posted
Within us all there is a silent system working to keep us healthy- the lymph system. Without it our bodies would swell up like balloons, swamping our cells with stagnant fluid. The lymph system's impact is so far reaching that many don't even realize that minor aches and pains, low energy or susceptibility to colds and flu may be due to a sluggish lymph system and a compromised immune system. In this article we'll discuss the anatomy of the lymph system, what happens during edema and how lymph drainage massage can help, as well as contraindications to lymphatic massage.
Lymph Vessels:
Lymph vessels make an intimate meshwork that covers every inch of your skin, and surrounds each organ in great detail. The lymph vessels start very small in what are called the initial lymphatic. Over 70% of the initial lymphatics are in and just under the skin. The initial lymphatic is a very delicate structure, one cell thick. Those cells are supported within the connective tissue by collagen and elastin fibers that help to anchor them in place.
When the pressure within the interstitial space increases due to a build-up of fluid, or when the skin is slightly stretched, the filaments deform the wall of the initial lymphatic, opening it up.
Then the interstitial fluid flows in and starts to move along the channel. At this point we start calling it lymph. Although only 2-3 litres of lymph is filtered through the lymph system per day, it is vital because it helps to remove proteins that that are too large to get back through the capillary wall. (Guyton and Hall, Human Physiology and Mechanisms of Disease, 6th edition, W.B Saunders Company, Philadelphia, 1997, page 139)
The spaces that open in the initial lymphatic are 4 to 6 times bigger than the spaces in the capillaries. Removal of protein is essential because draw water to themselves, so excess protein in the interstitial spaces causes swelling or edema. The lymph vessels also collect dead cells, waste products, bacteria, viruses, inorganic substances, water and fats.
By performing lymphatic drainage massage correctly, we can stimulate the opening of the initial lymphatic and increase the volume of lymph flow by as much as 20 times. But if we push too hard, we collapse the initial lymphatic, diminishing the lymph flow.
Excessive pressure can even break the filaments that hold the initial lymphatic in place. This is one reason that Deep styles of massage are contraindicated in areas of edema. Luckily if deep pressure has broken any filaments, they usually reform within 24 hours.
After the lymph has entered the initial lymphatic, the lymph moves into a larger vessel called the pre-collector, and then into even larger vessels called the collectors.
The collectors are 100-600 microns in diameter. These vessels have one way valves every 6- 20 mm that only allow the lymph to move in one direction. When you're performing lymphatic drainage massage, you never have to worry that you are damaging your clients by pushing the lymph in the wrong direction- because it literally can't flow backwards. Pushing in the wrong direction won't be very effective, but it won't hurt you client unless you are using deep pressure- and in that case, you are not doing lymphatic drainage massage.
From one one-way-valve to the next is called a lymphangion. The lymphangions have a layer of smooth muscle that spirals around them. Angion means heart- so this is really the pump that pushes the lymph. Each lymphangion has an internal stretch sensor.
The walls of the lymphangion stretch when they fill up with lymph, and then the stretch sensor tells the muscle to contract. This spiralling muscle contracts, squeezing the lymph into the next chamber. This swells the next lymphangion, which then contracts, pushing the fluid down the line. At the same time the lymphangion is pushing the lymph forward, it also is creating a vacuum behind it. It is partly because of this vacuum effect that the lymph gets pulled into the initial lymphatic in the first place. (Kasseroller, R., Compendium of Dr. Vodder's Manual Lymph Drainage, Haug, Heidelberg, 1998)
Once the lymphangions begin contracting, they cause a chain reaction, or a wave of contractions that start to push and pull the lymph through the body. In this way stimulating lymph flow in one area can increase lymph flow in another. Other factors that can assist the movement of the lymph are skeletal muscle contractions, breathing, the pulsing of arteries, as well the ability of the angions to contract independently of the stretch receptors.
Lymphatic Drainage Massage's effectiveness lies in its ability to activate the stretch response, which significantly increases the pulsation rate of the lymphangions, increasing lymph flow through the vessels.
