Lymphedema is a chronic, often progressive disease of long-term swelling. In Canada, most cases of lymphedemaresult from damage to the lymphatic system following the treatment of cancer (secondary lymphedema). In some cases, however, it is a sign of an already malfunctioning lymphatic system (primary lymphedema). The lymphatic system is a network of organs and vessels that (1) assist the cardiovascular system in moving fluid around in the body, (2) help with filtering out of waste products due to damage or injury, and (3) provide infection-fighting capabilities to the body that helps with immunity. When this system is not working properly, the high-proteinlymphedema results, which the body has a hard time clearing away on its own. Leaving lymphedema untreated may lead to serious skin changes and, eventually, serious infection.
Combined decongestive therapy (CDT) is the gold standard treatment for lymphedema. It is a program provided by specially trained and certified health care professionals which combines manual lymphatic drainage (MLD) treatment, bandaging/compression garments, special exercises, and skin care. CDT has 3 phases:
1. Initial assessment and treatment planning: The patient, together with the lymphedema therapist and medical team determine the extent of the lymphedema, A CDT strategy if deemed appropriate, and when to begin.
2. Intensive phase: The stimulation of lymph flow away from the affected area to reduce the visible swelling, soften fibrosis, and reduce pain.
3. Maintenance CDT: A lifelong plan to manage lymphedema symptoms and prevent infections
Manual lymphatic drainage (MLD) is a specialized form of manual therapy that uses light touch to move excess lymph fluid out of the tissues and back into the lymphatic vessels. Although it is often referred to as a type of massage, it is very different from traditional massages. MLD does not use any lotions or oils, and the pressure is very gentle as if the sun is being brushed. Clients often wonder how such a light touch can produce any effect. But MLD is well-researched as a component of the CDT treatment plan. Sessions will vary in length depending on the body part(s) treated and the severity of the condition.
To learn more about what lymphedema is, or how MLD and CDT is used in the management of lymphedema, you can visit the following trusted sites:
Note: Although more research is needed, MLD has also been shown to benefit some additional conditions, including muscle and joint pain, sinusitis, migraines, fibromyalgia, and post-operative swelling
It takes a significant amount of training in MLD and CDT, for a lymphedema therapist to provide effective care. If your lymphedema therapist recommends MLD or CDT, ask about his or her training and experience. Our Registered Massage Therapist at Leaps and Bounds: Performance Rehabilitation, Jennifer Hyland , has completed the most extensive and thorough MLD/CDT post-graduate training program through the Dr. Vodder School (TM) International. This post-graduate certification includes 160 hours of classroom time, months of practice and home-study, and finally, completing a series of written and practical exams. To learn more about the the training program, or to find a certified therapist near you, visit Vodder School.
The cost of lymphedema care will vary depending on the area of the body affected, the severity, and the extent of MLD/CDT treatment determined by your lymphedema healthcare team. Many extended health insurance (EHC) plans cover MLD/CDT when performed by a Registered Massage Therapist, and with a prescription from your doctor, it may also cover the cost of bandages. Furthermore, financial assistance may be sought through the Ontario’s Assistive Device Program in the case that your EHC does not cover, or only partially covers, the cost of compression garments. To learn more, visit the Assistive Devices Program page.
If you have any further questions about the lymphedema care provided at Leaps and Bounds: Performance Rehabilitation, feel free to give us a call. We will be more than happy to assist you!