Manual Lymphatic Drainage & Combined Decongestive Therapy

Manual Lymph Drainage (MLD) is a gentle manual treatment technique.  MLD should not be confused with massage. MLD is very specific, gentle and rhythmical. It is preformed in a precise sequence by a highly trained Lymphedema Therapist.

The main goal in treatment of lymphedema is to reroute the lymph flow around blocked areas to healthy lymph vessels.

Other indications for MLD treatment are:

Surgical: Post Mastectomy Edema, Post Hysterectomy Edema, Post Surgical Swelling, Pre Surgery Preparation, Pre/Post Cosmetic Surgery, Lymphedema

Musculoskeletal: sprains/strains, tendonitis, neck pain/whiplash, chronic pain

Ear/Nose/Throat: allergies, sinusitis, tinnitus

Neurological: tension headaches, migraines, stress

Other: constipation, arthritis, acne, rosacea, to complement Naturopathic treatment, Bronchitis

Combined Decongestive Therapy (CDT) is a combination of MLD, bandaging of the affected area (with Coban Bandages or short stretch bandaging), remedial exercises and skin care.  CDT is divided into a two-phase program.  An "intensive treatment phase" which is then followed by a "maintenance program" continued by the patient at home.  Even in advanced lymphedema, CDT achieves excellent results with no side effects.  CDT is labour intensive, time consuming and requires patient adherence to their treatment plan, therefore patients must be completely committed to the program.  Goals may also include prevention and decreasing the risk of infection and the reduction of fibrotic tissue.

Low Level Laser Therapy

Low Level Laser Therapy (LLLT) is the treatment of various conditions using laser to bring about a photochemical reaction at a cellular level.  The laser light penetrates into tissue where it is absorbed by cells and converted into energy that influences the course of metabolic processes.  The laser therapy unit is a non-thermal device.  The near-infrared beam is invisible to the human eye.  The laser operates at a wavelength of 904 nanometers.  The invisible wavelength penetrates deeply into tissue (much deeper than the often used red laser operating in the visible red region).

Laser therapy is recognized and used worldwide for treatments of numerous injuries in humans and animals.  It is especially effective in the treatment of : lymphedema, slow healing skin wounds, fibrous lesions, sprains and strains, muscle soreness and softening scar tissue.  

It is FDA approved in the USA as a tool to be used in the treatment of post mastectomy lymphedema.  The FDA noted that investigators observed no adverse effects from the laser treatments.  Since 2000, therapists in Austrailia have used LLLT to treat patients with lymphedema.  Research in Australia with double-blinded control studies has shown the efficacy of this treatment method as an adjunct to CDT treatment.  

Flinders Medical Centre in South Australia has conducted the only randomised double blind trial for any lymphedema treatment in the world.  Flinders research team is internationally recognized in the area of lymphology and lymphedema treatment.  The study has been published in the very reputable journal "Cancer" (2003 edition).

The trial showed that 52% of patients experienced a clinically significant decrease in Extra Cellular Fluid (ECF) after six weeks of laser treatment. In contrast, only 19% of placebo patients experienced the same result.  In the trials, 30% of patients had a reduction in limb volume of 200mls or more. This is a significant improvement.

More importantly (for patients) this improvement was maintained for 3 months. The patients had no other treatment, yet continued to improve over the three month follow-up period.

Professor Neil Piller, who supervised the study, said the laser treatment provided therapists with a powerful tool for reducing the impact of lymphedema on the lives of their patients. "The laser is a very significant, clinically-proven treatment option for lymphedema patients, the first new one in many years", he said.

"Current lymphedema treatments can be time-consuming, are continuous and often very expensive: They typically require patients to develop rigorous maintenance programs that are life-changing." (The laser) "benefits from 20-30% of treated lymphedema patients in a treatment that takes less time, requires fewer consultations and has a lower overall cost. It provides therapists with a valuable new treatment option for patients with lymphedema."

Does the laser work? This laser is the ONLY lymphedema treatment that has been trialled in a randomised double blind study. The laser works very effectively in about 30% of patients and with some effect in about 50% of patients.

Will it burn me?  The laser is a Class 1 laser and it will not burn, or raise the skin temperature.

What are the risks? Laser has been used since the 1960’s and there have been no reported negative effects. We do not recommend the use of the laser over active cancer sites.

What about eye safety?  It is a Class 1 laser and there are no eye safety requirements. 

Where do you use it?  The laser is used on the scar tissue, any hard tissue areas and in the lymph node areas (armpit or groin). Treatment time is usually 15-30 minutes.

Does it work for primary lymphedema?  A study has not been done for primary lymphoedema patients, but in Australia we have several individual patients who have reported benefits from using the laser for primary lymphoedema.

How does the laser work?  The laser affects the individual cells and re-energises them to be more active. This new energy helps to break up fibrous tissue.

Please click to watch a video on Laser for the treatment of Lymphedema - January 2017 

Part 1: General Laser Information, Part 2: Low Level Laser Research, Part 3: How To Use the LTU-904 laser. The Laser Research section starts at 12:37. The Usage section starts at 24:15.

Some of the information (ie. insurance, distributors and FDA) is aimed towards users in the USA, so won't be relevant for those in Canada or Australia or in other countries.

Aqua Lymphatic Therapy

At this time there are no Aqua Lymphatic Therapy (ALT) classes scheduled.  Please call or send me an email and I will add you to my contact list when future classes are scheduled.

ALT uses the properties of water (buoyancy force, hydrostatic pressure, drag, viscosity) to apply a gentle pressure or compression to the lymphatic system.  They hydrostatic pressure of the water is greater (and more comfortable) than a compression garment if used correctly.  Following a special exercise sequence done in a slow rhythm in the pool and combining it with self massage, you can use the properties of water to reduce swelling.

Measurements are taken of the affected limb before and after the ALT class.  Once calculations are made, you will know your fluid loss in mL's showing your progress which helps decide how to best continue with your individual goals.

Goals: improve or maintain lymphedema, improve range of motion, improve function and quality of life, improve muscle strength and endurance, group support and you are learning a treatment that you can do on your own.