Elke Liebe Lymphedema & Massage Therapist
Cancer Network Group Service
10:00 AM to 5:30 PM.
Chronic peripheral lymphedema, an accumulation of protein-rich fluid in the superficial tissues, is a very common and serious condition with significant consequences for the patient.
One of the main reasons for the development of lymphedema is surgical interventions in combination with lymph node dissections, such as mastectomy or lumpectomy due to breast cancer.
Since lymphedema is a progressive condition, treatment should begin as early as possible. The goal of the treatment is to remove the excess lymphatic loads of water and protein and to restore the disturbed equilibrium in the interstitial tissues of the affected area.
Treatment of Lymphedema with Complete Decongestive Physiotherapy
Complete Decongestive Physiotherapy (CDP), done successfully in Europe for decades, is a non-invasive therapy with long lasting results. CDP is superior to all other approaches to treat lymphedema (pumps, medication, surgery) and designed to reduce and to maintain the reduction of the swollen extremity.
At the end of the 19th century, Alexander von Winiwarter, Professor of Surgery, described the basic steps of this therapy for swollen limbs with special massage, compression, and elevation. The technique was improved in the 1930s by Vodder, a physical therapist from Denmark, who successfully treated lymphedema.
In the 1980s Prof. Michael Foeldi, M.D. considerably improved this therapy by developing a technique called Complete Decongestive Physiotherapy, which even in advanced stages of lymphedema shows remarkable results.
CDP is done in two phases. The first phase, intensive phase, lasts between two and four weeks (in extreme cases longer); treatments are done twice a day, five days a week. The goal of this phase is to decongest the swollen extremity to a normal or near normal size. Simultaneously the patient is instructed in techniques designed to maintain and even improve the condition after the intensive phase of the therapy.
The first phase is immediately followed by phase two, the maintenance and improvement phase which the patient continues at home.
For the safety of the patients and to achieve good results it is absolutely mandatory that the therapist is thoroughly trained in all components of CDP. Only certified MLD/ CDP therapists have a complete understanding of the pathophysiology of lymphedema and its treatment.
CDP Consists of Four Basic Steps:
- Manual Lymph Drainage
- Compression Therapy
- Meticulous Skin and Nail Care
- Remedial Exercises
Manual Lymphatic Drainage (MLD) is a gentle manual treatment technique which improves the activity of intact lymph vessels by mild mechanical stimuli, the goal of this treatment is to move excess lymphatic loads of water and protein into areas with still sufficient lymphatics.
This is a very light special skin technique which is directed toward stimulating the activity of the lymphangions, designed to empty and decompress the obstructed lymph vessels. MLD allows the natural pattern of existing vessels located under the skin and areas where the lymph system and venous system join to assume the function of transporting lymph fluid. The hands of the therapist are used to soften fibrotic lakes which can accumulate under the skin. The areas located away from the limb are always treated first. MLD techniques are very specific and involve pressures and release of pressures along with strokes.
Since the elastic fibres of the skin are destroyed during the course of lymphedema it is mandatory to apply sufficient compression to the affected area in order to prevent re-accumulation of fluid. Compression in phase one is achieved by short-stretch bandages applied after each treatment. It consists of 4 layers of material that protect lymphatics, offer gradient compression, and soften the skin. Bandaging does not permit the treatment areas to refill with fluid.
After the extremity is decongested the patient is fitted with a sufficient compression garment that needs to be worn during the daytime. At night the patient applies mild compression using bandages.
Before treatment can be started, the skin has to be free of infections or fungal infections. During treatment a low-pH lotion is applied to maintain the moisture of the skin.
Remedial exercises performed by the patient wearing the compression bandage or garment aid the lymphokinetic effects of the joint and muscle pumps. Muscle activation with the bandages in place provides resistance. When resistance is met, increased lymph flow and reduction is the result.
The Bandaging is Bulky and will not Accommodate Tight Fitting Clothing:
- Patients being treated for arm lymphedema are asked to bring a short sleeved garment for exercises. If you do not wish to wear the short sleeved garment out of our facility, clothing with loose fitting arm sleeves is required.
- Patients being treated for leg lymphedema will need shorts or loose fitting pants for exercise therapy. When leaving our facility, a skirt could be worn if desired.
- Leg patients will need very large sneakers, sandals, or something comparable.
How do I access this service?
Please call (09) 407 4673
10:00 AM to 5:30 PM.
|Tue – Sat||10:00 AM – 5:30 PM|
For scheduled appointments, please ring the doorbell under the "Life Balance Bodywork" sign and wait in the parking area where our therapist will meet you.
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This page was last updated at 3:44PM on July 22, 2021. This information is reviewed and edited by Elke Liebe Lymphedema & Massage Therapist.