Lymph Nodes:
Eventually, all lymph vessels lead to lymph nodes. Lymph nodes can be as small as the head of a pin, or as big as an olive. There are 400-700 lymph nodes in the body, half of which are located in the abdomen, and many are in the neck.
The primary function of lymph nodes is to filter and purify the lymph. The lymph nodes produce various types of lymphocytes. Lymphocytes destroy harmful substances within the body, and are a big part of the immune system. The lymph nodes reabsorb about 40% of the liquid content of the lymph. This makes the lymph much thicker. Because of this thickening and the filtering process, the lymph nodes offer the greatest resistance to the flow of lymph. In fact the lymph nodes offer about 15 times more resistance than the vessels themselves. Lymphatic drainage can help overcome this resistance and gets the lymph flowing.
Edema:
Each cell is nourished by the nutrients, oxygen and proteins that flow across the walls of capillaries into the interstitial fluid. There is a dynamic balance between the forces that help those nutrients to first exit the capillaries, and then get reabsorbed back into the blood stream. Proteins play a big part in this transfer because they have a tendency to draw water to themselves. This means that the proper amounts of protein on both sides of the capillary wall are vital to keep the tissues balanced. If there are too many proteins within the interstitial spaces, fluid will start to accumulate, causing edema.
The lymph system's role of removing proteins is vital to keeping edema down. If the lymph system becomes sluggish, or is damaged by surgical removal of lymph nodes, edema can develop. This type of edema is called lymphostatic edema- or a high protein edema. Lymphatic drainage can be helpful in reducing this type of edema because the cause is a reduced functioning of the lymph system.
Other causes of edema can be a chemical imbalance in the body caused by liver disease, diabetes, or a variety of other ailments. This type of edema is called lymphodynamic edema, and requires other forms of therapy due to the fact that it is a chemical imbalance. (Kasseroller, R., Compendium of Dr. Vodder's Manual Lymph Drainage, Haug, Heidelberg, 1998)
Indications:
Lymphatic drainage massage is a profound technique to help increase lymph flow. With an increase of lymph flow immune function is increased. Harmful substances are removed from the tissues and neutralized in the nodes. It has also been shown that an increase in lymph flow stimulates an increased production of lymphocytes- enhancing immune function.
Patients that have extreme amounts of edema should work with a group of healthcare practitioner trained in lymph drainage, bandaging and other modalities. However, with a proper understanding of contraindications and some basic training, massage therapists can enhance the health of their clients and reduce minor cases of edema.
Lymphatic drainage in this arena can be applied to clients who are suffering from a lack of energy, or a sluggish immune system.
Lymphatic drainage massage is also useful when working with clients who have sports injuries. After the initial inflammatory stage has passed, lymphatic work can be applied after Sports or Neuromuscular massage has been completed. This will help to clear the tissue of debris, and help to reduce the minor edema that sometimes occurs after deep massage. Continued applications of lymphatic drainage while the client is healing can help to enhance the tissue regeneration process by keep the tissue as health as possible.
Not only is lymphatic drainage useful for sports injuries, but it can also help scars. (Godart, S., "Lymphatic regeneration after second degree burn," Progress in Lymphology, 1975/ Hutzshenreuter, P.O. and Brummer, H., "Manual Lymph Drainage used for Scar Healing," University of Ulm).
Lymph work has been shown to help the scarring process by enhancing circulation and immunity. As the lymph flow around the scar is increased, lymph vessels that have been damaged are stimulated to heal, and the increased lymph flow also draws away toxins, improving the health of the tissues
When attempting to assist healthy scar formation, it is important not to push the lymph into the scar, which can cause the formation of keloids (a build-up of collagen fibres). All scar work should be done without deforming a newly forming scar- so as to not rip the tissue. One way is to work above the scar (closer to the node that drains the area). For example, a lymph therapist could work in the axilla and upper arm to help increase the lymph flow around a scar in the forearm.
