How Can A Physical Therapist Help Treat Lymphedema

August 20, 2022

I am thrilled to add lymphedema management to my list of physical therapy service offerings. When I joined the staff at Activcore, I had the chance to observe a lymphedema trained specialist, Dr. Lisa Ochman. She applied lymphatic drainage in ways that were incredibly creative and effective. So I decided to get my Certified Lymphedema Therapist (CLT) certification in order to support our patients with this specialized physical therapy framework.

But what even is lymphedema PT?

To understand what lymphedema treatment (also known as Complete Decongestive Therapy) entails, it is useful to understand the role of our lymphatic system. The lymphatic system consists of lymph vessels and lymph nodes throughout the body. It works closely alongside our circulatory system and plays an essential role in immune function, by primarily helping to clean up metabolic waste from our cells in order to maintain a healthy cellular environment.

Lymph fluid is made up of water, protein, cellular debri, white blood cells, and fatty acids. The lymphatic system transports this fluid around the body via a pressure gradient. The lymph fluid movement can also be impacted by our breathing, muscle contractions, central nervous system, hormones, exercise, temperature, arterial blood flow, and the process of lymphedema physical therapy.

Lymphedema is a malfunction of the lymphatic system. Characteristics of lymphedema include changes to the way lymph fluid moves through and processed by the body. One might notice increased limb volume, swelling, skin changes, and pain. Another aspect of this type of swelling is that it often doesn’t resolve with elevation. Patients will often describe heaviness to the limb or difficulty getting rings on and off. One might notice hardening of the skin tissue or swelling that when pressed on leaves an indent in the tissue. While there is no cure for lymphedema, it can be managed to limit impact on daily life.

There are a variety of diagnoses that can respond well to lymphedema management including: 

  • Lymphedema
  • Lipedema
  • Phlebo-lymphostatic edema (aka Venous Edema due to Chronic Venous  Insufficiency)
  • Complex Regional Pain Syndrome (CRPS)
  • Rheumatoid arthritis, scleroderma
  • Paralysis

These conditions are treated using Complete Decongestive Therapy (CDT) which involves:

1. Manual Lymph Drainage (MLD): This is gentle, relaxing manual therapy to improve lymphatic flow and limb volume reduction. People often compare MLD to a massage because of its pain relieving effects.

2. Compression Bandaging: This can take the form of bandages that your therapist will teach you how to adhere or the use of a compression garment. In either case, the goal is to maintain and improve the limb volume reduction achieved by MLD and exercise. 

3. Skin and nail care: It is vital to keep the limbs free from infection and wounds that can aggravate one’s condition and slow down treatment progression.

4. Exercise and physical activity: I’ll work with you to find exercises that help continue improvements to lymphatic flow and fit into your life.

5. Education: No matter what condition or person I am treating, I want you to leave each visit understanding more about your body, how you can help improve your health, and feeling empowered!

Each person’s treatment plan is tailored to their individual needs, health conditions, and goals. To learn more about how lymphedema PT can help you, click here

REFERENCES:

Components of the lymphatic system | SEER Training.

Norton School of Lymphatic Therapy. Course Manual. 2022

Lymphatic system: Crash course anatomy & physiology #44. YouTube. https://youtu.be/I7orwMgTQ5I. Published November 30, 2015. Accessed August 6, 2022. 

Disclaimer: The views expressed in this post are based on the opinion of the author, unless otherwise noted, and should not be taken as personal medical advice. The information provided is intended to help readers make their own informed health and wellness decisions.

Dr. Molly Weingart

Physical Therapist
Molly Weingart is a Doctor of Physical Therapy (DPT) who specializes in pelvic health, women's health, lymphedema treatment, and general orthopedics. She works at Activcore in Princeton, New Jersey, located just 2 miles from Princeton University. Molly believes in tailoring each patient’s treatment to fit that individual’s goals and lifestyle.
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