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Physical and Occupational Therapy for Lymphedema

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Lymphedema is a chronic disease that affects your lymph nodes. Your lymph nodes are small organs that help your body filter out waste and maintain healthy fluid levels.

Lymphedema may occur if your lymph nodes are damaged, removed, or don’t work properly. This may cause a buildup of fluid and swelling in the affected tissue. Lymphedema commonly affects the arms or legs, but it can also occur in the face, trunk, abdomen, or genital area.

Often, lymphedema may be associated with having lymph nodes removed or having radiation as part of cancer treatment. There may also be non-cancer-related lymphedema associated with other medical conditions and causes. Being overweight or older are known risk factors.

There is no cure for lymphedema. However, physical and occupational therapy can play a vital role in treatment. Seek treatment right away to help manage the condition. If left untreated, it can cause serious long-term health consequences.

The University of Miami Lymphatic Program offers individualized physical and occupational therapy for lymphedema, using the latest evidence-based practices. If you or someone you love is struggling with lymphedema, we can help you manage symptoms, improve mobility, and enjoy a better quality of life.

Lymphedema Management — Why Timely Treatment Matters

Treatment for lymphedema helps you prevent your symptoms from worsening. It will help you feel better and learn how to effectively manage your symptoms at home.

During the early stages, the main symptom of lymphedema is swelling. You may notice that symptoms can get worse if you sit or stand for too long. Your clothes and jewelry may not fit the same due to fluid buildup, and it may be harder to move. Also, your skin may feel tighter or heavier.

As the lymphedema progresses, the swelling causes a hardening of the affected tissues. In the later stages of lymphedema, you may notice:

  • Increased hardening
  • Extreme increase in swelling
  • Fungal infections

Beyond the physical challenges, lymphedema can affect you emotionally. For example, you may feel self-conscious about how your body looks. Or your symptoms may keep you from doing your everyday activities. That’s why it’s important to get treatment as early as you can.

Who benefits from lymphedema physical therapy?

Our lymphedema therapy team supports a wide range of people struggling with lymphedema. This may include:

  • People who have been diagnosed or treated for cancer, including breast cancer, head and neck cancer, prostate cancer, melanoma, and other kinds of cancers
  • People who have been diagnosed or surgically treated for other medical conditions affecting the lymph nodes
  • People who have genetic (present at birth) lymphedema
  • People with conditions associated with lymphedema, such as venous insufficiency and lipedema, which is an abnormal buildup of fat, usually in the legs, which can cause lymphedema

Imaging tests

In some cases, your specialist may recommend you undergo an imaging test to closely examine the area of your body affected by lymphedema. This may include a magnetic resonance imaging (MRI) scan, a computerized tomography (CT) scan, Doppler ultrasound, and/or lymphoscintigraphy.

Key Components of Lymphedema Physical and Occupational Therapy

Our team uses a non-invasive approach called complete decongestive therapy (CDT). CDT therapy is considered the gold standard for helping to reduce swelling and improve quality of life for people living with lymphedema.

Our goal is to help you get your lymphedema under control and then manage it independently. Key components of our program include the following:

Manual lymphatic drainage

Manual lymphatic drainage (MLD) is a gentle technique that helps to move the lymph fluid out of swollen limbs. You typically start by doing deep breathing to prepare your system. Your therapist then applies light pressure to stimulate your lymph nodes. After that, your therapist performs a gentle massage to move the fluid away from the affected tissue and toward your heart.

As a final step after MLD, your therapist will apply a special, short-stretch compression bandage to the affected limb. This is known as compression therapy.

Compression therapy

Compression therapy is a technique used to prevent fluid from building up in tissue affected by lymphedema. It uses a short stretch bandage or garment (such as a sleeve) to put pressure on the tissue and move fluid through the lymph vessels. Therapists typically use compression therapy after an MLD treatment. This can help keep swelling down.

Compression therapy can also be used proactively to prevent fluid buildup. For example, if you’re planning to do activities such as travel or exercise, your therapist may recommend that you wear a compression garment to help prevent swelling. If you need compression therapy, you may have a garment custom-designed for you.

Lymphedema exercises

As your muscles pump, they move the lymph fluid out of the affected area. Therefore, staying physically active can help you manage your lymphedema and your overall health.

Your therapist will help you find exercises that work for you. If you’re already physically active, you can plan to get back to your regular exercise routine. If you’re not active, your therapist will help you get started at your own pace. What’s most important is to find an exercise program that can help you manage your lymphedema and support a healthy lifestyle.

Patient education

Managing lymphedema is not easy. However, you can live a full and active life with a personalized treatment plan. We focus on teaching you how to control the things you can control. These include:

  • A healthy diet
  • Physical exercise
  • Maintaining a healthy weight
  • Stress management
  • Compression
  • Self-massages
  • Skin and nail care to help prevent infections

We understand that you will have ups and downs, and we help you develop a plan that fits into your life. If your lymphedema is associated with cancer treatment, you can find extra support from survivorship care services through Sylvester Comprehensive Cancer Center.

Benefits of Lymphedema Physical Therapy

Lymphedema physical therapy can help you achieve meaningful improvements in your health and overall well-being. Key benefits may include the following.