Beyond its application for injuries, Estheticians have been using lymph drainage massage for years to enhance the quality of the skin, especially on the face. When the lymph is flowing, the cells are being bathed in fresh fluid, causing the skin to look fresh and alive.
We have all experienced having minor edema in our faces- that puffy feeling and baggy eyes when we first wake in the morning after a long night. Usually after a few minutes of being vertical the lymph system starts to drain the face. A great way to see the power of lymph drainage is to apply a few strokes on one of those mornings, and watch in just a few minutes the tissues drain right before your eyes- leaving you looking vibrant and healthy.
Another common use for lymph drainage massage is with women who have had Breast Cancer and had some axillary lymph nodes removed. Sometimes these people develop edema in their arm. If there is a great deal of swelling, then this is out of the scope of practice for a most massage therapists due to the need for bandaging. If the swelling is minor however, then a massage therapist with a good knowledge of contraindication and a few techniques can do a great amount of good.
Contraindications:
For the most part lymphatic drainage massage is safe. With such a light touch, the danger of causing damage to the tissue is slim. However, there are a few conditions that are contraindicated, and these happen when an increase of lymph flow would be detrimental. It is a good idea to get clearance from their doctor if you ever feel uncertain about working on someone.
Acute inflammation, Malignant tumors, Thrombosis and major heart problems are all contraindications to lymphatic drainage massage.
Lets look at these one at a time:
Acute inflammation caused by bacteria, viruses, poisons or allergens is contraindicated. You can tell if this is the case because the tissues will be, and painful, with congestion accompanied by fever. Lymphatic drainage massage will push these substances into the lymph channels before the body has a chance to eliminate them through phagocytosis in the interstitial spaces.
If you perform lymphatic drainage you can spread the toxic substances throughout the body. Wait a few days until the condition is not acute, and the body has had a chance to clean up the area.
Malignant tumors are a contraindication for lymphatic drainage massage because of the fear of spreading the cancer. Wait until after the malignancy is treated to perform lymphatic drainage massage.
Thrombosis and phlebitis are two conditions that can lead to free floating blood clots. Usually people with these conditions will be in a hospital on blood thinners. If you are working in a hospital setting, do not work on these patients. In your practice, one indication of a possible femoral thrombosis is when the client has pain in one leg and a sudden swelling and bluish discoloration of the skin. People who are bedridden have a greater likelihood of developing thrombosis in the legs.
Major heart problems: If the heart is not fully functioning the edema can be lymphodynamic, due to lack of venous return. Putting more fluid into the heart would only stress it more, worsening the condition.
After reading the contraindications for a modality, many therapists experience fear of working on anyone. The most appropriate response to this list is to add it to your client intake questionnaire. It should also make you take pause to reflect on the power of this type of work- to do harm as well as good.
Lymphatic drainage massage is a great ally in any massage therapist's tool kit. By being able to address the lymph system directly, client's immune system function can be significantly increased. When we have a strong immune system, we are happy, balanced and whole. Lymphatic drainage massage can go where Deep Tissue and Swedish cannot- into swollen areas. The paradox is that such a superficial technique has such a deep impact.
All the Lymphatic Drainage strokes are based on one principle motion. Research has found that the initial lymphatics open up and the lymph angions are stimulated by a straight stretch, but even more so with a little lateral motion. After these 2 motions, we need to release completely to allow the initial lymphatics to close and the lymph to be sucked down the channels. In this zero pressure phase don't completely disconnect from the skin, just return your pressure to nothing. Also don't pull the skin back with you as you return, let it spring back by itself.
This basic motion may resemble a circle, and is called stationary circles. All motions are based on this principle.
In orienting this motion, we always want to push the lymph towards the correct nodes, so the last, lateral stretch motion should be going towards the nodes.
Think about moving water. Visualize those initial lymphatics just in the skin, stretch, opening them up, then release and wait for the lymph angions to pump the lymph down the vessel. Remember how superficial this is. If you are feeling muscle, or other tissue under the skin, you are pushing too hard.
