Treatments

The cornerstone of the treatment is the application of MANUAL LYMPHATIC DRAINAGE. This technique is entirely different from classical massage; it aims to stimulate the circulation of lymph fluid through very gentle, rhythmic and specifically directed movements applied to the skin’s surface.

• Fluid Redirection: This involves manually directing fluid from blocked or damaged lymphatic vessels towards healthy, functioning lymph nodes.
• Reducing Swelling: Reduces tension and pain by accelerating the drainage of protein-rich lymph fluid from the interstitial spaces.
• Immune Support: By boosting lymphatic flow, it helps the body eliminate toxins and strengthen the immune response.

The most effective method for preventing the space drained during an MLD session from refilling with fluid is the application of BANDAGING. This stage plays a critical role in the ‘drainage’ phase of the treatment.

• Short-Stretch Bandages: They apply low pressure during rest and high pressure during muscle movement, thereby enhancing the “muscle pump” effect.
• Customised Layering: A bespoke structure is created using different layers and pads tailored to the shape of the limb and the firmness of the oedema (degree of fibrosis).
• Tissue Softening: This is vital for softening hardened lymphoedema tissues and ensuring that the reduction in volume is permanent.

COMPRESSION DEVICES, which support treatment and can be integrated into home programmes, form part of modern lymphoedema management.

• Intermittent Pressure Therapy: The devices assist lymphatic drainage by inflating and deflating with air via special sleeves fitted over the limb.
• Fluid Mobilisation: This is particularly effective in cases of venous insufficiency and lower limb (leg) oedema, as it helps to move fluid towards the proximal (upper) regions.

Lymphatic flow does not have a pump like the heart; the primary force driving this flow is muscle movement. For this reason, exercise is approached in two stages at our centre:

Personalised Exercises

PERSONALISED EXERCISES are planned following an analysis of the patient’s current physical condition, joint range of motion and level of swelling.

• Muscle Pump Activation: These exercises, performed whilst under compression (from a bandage or garment), help the lymphatic vessels to function more effectively.
• Breathing Exercises: Diaphragmatic breathing increases the pressure difference in the main lymphatic channels, thereby aiding drainage.

Preventive Exercises and Measures for Lymphoedema

Once the condition has been brought under control, PREVENTIVE EXERCISES AND PRECAUTIONS FOR LYMPHEDEMA are of great importance.

• Infection Control: Patients are advised to maintain skin integrity, practise nail care and prevent minor cuts (which carry a risk of infection or cellulitis), and to avoid having blood drawn or blood pressure measured on the affected side, as well as to avoid trauma.
• Load Management: You will learn how to move the limb in a controlled manner without overstraining it.
• Heat and Sun Protection: This section explains methods for protecting against excessive heat, which can cause dilation of blood vessels and increased swelling.

Once treatment has been successfully completed, the process moves on to the stage of prescribing a custom-made compression garment to maintain the results achieved.

• Fitting Accuracy: Custom-made garments tailored to the patient’s exact measurements are preferred over ready-to-wear garments.
• Selection of Pressure Class: The pressure class appropriate to the patient’s stage of lymphoedema (Stage 1, 2 or 3) and tissue firmness is determined by a specialist doctor and a physiotherapist.
• Knit Type Decision: In cases of lipoedema or fibrotic lymphoedema, ‘flat-knit’ fabrics are generally prescribed to ensure maximum control over the tissue.