What is Lymphoedema Massage?

Lymphoedema massage is a specialised form of massage which moves the skin in specific directions based on the underlying anatomy and physiology of the lymphatic system.

Lymphoedema is the term used to describe swelling that can occur anywhere in the body, but most commonly affects the limbs. It is important to note, that swelling can occur for different reasons, and it is important that a diagnosis about the underlying cause of swelling is made by a qualified health care professional.

Lymphoedema is characterised by swelling of certain parts of the body, caused by problems with the lymphatic system. Normally, fluid and proteins leak into the body tissues regularly, from the blood. This tissue fluid bathes the cells, supplies their nutritional needs and receives back the products of their metabolism. The lymphatic system is a network of tubes throughout the body that drains this fluid (called lymph) from tissues and empties it back into the bloodstream. When this system is not working properly, lymphoedema can occur.

Any part of the body can be affected by lymphoedema, but it tends to target the arms and legs of the arm and, sometimes, the adjacent chest wall on the affected side.

The lymphatic system

The main roles of the lymphatic system include managing the fluid levels in the body, filtering out bacteria, and housing types of white blood cells crucial to the body's ability to fight infection. Muscular movements and contractions of the larger lymph vessels pump the lymph through the network of tubes, helped by one-way valves in the vessels that prevent the lymph from traveling backwards. The lymph is filtered for micro-organisms in glands of tissue called lymph nodes located around the body. The lymph is eventually returned to the bloodstream, mainly via blood vessels in the neck.

Primary Lymphoedema

Primary lymphoedema is characterised by structural problems with the lymphatic system. The vessels may pump sluggishly or there may be insufficient numbers of vessels, or both. Primary lymphoedema may be present before birth (congenital lymphoedema) or develop during puberty (lymphoedema praecox) or middle age (lymphoedema tarda). Primary lymphoedema can also be triggered by a case of secondary lymphoedema.

Secondary Lymphoedema

This occurs in the regions which are further away from the trunk (distal) and drain through the lymphatics which have been damaged, e.g. if the lymph nodes have been removed by surgery or fibrosed by radiotherapy. Thus, it often occurs in the arm following a mastectomy, in an arm or leg after an operation for melanoma, and in one or both legs after surgery for cancer in the pelvic region. It is also quite frequent after a severe accident (e.g. on a motorbike) which causes many lymphatics to be severed.
Oedema (Edema).

The lymphatics help to remove the excess fluid and protein which enters the tissues from damaged blood vessels, in any inflammation (e.g. after a burn, or other injury). If they cannot remove it all, the part swells (oedema, edema). However this swelling is usually only temporary, because the tissues heal and the blood vessels no longer leak excessively.

In an acute injury, e.g. a sprained ankle, the lymphatics are essentially normal. Although there is initial swelling, this is gradually removed over days to weeks. The overload is only temporary although, depending on the severity of the injury, some fibrosis will occur. This may remain for months or even permanently.