In the working phase of the stroke lymphatic structures located in subcutaneous tissues are stretched, resulting in an increase of their activity (lymphangiomotoricity). In addition to increased lymphatic activity, the light directional pressure in the working phase of the strokes causes lymphatic fluid to move in the desired direction, thus contributing to the reduction of the swelling.Certain MLD strokes are designed to manipulate lymph vessels located in the subcutaneous tissues of larger body surfaces, such as the trunk, other techniques are better suited to be applied on contoured surfaces, such as the extremities.Stationary circle: This technique consists of an oval-shaped stretching of the skin with the palmar surfaces of the fingers or the entire hand. Stationary circles can be applied with one hand, or bimanually and are used on the entire surface of the body, but mainly on lymph node groups (axilla and groin), the neck and the face.Pump technique: The entire palm and the proximal (upper) phalanges are used to apply a circle-shaped pressure on the skin, operating within almost the full range of motion in the wrist. Pumps are primarily used to manipulate lymph vessels located in the extremities and can be applied with one hand or bimanually.Rotary technique: This stroke is used on large body surface areas, such as the trunk.
The entire surface of the hand and fingers are used in an elliptical movement during the working phase. Like the scoop technique, rotaries are applied dynamically, meaning the working hand moves over the surface of the treated body part in a continuous fashion. If applied bimanually, the techniques are alternating.Scoop technique: Scoops are applied mainly on the lower parts of extremities and consist of a spiral-shaped movement. During the working phase, which can be applied with one or both hands, the palmar surface of the hand moves dynamically over the skin.
The hand movement is facilitated by transitional movement in the wrist, combined with forearm pronation and supination. Lymph Vessels in the SkinCompared to traditional massage, the pressure applied with manual lymph drainage is much lower in intensity. The goal of these techniques is to manipulate the lymphatic structures located in the subcutaneous tissues. In order to achieve the desired effect, the pressure in the working phase should be sufficient enough to stretch the subcutaneous tissues against the fascia (a structure separating the skin from the muscle layer) located underneath, but not to manipulate the underlying muscle tissue. The amount of pressure needed in MLD is sometimes described as the pressure applied stroking a newborn’s head.In the resting phase of the stroke the pressure is released, which supports the absorption of lymph fluid into lymph vessels.
Thank you for this detailed, crystal clear explanation. I do have a related question: I had breast reconstruction after bilateral mastectomy, using the d.i.e.p. Autologous flap method–meaning that fat and blood vessels were taken from the lower abdomen and repurposed to form the replacement breasts. I have a continuous scar below the belly button, running about 60%-70% around the body. And I have lymphedema, which presents at the upper arm and in the trunk under the axilla. To compound matters, I find that fluid pools just above the scar as the day progresses (recedes during sleep).All of this detail leads to the question: For MLD to successfully nudge lymph toward the inquinals, the lymph would have to travel under, through, or over that scar, because ‘around’ is not possible due to its length.
Is there hope that with patience and some kind of scar massage, the superficial lymphatic vessels can eventually cross that barrier? My lymphedema therapist has suggested moving the lymph around the back and toward nodes located near the pierformis muscle in the hip–I think I would have to be a circus contortionist to make this work!Many women are getting diep reconstructions, and the loss of a pathway to the inguinal nodes seems to invite midriff swelling, which is a common complaint after reconstruction. For those of us with lymphedema, it also results in blocking access to one of the destinations for redirecting upper-quadrant lymph. Lots of us will look forward to your comment, so many thanks in advance if you can take time to answer. Joachim- I’m 38 with primary lymphedema, bilateral lower extremity, asymptomatic in my right leg, diagnosed through lymphocintogram at 35, after14 years of no diagnosis (frustrating) symptoms appeared suddenly at age 21 after a new years eve wearing tight shoes. I visited a lymphatic care center, the course of treatment and subsequent wrapping required of both legs up to my goin totally terrified me. Other than elevating my leg at night, I have done no treatment, head in the sand syndrome, I feel intimidated my this condition and long term prospects.