Reduced swelling and pain

Results of therapy can vary. However, CDT therapy has been found to be highly effective in reducing swelling. Reports have found limb volume reductions of 50–70% with this therapy approach. CDT has also been found to help alleviate other symptoms, such as pain and heaviness in patients with breast cancer-related lymphedema.

Improved mobility and function

Lymphedema can affect the mobility of both the upper and lower limbs, depending on which tissues are affected. For example, pain and swelling in your arms may affect your range of motion and arm strength. Swollen and painful feet and legs can make it difficult to walk and wear your regular shoes. Taking part in physical therapy with CDT has been found to improve mobility and promote greater independence for people with both lower limb and arm mobility challenges.

Enhanced quality of life

Research on CDT therapy for lymphedema consistently shows positive improvements across multiple areas. This includes improvements in function, cosmetic appearance, and overall health. Positive changes have also been found in areas such as sleep quality, fatigue levels, and general quality of life.

What to Expect During Your Physical Therapy

Our goal is to help set you up for success so you can manage your lymphedema independently.

The length of your physical therapy can vary. In general, you should plan to commit to four months of physical therapy appointments before you’re ready to move to self-management.

Initial evaluation

Your initial evaluation will help us better understand your health and goals for therapy. It and all of your therapy sessions will last one hour.

Topics and activities covered typically include:

  • Your health history. We’ll discuss your health history and how you’ve been managing your lymphedema.
  • Physical exam. We’ll conduct a thorough physical exam to confirm the diagnosis of lymphedema.
  • Lymphedema assessment. We’ll measure the circumference of limbs affected by lymphedema and assess your functions such as strength and balance.
  • Mini therapy session. We’ll perform a mini therapy session. For example, this may include a short massage or exercise. During this time, we’ll also get to know you better and answer questions you may have about therapy.
  • Compression garment planning. We’ll discuss compression therapy and connect you with a representative who can help you get a custom garment (if needed). This may include compression stockings for swollen legs, or a compression bra for breast swelling.

Treatment plan development

Based on your goals and needs, we’ll develop a customized plan to help you manage your lymphedema. This plan will include the components of complete decongestive therapy (CDT), such as manual lymphatic drainage, lymphedema exercises, and compression.

We’ll also provide ongoing education to prepare you for self-management. This may include things like managing your diet and stress, which can both impact lymphedema symptoms.

Typically, we start with two to three one-hour sessions per week. We call this the intensive phase. Our goal is to get the swollen limb as small as we can. We gradually reduce the frequency of sessions, which is the maintenance phase. Finally, you’ll move to self-management. The exact amount of physical therapy sessions you need and timing can vary from patient to patient.

Ongoing sessions and monitoring

By the time your physical therapy is complete, you should have the tools you need to manage your lymphedema on your own. Don't worry. We’re still available to help you with more sessions and monitoring, as needed.

We understand that you may experience setbacks or challenges periodically. Also, events in your life may sometimes disrupt your treatment routine. If you need extra help, our physical therapy team is here to help you get back on track.

At-Home Therapy Techniques

Our goal is to set you up for effective self-management at home. Here are some of the ways you can maintain your progress and support your overall health.

Keeping up with your at-home exercises can help you keep fluids moving and prevent swelling. It can also help you maintain a healthy weight, which is important for lymphedema management and your overall health.

Proper use of compression garments

Using your compression garments as instructed can help you manage your lymphedema symptoms and prevent swelling. As this area of therapy has grown, more types of garments have become available. You can even find garments in special patterns and colors to reflect your individual style and personality!

Skin care and infection prevention

Keeping up with your recommended skin care routine is important to manage challenges that can occur with lymphedema. One of the most important things to remember is to stay hydrated inside and out. This can include drinking water and using moisturizer to prevent cracked skin and infections.

Why Choose UHealth?

Expertise of our physical therapists. Physical and occupational lymphedema therapists at UHealth are certified specialists. Plus, each therapist has an extra specialty to further customize care. For example, therapists may specialize in areas such as oncology, pelvic floor health, neurology, and others. This gives you access to comprehensive care from therapists who understand your unique challenges and how to manage them.

Personalized treatment plans. We tailor all aspects of therapy to your individual needs and goals. Also, we provide one-on-one therapy for one hour during each therapy session. Our therapists understand that you’re managing your lymphedema while also juggling your other responsibilities and goals. We work hard to develop a personalized and effective treatment plan that helps you achieve your goals for better health and thrive in your everyday life.

Recognized, cutting-edge lymphedema care. Our Comprehensive Lymphedema Program has been designated as a Center of Excellence by the Lymphatic Education and Research Network (LE&RN). Our program was the first comprehensive lymphatic Center of Excellence in South Florida. To help maintain a high level of care, we have a dedicated lymphedema task force that focuses on ways to better serve our patients. Our advanced therapy techniques include specialized services such as cupping, which involves lifting the connective tissue in the skin (fascia) to help move the fluid underneath.

Comprehensive, evidence-based treatments. Our complete decongestive therapy (CDT) approach uses evidence-based techniques that have been found to have a positive effect in managing lymphedema. If you need other types of specialized lymphedema care, you can find it with us — all in one place. Along with physical and occupational therapy, we offer lymphedema rehabilitation care, lymphedema surgery, and interventional radiology procedures for lymphedema. We also offer cancer survivorship services through the Sylvester Comprehensive Cancer Center to provide extra support for people managing lymphedema related to cancer treatment.

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