Here are four points remember when performing Lymphatic Massage:
1. Correct pressure is deep enough so that you do not slide over the skin, but light enough so that you don't feel anything below the skin. This is about 1-4 ounces. It is very common for massage therapists trained in Swedish or deep tissue to apply too much pressure with lymphatic drainage massage. Sometimes it is hard to believe that something so light could be effective. Always remember- you are working on skin. How much pressure does it take to deform the skin? Almost nothing. Remember- if you push too hard you collapse the initial lymphatic.
2. Direction of your stroke is of great importance, because we always want to push the lymph towards the correct nodes. If you push the lymph the wrong way, your work will not be effective.
3. Rhythm is very important because with the correct rhythm and speed, the initial lymphatics are opened, and then allowed to shut and then there is a little time that is given for that lymph to get sucked down along the vessel. An appropriate rhythm will also stimulate the parasympathetic nervous system, causing the client to relax.
4. Sequence means the order of the strokes. When we want to drain an area, we always start near the node that we are draining to. Always push the lymph toward the node. Then as we work, we move further and further away from the node, but always pushing the fluid back in the direction of the node. In this way we clear a path for the lymph to move, as well as create a suctioning effect that draws the lymph to the node.
Posts: 8337 | From the other shore | Registered: Jul 2002
| IP: Logged |
posted
Mo thanks for the info. I just wanted to post about Edema. I retain water like the Hoover Dam, and I was wondering if this is normal Lyme symptom.
My LLMd thought it might be due to a gluten allergy. I've been off wheat for almost 6 mo. (ofcrse I slip up sometimes ) andi still have trouble with water retention.
My Lymph nods are sometimes very sore, and swollen under my chin. Also sore under my arms. I have suspected it might be due to my Lymphatic system being all sludged up.
I'll look into Lymph Drainage. Thanks again. Love & Light
Posts: 188 | From NM | Registered: Feb 2006
| IP: Logged |
posted
Mo thanks for the info. I just wanted to post about Edema. I retain water like the Hoover Dam, and I was wondering if this is normal Lyme symptom.
My LLMd thought it might be due to a gluten allergy. I've been off wheat for almost 6 mo. (ofcourse I slip up sometimes ) and I still have trouble with water retention.
My Lymph nods are sometimes very sore, and swollen under my chin. Also sore under my arms. I have suspected it might be due to my Lymphatic system being all sludged up.
I'll look into Lymph Drainage. Thanks again. Love & Light
Posts: 188 | From NM | Registered: Feb 2006
| IP: Logged |
Marnie
Frequent Contributor (5K+ posts)
Member # 773
Adding...Bb locks onto heparin receptors of the endothelial cells. These cells line our blood vessels AND lymph vessels.
In the news just recently...HIGH doses of Crestor not only lowered someone's cholesterol, but...the blood vessels (clogged) HEALED. Repaired themselves!
A choline deficiency disrupts the Na-K pump. There's the edema clue.
A serious electrolyte imbalance.
"These effects were most marked during 10 Hz stimulation where, in some efferent preparations, greater than 5-fold increases in lymph flow and contraction frequency were observed. These results suggest that the observed increases in lymph flow were due to direct neurogenic stimulation of lymphatic pumping."
PMID: 3446793
Even for TMJ...
Experimental and clinical trials were made to compare systemic effects of bipolar-impulse and sinusoidal modulated currents including redistribution of extracellular liquid.
When used in patients with temporomandibular painful dysfunction syndrome and temporomandibular deforming arthrosis, the technique developed by the author promoted normalization of locomotor function and has a definite lymphodraining action.
PMID: 12924189
Enzymes and Lymph Drainage
The Doctor Voddar method of lymph drainage has become an acceptable form of detoxification therapy internationally. Lymph drainage application is a precisely timed series of minute "pumping" manipulations that can be performed anywhere on the body.
Dr. Elizabeth Stenvik of Trondheim in Norway, one of Northern Europe's top research therapists and a teacher of the Vodder method, is absolutely convinced that enzyme muscle banding therapy is another high tech approach to lymph drainage. She is currently researching this potential in a series of clinical trials and the results look promising.