Do you have advice for how a person like me should handle this condition, when it’s not debilitating, but definitely impacts my life, my mobility and my self esteem in enormous ways?. Dear Sandra: While you are correct thatthe treatment of lymphedema using Complete Decongestive Therapy would involve the application of short-stretch bandages to the legs, this would be only a temporary situation. Bandages are applied until the limb is decongested to a normal or near normal size, at which point you would be measured for compression garments. Garments are much less bulky and are very effective to maintain the results achived during the therapy phase. Without the use of any form of compression, there is a good chance that tyhe swelling will ncrease over time.
While elevation is certaionly helpful, deep breathing (abdominal breathing) exercises would be very beneficial as well. However, ultimately the best option would be to seek the services of a trained lymphedema therapist. I had an appendectomy at age 17, forty years ago and developed lymphedema as a result of that surgery. At that time I was told NOTHING could be done and in Texas where I live, there was no known methods of treatment.
I found about a lymphedema clinic 3years ago(37 years later) and began treatment. I think I had one of the worse case senerio of lymphedema possible, with huge thighs, legs ankles and feet.After therapy, bandaging and pumping, mt legs are much better, but my trouble area are the thighs. It is extremely hard to keep bandaged and I have not been able to find compression wear that fit or require 2 or 3 people to help with putting them on. I am dealing with this condition and I try to do all I can and know how to do.Any help, advice or suggestions would be greatly appreciated.
I have had a couple of sessions of MLD, but both of them made me feel very unwell fro 36 hours after the session. I felt dizzy and so unwell that I felt as if I was having chemotherapy again for my grade 3 stage 1 triple negative breast cancer. Lymphoedema occurred after my mastetomy, but prior to chemotherpay and radiotherapy. My lymphoedema nurse has refused to continue treating me until my doctor says I can continue. (The doctor I went to see for permission didn’t even know what MLD was!) I am desperate to restart the MLD as after the 36 hours I felt absolutely fantastic – the fatigue I have had for 4 years since treatment disappeared and I have started to feel normal again. Do you know why MLD made me feel so unwell afterwards and is it a common thing that cancer fatigue can be done away with by dealing with lymphoedema in this way.Many thanksNatalie. Its very disheartening to be told that unless you are a nurse, you can not go anywhere to learn the massage needed.
I have spent years watching what was once my life, draining away:( My husband feels so helpless.We do not have insurance and spent over 10k on professional therapy which never led to my being able to wear compression stockings. We want to learn PROPER massage.This is a “LIFER”. Why cant we be taught and certified for the massage? I just dont get it. I have machine here that now I am afraid to use.
I now have the belly apron.Its disgusting and painful. I have huge lumps on my thighs. All from IMproper massage of the toxins. Its truly a living hell. 🙁 I cant be the only one who feels this way.
How can we go about CHANGING it?. Hello,I have recently qualified with the Dr Vodder school & went on to do T2 & T3 I work mainly with women after mastectomy & resulting arm lymphedema Apart from that I treat women in a slimming clinic & offer detox etcI have had a request from a fybromyalgia suffer wanting me to treat her. Would you be able to advise me regarding a treatment plan? She has had MLD for this condition in the past but it was not successful.I know that it can be very successful in treating her condition & I don’t want to let her down.Any advice or references would be appreciatedMany thanks. I have lymphedema in my left leg from a cancerous lymph node 20 plus years ago in my groin.All said and done it has been kinda OK up until about 4 years agoI had a hernia in the same area and all about the same time I fell and have nerve damage on my left side and that is the affected area. My question is and of course the surgeon says no, but could the hernia surgery and mesh screen disrupted the natural migrating flow the area had acquired on it’s on? Is there anything that could help it now?
Has anyone ever heard of anything like this. I have plenty of problems nowThanks.
Unforrtunatly as my wife and I have discovered, it is also possible for lymph to cause an extreme burning sensation throughout the body,and even for it to burn its way out through the skin from badly effected node areas. We have FMS., CFS, MCS, and chronic myofascial pain syndrome.
I had on idea how much of my pain was lymphatic until I went on cleaves to try and control the painful swelling in my legs and feet. The first few weeks on it, my leg drained a lot nd they developed massive ungodly painful burning lumps in the large lymph vessles: of the inner thigh, which had to be rubbed to unclog themThese blockages where visible to the eye. It was possible to easily see a dent where the course of the leg lympatic vessel was and shifting my my position caused the vessel to immediatly fill again. By the end of a month my pai n level had dropped so much I had to reduce my opiate pain management dose by 1/3.
