Lymphoedema and How Physiotherapy Can Help
What is Lymphoedema?
Lymphoedema is an abnormal accumulation of swelling in a limb, due to disruption of the lymphatic system. The lymphatic system is a network of vessels throughout the body that drains and filters fluid (called lymph) from tissues and empties it back into the bloodstream. Most commonly it occurs as a side effect of cancer treatment where lymph nodes have been removed or damaged. Lymphoedema may also arise due to trauma, chronic inflammation, venous disease, immobility, filariasis and obesity.
Common Signs and Symptoms
- Swelling
- Redness
- Complaints of heaviness, achiness and the feeling of tension or bursting
- Skin feels hot and tight
- Hardening and thickening of the skin
- Decreased range of movement in the affected limb
- Recurrent cellulitis
How can Physiotherapy reduce Lymphoedema?
A Physiotherapist will perform a thorough subjective and objective assessment of the affected limb/s and trunk to rule out other causes of oedema. If the oedema is confirmed to be lymphoedema the physiotherapist will manage it with Complete Decongestive Therapy (CDT):
Manual Lymphatic Drainage
Type of massage that increases lymphatic movement, increases reabsorption of the fluid, promotes relaxation and creates a pain-relieving effect.
Compression therapy
Bandaging and garments improve the efficiency of the muscle and joint pumps and prevent re-accumulation of evacuated oedema.
Exercise
Exercise in conjunction with compression promotes the muscle and joint pump, therefore, facilitating lymphatic and venous return.
Education on skin and nail care
Meticulous skin and nail care are important for decreasing the incidence of infections.
Instructions in self-care
Self-care is important to ensure patients can maintain their results obtained with CDT. Self-care includes, but is not limited to donning and doffing garments, self-drainage, self-bandaging, ensuring a good understanding of risk reduction practices.
Meet our Lymphoedema Physiotherapist
Cara is an Australasian Lymphology Association accredited Lymphoedema practitioner. She graduated from the Australian Catholic University after completing her Bachelor of Physiotherapy. Cara completed her Lymphoedema courses at the Royal Brisbane Hospital. She is qualified to treat lymphoedema in the upper and lower limbs, breasts, genitals, trunk, abdomen and paediatrics. Cara is also a recognised DVA lymphoedema practitioner.
Other Conditions Cara can treat:
Chronic Venous Insufficiency (CVI)
The most important element in the treatment of venous disease is compression. This holds true even if an ulcer is present.
- Cara can prescribe compression garments for your patients.
- Manual lymphatic drainage may be necessary in cases of CVI that have associated lymphoedema.
Lipoedema
Lipoedema is asymmetrical, bilateral enlargement of fatty tissue usually from the pelvic region to the ankle. It almost exclusively affects women, and the onset is usually puberty due to hormonal changes. Unique signs of lipoedema include hypersensitivity of the tissues, the tissues bruise easily and it is resistant to diet and exercise. These patients can also start to develop lymphoedema.
These patients are managed with Complete Decongestive Therapy.
Paediatric Lymphoedema
Lymphoedema in young children is caused by malformations of the lymphatic system. Here are the two most common conditions:
- Milroy’s Disease: Swelling is present at birth or within the first year of life and is caused by a specific genetic mutation.
- Meige’s Disease: An autosomal dominant disorder, where lymphoedema mainly affects the lower extremities. The onset is most frequently around the time of adolescence.
If you or someone you know may need help with Lymphoedema get in contact with the Total Rehab Solutions Team and see how our Physio Team can help you! 
admin@totalrehabsolutions.com.au
1300 685 046
Written By, Physiotherapist Cara Niven