This one says "hands on" (direct massage) is the most effective:
Other studies (Ladd and Blanchard; Pflug, 1975; Wood et. Al., 1991) comparing massage, passive movement and electrical stimulation again showed lymph flow to be greatest following massage. There is a common consent within the literature demonstrating an increase in lymphatic flow.
Treatment of secondary lymphedema of the arm with physical decongestive therapy and sodium selenite: a review.
Kasseroller RG, Schrauzer GN.
Medical Department, Wittlinger's Therapy Center, Walchsee-Alpenbad GmbH, Walchsee, Austria.
Secondary lymphedema (LE) in the proximal extremities develop with relatively high frequency in cancer patients after tumor resection, lymph-node obliteration, and/or postoperative irradiation.
Physical therapy combined with manual or mechanical lymph drainage and compression bandaging provides symptomatic relief but does prevent the progression of degenerative changes in the affected tissues.
As biochemical studies have linked these changes significantly to the excessive generation of oxygen radicals in the affected tissues, LE therapy should aim to eliminate oxygen radical production.
Because selenium is a functional component of antioxidant enzymes, has anti-inflammatory properties, and reduces the expression of endothelial cell adhesion molecules, its effect was investigated in postmastectomy patients with LE of the arm.
Sodium selenite administered orally in isotonic solution (selenase) at oral dosages of 800 microg Se/day on days 1 through 4 and 500 microg Se/day on days 5 through 28 produced a spontaneous reduction in LE volume and normalized blood parameters in a manner consistent with diminished oxygen radical production.
In a randomized, placebo-controlled, double-blind study with postmastectomy LE patients undergoing combined physical decongestion therapy (CPDT), selenite at similar dosages increased the efficacy of CPDT and improved the mobility and heat tolerance of the affected extremity.
The patients in this study received 1000 microg of Se/day orally during the first week, 300 microg Se/day during the second and third weeks, and a maintenance dose of 100 microg Se/day during 3 months of follow-up. All patients remained erysipelas-free during the 3 weeks of CPDT and the 3-month follow-up period.
Based on the available evidence, supplementation with sodium selenite in isotonic solution is judged to be a valuable and safe extension of the physical decongestive therapy of LE.
PMID: 11486162
Posts: 9481 | From Sunshine State | Registered: Mar 2001
| IP: Logged |
posted
Thanks for the Vodder info, Marnie - I haven't gone for any draonage massage yet myself, but I hear it is great.
I am doing the 'health bounce' on a rebounder for Lymph drainage. I'll post back how it works for me now, but I can say it worked very well in the past.
That and Lymph brushing, but you have to get the right touch going.
I am also looking into the Chi machines, (they run about 200 bucks for the Chi Vitalizer machine, there are other brands but that's the best for the buck IMO) .. and they are a machine that basically rocks your legs.
I'm not sure that is necessary if one is rebounding, but may be great for one who needs to work on Lymph lying down, or cannot excercise.
There are also herbal teas that can help clear Lymph - I have a Lymph cleansing diet here too somewhere, that is mainly homemade veggie broths.
Yemaya - I nave nad swollen/clogged Lymph on and off through illness, and often times with effective treatments and cleansing.. just after them everything would swell.
all the toxins and debris can get blocked up in this great system.. so now I think it's more important than alsmost anything to keep this system moving and healthy ..
other wise you are just recycling garbage in your body.
(also make sure colon and kidneys are cleansed, so the Lymph has a working system to carry out it's waste - you definitiely want them clear as well, or you'll get the back up/inflammation/problems there)
Mo
Posts: 8337 | From the other shore | Registered: Jul 2002
| IP: Logged |
The Lyme Disease Network is a non-profit organization funded by individual donations. If you would like to support the Network and the LymeNet system of Web services, please send your donations to:
The
Lyme Disease Network of New Jersey 907 Pebble Creek Court,
Pennington,
NJ08534USA http://www.lymenet.org/
UBBFriend: Email this page to someone!
Printer-friendly view of this topic