Tag Archives: guest post

Guest Post: Lucie’s Physiotherapy Experience

Lucie Crouch recently underwent physiotherapy for her lymphedema. After a positive experience, she decides to share her story.

I’ve been living with lymphedema for around eight years now. I’ve pretty much been through it all: painful leg drainage, herbal remedies, hardcore and rather painful CDT (complete decongestive therapy)… I’ve tried a plethora of different massage techniques and exercises, and don’t get me wrong – they all worked ‘quite well’ – but nothing really hit the spot. I also began to see a recurring infection in my left leg. It literally became as a hard as a rock, and during one bad spell I was in the hospital with IV antibiotics for two months. Then I came across physiotherapy for lymphedema patients and my condition drastically changed.

One problem I found was getting in touch with a physiotherapist who had experience and knowledge of lymphedema and understood how their profession could really be used to combat the condition. Most physiotherapists will tell you that they can treat you, but my advice would be to find a therapist who has had successful results with a lymphedema case before. I spent quite a lot of time and money testing the waters; it can end up being extremely painful if you’re landed with a therapist who doesn’t understand or have any experience with lymphedema.

Then I came across a therapist whose daughter actually had the condition and my therapy instantly took a turn for the better, and honestly I think this is an underestimated, gold-star treatment for the condition.

Unlike your normal drainage massages, physiotherapy combats the problem in a more organic way. The aim of the game is to stop excess fluid from the lymph by sorting you out with exercises which:

• Increase range of motion/flexibility
• Decrease swelling
• Decrease pain
• Increase strength
• Restore function and improve the quality of life.

I found that because my therapist understood exactly how and why lymphedema effects your body and your life, she had some really good exercises which not only helped drain away the swelling, but actually built the muscle up in my back and legs as well, so when I could walk again, it wasn’t like Bambi on ice.

Another thing she did which I’ve never encountered before was using a massage couch. Basically this tilts you backwards so the whole time you’re in therapy, your legs are elevated as well as being massaged so you’re sort of getting the best of both worlds.

It took a few weeks or so for the therapy to really kick in; the best part was the exercises she taught me involving simple movement which really helped me bring the strength back into my legs. Just sitting on a bed or chair so your legs are at a right angle, and lifting them into the air, slowly and carefully, is something you can do anywhere and it really helps circulation. She also taught me a great, really simple exercise which has loads of benefits for any area which is affected: the idea is that you want to move, stretch and tone any area of your body where your lymph nodes need a bit of encouragement. For example, if it’s your arm that’s affected, hold your arm in front of you, stretch from your shoulder all the way down to the tips of your fingers and twist your arm slowly to the right and the left. You want to twist the arm with the skin and the muscle, basically getting blood to all of the organs, tissue and muscle on that limb. This can easily be done on your leg or any other parts of your body – just make sure you don’t hurt yourself when you’re doing it.

I’m now really mobile and sixth months after starting therapy I’m completely mobile; I have my own massage chair so I can rest comfortable with my legs elevated on a daily basis which also makes the world of difference.

I’d honestly recommend physiotherapy to anyone who is thinking about having it. It’s genuinely worth your time, and when you find a good therapist it can make all the difference to your lifestyle.

Guest Post: Jim’s Tips for Exercise

Jim Miller has had lymphedema for over forty years, but doesn’t let that get in the way of leading an active lifestyle! He’s biked the coast of Oregon, participated in Bike MS, and now he’s here to share some tips on staying active with lymphedema.

First, I’m not a doctor; don’t play one on TV; and urge you to go see your own physician before undertaking any strenuous physical activity. There – the “fine print” is out-of-the-way up front.

Alexa asked me to put together a few tips for those of us (like Rosie who posts to “The Lymphie Life”)  who insist on putting our lymphedema through some strenuous sporting events. Rosie just did a triathlon after deciding she wasn’t going to let her lymphedema stop her from getting out and enjoying life even more. A triathlon probably takes several hours to complete, depending on its length, and my 65-70 mile bike rides to raise money to fight MS often take 6 or 7 hours. You’re going to build up some extra fluid, but not to worry: we have ways of taking care of that.