The brown stains on my lwer legs have slowly faded and my legs though they still hurt are no longer hell. There is a real tie to burning toxic lymph in fibromyalgia. It is like having a caustic substance (we measueed it at ph 9.5) in all of you tissues. We have pictures of cooked blood coming out of lymphatic sores on my wife’s chin and of the empty lymph channels dented inward on my legs.
Every trip into town (the toxic world most people live in) results in burning, and swelling and errupting burning sores. Dysbiosis (which can be caused by ones toxic load) causes villi damage which causes in turn significant lymphatic trouble. Clogging with protein deposits, a slow down of detoxificatuon & a buildup of increasing levels of poisons in the lymph. This can becagonizing withvpai everywhere. NOBODY seems to treat this – not even alternative people.
30 years ago I had breast cancer in left breast, in those days they took my lymph nodes out, which they should not have done, as the nodes were clear, so that leaves me with the swelling in left arm, it is larger then my right, but not too bad, like some I have seen. I use the pump 2 times aday, and wear a compression sleeve 8 hours aday, like they told me to. I have no pain, but hate the ugly swelling, have been to many Doctors, all say they can help, not never do anything that works. I have used the nite time huge sleeve, cannot sleep with it on, have tried wrapping,why is there no help for people like us, that works, why cannot they figure out how to get the fluid working again? One doctor in Southern California, told me he could take a lymph nodes out of my body(said they are a cluster, and put them into my wrist, to pump the fluid back up into the body. But then after many trips to see him, he said it could not work.
I sure would like to find something that will work. Can u help me?. I have just started CDT with a certified Lymphedema Therapist in Los Angeles. I have Primary Bilateral Lymphedema in my lower extremities effecting both the distal and proximal leg. I am at Stage II and was misdiagnosed 35 years ago by my pediatrician. Therapy was further delayed when I was misdiagnosed with venous insufficiency, but thank God that I was prescribed support stockings.
I have been hospitalized twice with severe infections which went septic. I have had multiple infections over the last 5 years, but was taking antibiotics prescribed by my Infectious Disease Specialist. ‘I have a few questions I would like your opinion on:1.
How long should each therapy session last for both legs and what would your therapy session entail?2. My therapist is unsure if MLD is effective and is only bandaging my legs (4 layers plus 1/2 foam). I was under the impression that MLD is essential in this therapy in order to re-route the lymph. What is your opinion?3. How often should one receive treatment (initial therapy, then there after)?Thank you for your help.
Dear Jacquie: The general procedure for the treatment of lymphedema by a trained and certified lymphedema therapist in a case such as yours would be as follows:If both legs are affected by lymphedema, it is generally not advisable to treat both extremities at the same time. Experience indicates that it is generally more successful to treat one extremity until it is decongested or the measurements plateau, and then start treating the other extremity. MLD is an essential component of CDT and there is no reason other than any kind of contraindication, not to perform MLD on a lymphedemateous extremity and the drainage areas.
Drainage areas in your case would be both axillary lymph node groups, the inguinal-axillary anastomoses on both sides and abdominal, as well as deep abdominal techniques, if not contraindicated. A typical treatment session should last about 30-45 minutes when treating one extremity, longer if both extremities are treated. In the initial phase (phase I of CDT), treatment should be administered on a daily basis (Mo. Through Fri.) until the affected extremity is decongested, or the measurements plateau. Treatment frequencies in phase II of CDT vary according to the individual situation. Here is a link explaining CDT:. Hi,I have been working with a unilateral LE patient, who was going down consistently below the knee region, but I’m having trouble getting her upper thigh to go down (this week’s measurements in fact when up 10cm).
What Is Manual Lymphatic Drainage
I’m finding that some of the lymph is collecting by her hip / right above where the upper thing foam ends, though have tried to use hip bandaging, kinesiotape to direct from affected inguinal node to unaffected inguinal, as well as biker shorts underneath the bandaging. Do you have any other suggestions you might suggest? Today I worked on primarily the uppermost thigh and trunk, with not much work on lower thigh or below knee, as I thought perhaps in doing everything it was overloading the system. I know plateaus can happen, but any perspective is appreciated.