Tell Me – What is Lymphatic Drainage?
Lymphatic Drainage is a modality that has been used to treat a myriad of health conditions for hundreds of years. Over the last fifty years it has spread world wide and has become a popular treatment in many European hospitals and clinics. It is now beginning to gain acceptance in New Zealand as a component in the treatment and control of lymph oedema and chronic pain.
January 2008, manual lymphatic practitioner Hans Lutters from Christchurch gave an in-service presentation to his colleagues about Lymphatic Drainage. Hans works part time for Sportsmed which is one of New Zealand’s leading sports medicine and injury rehabilitation Clinics.
Monthly presentations are given at Sportsmed to share and exchange information in order to continuously increase knowledge. As a result clients’ health and well being has proved to benefit from this multi disciplinary interaction where physicians, chiropractors, physios, podiatrists and massage therapists are involved.
The Lymphatic System – How does it work?
The lymphatic system, which amongst other things acts as a battleground for the immune system, is part of the circulatory apparatus. But rather than traveling in a continuous loop as is the case with the venous and arterial systems, the lymphatic system is a one way system beginning in the interstitial environment and ending in the venous system.
The lymphatic system is anatomically divided by watersheds. Containing more fluid than the venous system, the lymphatic system’s major function is to remove excess fluid and products from the interstitial environment (around the cells).
This process begins with waste product elimination (including toxins, dead cells, bacteria and excess protein) and fluid being directed into the capillaries of the lymphatic system, the fluid being derived from the venous plasma which has escaped from the circulatory system. On entering the lymphatic capillaries, the fluid becomes lymphatic fluid (lymph).
The lymph transports its load via the lymphatic pathways to lymph nodes. Lymph nodes are stationed around the body tissues and organs. The lymph fluid carrying its load, is directed into the nodes where it is filtered and purified. Waste products and excess proteins are broken down to be more easily handled by the organs of elimination like the liver and the kidneys. Lymph nodes also produce lymphocytes. These cells have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases.
The lymphatic system is affected by factors such as venous insufficiency, radiotherapy, (sports) injuries, stress, tiredness or chemical overload. These factors cause the circulation of fluids and, therefore, the cleansing process to slow down, which in turn compromises the health of the soft tissue environment and opens the way to physical ailments.
What is Lymphoedema?
Lymphoedema is a swelling of the superficial tissues which occurs when the lymph load is greater than the lymphatic transport capacity. A well functioning lymphatic system is pivotal in the control of lymphoedema.
To develop swelling, there has to be a fairly significant damage to the lymphatic system in the affected area. It is believed that it is working at only about 10% of its capacity at rest and that to show signs of failure, about 90% of the transport capacity must have been destroyed.
Foeldi et al (2003) has divided lymphatic failure into categories.
Mechanical Insufficiency, in which there is a normal lymph load on a damaged (due to surgery/radiotherapy) lymphatic system.
Dynamic Insufficiency in which there is an increased load (due to high vascular permeability or high venous pressures for what ever reason) on a normal system and the very serious problem of an increased load on a damaged lymphatic system.
According to French medical practitioner Dr Chikly, there is an unending list of indications that still need to be explored. The following indicates some of the situations for which the therapy can be used: Lymphoedema, acute sport injuries, chronic pain, pre and post surgery, rheumatoid arthritis, headaches and migraines, detoxification, stress, fatigue, cosmetic conditions and irritable bowel syndrome.
Lymphatic Drainage Techniques
Manual Lymphatic Drainage (MLD) is an advanced therapy in which the practitioner uses a range of specialized and gentle rhythmic pumping techniques to move the skin in the direction of the lymph flow. Each move can take several seconds to complete, with an active and a passive phase. Pressure used on the vessels is feather light. The hand movements applied create a traction of the skin tissue. These movements are quite different from those used in any other modality.
To ensure that the highest standards of Manual Lymphatic Drainage are maintained, practice should be confined to those who have undertaken, or who are undertaking, training through the Vodder, Casley-Smith, Leduc, Földi, and Asdonk schools or with someone who is well trained and experienced.
For more information about Manual Lymphatic Drainage visit www.lymphaticsinstitute.com handsonmassage.co.nz or contact Hans Lutters at firstname.lastname@example.org for information about MLD courses.