Here’s some things I’ve learned about exercise with lymphedema:

  • I have been told for years that regular exercise, staying fit, and maintaining a healthy weight are very important for managing your lymphedema. What I learned more recently is that regular exercise also helps keep your lymphedema from getting too fibrous, which makes it harder to reduce with compression wrapping.
  • Strenuous exercise generates more lymph fluid so anticipate some extra swelling, especially after long events.
  • Be sure you always wear your garment when exercising – whether light or more strenuous. Don’t even consider skipping it – the garment’s compression and its pumping action helps you get rid of the extra fluid.
  • Heat also affects our lymphedema as we all are aware, so heat plus exercise will create some conditions we’ll need to manage after our event is done.
  • If it is very hot, I liked the idea somebody posted on Alexa’s blog about wetting down your lymphedema limb. I did that after my first riding day this year and it was wonderful.
  • Drink plenty of fluids while exercising, especially for those longer events. Keep your body hydrated and your lymph fluid watered down. I know it helps.
  • Speaking of hydration, did you know Americans are as a rule 30% dehydrated? So when you go out and exercise you’re starting from a “negative” hydration status. I drink extra water for a day or two before a long, hot event like this month’s ride.
  • After the event, be sure to set aside time and do your manual lymph drainage. You have to help that fluid get out. I got a neck/back massage after our ride and learned my masseuse was a certified lymphedema therapist. Had there been more time and privacy she could have helped with my MLD massage. So if you don’t do your own MLD, look for someone to help you.
  • Oh, and one other little trick I learned last year while cycling the Oregon coast was to use what I call “spot wraps” to reduce swelling in specific areas. If my foot starts to swell after a few days of exercise (it did) I’ll take my Farrow Wrap foot piece, cut bits of white Comprex-Binde foam to fit over the ankle and across the top of the foot and snug down the velcro straps over night. Then I can be sure to fit into my cycling shoes in the morning. It worked like a charm this summer, too.
  • Even with MLD and a good compression garment, there seems to be a residual build-up of fluid that, for me, takes about three days to show up. So be prepared to see more swelling. This year I just bit the bullet and wrapped my leg for a couple of days during the week following the long bike ride. Hey, we do what we have to in order to live an active life with lymphedema.

The National Lymphedema Network has some excellent exercise tips here: http://www.lymphnet.org/pdfDocs/nlnexercise.pdf

What tips and tricks do you have up your compression garment that help you manage your lymphedema under some special circumstances, like long or strenuous exercises?

Self Care for Lymphedema Management – Get To Know Your Neck!

As a Certified Decongestive Therapist trained in manual lymphatic drainage, and a Registered Physiotherapist, I’m often asked by my lymphedema patients why I am so focused on the neck during my lymphatic massage treatments, even when the Lymphedema is presenting in an arm or leg.   The reason is simple:  there is a huge collection of cervical lymph nodes located in the neck region that can be capitalized upon to stimulate the lymphatic system to improve its overall flow.  The number of lymph nodes located in the neck region is approximately 300, far greater than in the armpit, groin, or abdomen, and may represent over half of the total number of lymph nodes in the body. This is not surprising given that it is at the neck where lymphatic fluid rejoins the cardiovascular system via the subclavian vein.

The neck represents a great target for improving overall lymphatic flow, not just because of the total number of lymph nodes present, but also because of the infrequency of functional limitations in the lymphatics at the neck.  Patients with Secondary Lymphedema which arises due to radiation to, or removal of, lymph nodes in the armpit region from their breast cancer treatment (for example), typically retain full functional capacity at the neck.  Similarly, in the case of Primary Lymphedema, the nodes at the neck typically retain sufficient functional capacity as well.

In manual lymphatic drainage massage, we always begin the massage series with several strokes specific to the neck region, to draw lymphatic fluid from other regions of the body, and send this fluid back into the cardiovascular system.  Such stimulation contributes considerably to the results we see with manual lymphatic drainage.  We encourage all of our Lymphedema patients, be they Primary or Secondary, to incorporate self-massage of the neck into their daily self-management strategies.  The entire series of neck strokes should only take about 5 minutes to perform, and is easy and comfortable to do.  A certified Lymphedema therapist would be able to show you the appropriate technique. You can also learn more by visiting our website where we have posted a short video demonstrating lymphatic drainage self-massage at the neck.  Best of luck!

Lindsay Davey, PT, MScPT, MSc, CAFCI, CDT
Toronto Physiotherapy