Many women who have had breast cancer surgery or radiation treatment develop swelling in the arms known as lymphedema. During surgery, lymph nodes that carry waste out of the body are destroyed, resulting in swelling due to the build-up of lymphatic fluid in the tissues. Other causes of lymphedema are wounds that have become infected, overuse of the affected limb and vigorous massage following mastectomy or breast surgery. Lymphedema most commonly affects the arms but it can sometimes also affect the legs or abdomen.
Physiotherapy has proven very successful in treating lymphedema, employing a variety of techniques including bandages, compression garments, massage and exercise. During the course of treatment, your physiotherapist would take measurements of affected limbs for future comparison.
Special low-stretch bandages are purchased for lymphedema treatment. You will be taught how to wrap the limb in a spiral fashion, beginning at the wrist and moving up the arm toward the armpit. The limb should not be wrapped too tightly as this can aggravate the condition. Watch for numbness in the hand, coldness or change in the colour of the fingers. These may indicate that the bandage is too tight, in which case it should be removed immediately. Compression garments are used in conjunction with bandages help to relieve swelling faster.
Lymphedema massage is a special technique that assists the body to get rid of the stagnant fluid. Unlike regular massage, it is light and rhythmic and aimed at stimulating the lymph vessels just below the skin. It uses small, circular movements to move the fluid from the affected side in the direction of the lymphatic drainage system where it can be drained away. This type of massage is performed by trained physiotherapists who can then teach you the correct way to do self-massage at home. Massage for lymphedema needs to be done daily, preferably for an hour until the lymphedema is resolved. It is important that only a trained physiotherapist in lymphedema performs this type of massage and teaches you how do it, as the wrong technique can actually worsen the swelling.
Following massage, the limb is wrapped and the patient moves to the next phase of treatment, which is exercise. We will train you how to do this, either using your own movements or with the help of specially-designed equipment. Exercise helps to pump fluid out of the body and restore joint mobility, muscle strength and length.
If you suffer from lymphedema or know someone who does, come in and see us at SportsPhysioSA or tell your friend how physiotherapy can help.
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