What is Lymphedema?
Lymphedema is a condition characterized by excessive swelling of the tissue with protein-rich lymph fluid. It commonly develops in the arms or legs, but can occur anywhere in the body that is adjacent to the affected lymph nodes. This is caused by abnormal development of the lymphatic vessels (primary) or damage to the lymphatic system (secondary).
What causes Lymphedema?
Lymphedema caused by abnormal development of the lymphatic vessels is referred to as Primary Lymphedema.
Lymphedema caused by damage to the lymphatic system is known as Secondary Lymphedema. This type of lymphedema can occur at any time after surgery, from 1 day post-op to decades after the surgery was performed.
The Lymphatic System
The lymphatic system is part of the body's immune system. It moves lymph, a clear fluid that cleanses the body's tissues, delivered to tissue by the arteries and returned to that cleanse the body's tissues.
Proteins found in the lymph fluid are not the same proteins that we ingest through food. These proteins cause the pitting in the skin that is sometimes seen with excess swelling.
Lymph nodes are the body's internal filter to trap bacteria, viruses, cancer cells, and other unwanted substances. These unwanted radicals are then safely eliminated from the body by the lymphatic system. In the circulatory system, arteries deliver blood with oxygen and nutrients to the tissues in the body, and then veins take the blood back through the heart to be replenished. Similarly, lymph fluid also has to be replenished, and is taken back to the heart by the lymphatic vessels and nodes.
Prevention & Risk-Reduction
The non-modifiable factors predisposing an individual to lymphedema could be congenital, surgical, or treatment-related (eg. radiation therapy, chemotherapy, or seroma).
There are, however, several factors that an individual could control:
Obesity can play a major role in developing & worsening lymphedema.
Injury to an affected area can aggravate the lymphatic system. A cut, scratch, or puncture would should be cleaned with warm, soapy water and protected by a bandage.
Insect Bites inject toxins into your system. If the bite welts abnormally, you may need an antihistamine to counter the reaction & reduce swelling.
Strenuous Activity for long periods of time should be avoided, including house cleaning, yard work, & sports.
Repetitive activities can cause stress injuries over long periods of time. No ball squeezes, and avoid long hours of computer use, typing, or texting.
Constriction of the extremity should be avoided, including blood pressure cuffs and tight clothing or jewelry.
Exercise is recommended, but the way you exercise with lymphedema is extremely important. The safest bet is a slow progression of strength training, aerobic activity, yoga, and/or pilates.
Stick to the 7 Basic Rules of Exercise:
1. Begin your workout with deep breathing exercises
2. Start moving with simple, basic exercises. Gradually progress to more challenging exercises
3. Perform all exercises at moderate-to-slow speed. No sudden movements!
4. Start with low weight (2-3 lbs.) and build up to 5-8lbs or more according to your strength
5. Start with smaller sets and fewer repetitions (1x10 reps), building up to 3x15 reps.
6. Perform all stretches slowly, holding for at least 30 seconds in each stretch
7. End your workout with deep breathing exercises
Treating Lymphedema
Proper treatment of lymphedema is important to decrease the risk of infection, improve function, decrease discomfort and pain, and improve the overall appearance of the affected area.
Treatment may include:
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Manual lymph drainage
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Compression bandages
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Skin care & hygiene regimen
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Exercise
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Diaphragmatic breathing
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Compression garments
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Intermittent pneumatic compression device