Lymph Basics
Pathology
Treatment
Post-Surgical
Do or Don’t 👀
Contraindications
100
This system returns excess fluid back to the bloodstream
What is the lymphatic system?
100
This fluid buildup can occur after surgery when significant amounts of tissue have been removed.
What is a seroma?
LMTs can help if a seroma is formed by using MLD directly on and around (with doctor approval), if it is stubborn they should talk to their doctor. Sometimes another procedure is needed, sometimes antibiotics. They can be permanent. This can happen in cosmetic and traditional surgeries.
100
This technique uses light, directional strokes to move lymph
What is manual lymphatic drainage (MLD)?
100
Heat, vibration, cupping, MLD
What are techniques to help with post surgical swelling after 4 weeks and doctor's approval?
100
A licensed massage therapist with no additional training is equipped to deal with complex cases of swelling, edema, and lymphedema
What is a don't?
100
A client has visible swelling and asks for “firm pressure to break it up.” What is your response?
What is avoid deep pressure and educate that lymph requires light, directional work?
200
The lymphatic system relies on this instead of a pump
What is muscle movement / breathing?
200
Lipedema is symmetrical or asymmetrical?
What is symmetrical?
200
This breathing technique helps move lymph
What is diaphragmatic breathing?
200
T/F Cupping can be used to reduce fibrosis in scar tissue at 2 weeks post procedure
What is false!
Cupping is great at breaking fibrosis up. Wait at least 4 weeks until all incisions are healed and physician has given the OK!
200
Massage over fresh incisions
What is don't?
Wear gloves up to 2 weeks/until incisions healed, avoid all incisions. At about 4 weeks post op, work on scars can start
200
A client is 2 days post-op with surgical drains still in place. What is your course of action?
What is avoid massage and defer treatment or work only outside scope?
300
name three major lymph node regions
What are cervical, axillary, and inguinal, etc?
300
A CLT-Certified Lymphedema Therapist
A certified professional trained to manage symptoms of post cancer, post surgical, and moderate and severe cases of edema and lymphedema
300
Post MLD treatment client instructions
What is: increase water intake, rest. Expect to feel relaxed and a little sleepy the rest of the day. In some cases feelings of nausea.
300
Before working on a client, you should know these things
What is the surgery date and procedure, doctor approved, any drains still in place?
300
A licensed massage therapist with a basic understanding of the lymphatic system and training in some of the techniques of MLD are equipped to perform a lymphatic drainage massage or integrated lymphatic massage on otherwise healthy individuals cleared by their doctors
What is a do!
300
A client has congestive heart failure and presents with bilateral lower leg swelling. Why is lymphatic massage potentially contraindicated?
What is because increasing fluid return to circulation can overwhelm the heart?
400
These divide the body and determine lymph flow direction
What are watersheds?
400
A client has an active infection in the leg with redness, heat, and swelling. Should you perform lymphatic massage?
What is NO, due to risk of spreading infection
400
Common characteristics of different MLD types (Vodder-we learned, Chikly, Foldi, Casley-Smith)
What is slow strokes (1 second), rhythmic, light pressure?
400
MLD can begin in this timeframe after surgery
What is 24-48 hours!
As an LMT, as soon as the client can ambulate themselves and post surgical fluids have stopped draining
400
Share your opinion on cosmetic surgeries, comparing the work the doctor did to other clients, talking about how a problem area is healing.
What is don't!
If a client has a question regarding their healing process, encourage them to reach out to their doctor. It is ok to point out hard spots, areas of swelling and if there is change to the tissue. You can encourage them to remain lightly active as advised by their physician and to hydrate.
400
A client has kidney failure with edema. Why should lymphatic drainage be used with extreme caution or avoided?
What is because the kidneys cannot properly filter the increased fluid load?
500
Why pressure should be light in lymphatic work
What is it is a low pressure system that is just beneath the skins surface?
**Hard pressure can interfere with natural flow of lymph, it is ok to do deep tissue and lymph together--end with lymph!
500
T/F The training received in massage school prepares a licensed massage therapist to work on this client
This is a trick question. Right now, you could be a part of someone's care team and your training could help relieve some heavy swelling! As long as they are cleared by their doctor
Usually in moderate and severe cases they work with a physical therapist and nursing team in medical clinics where insurance covers the massage as well as bandaging. Some clients do additional sessions at massage clinics.
500
Benefits of MLD
What are:
-reduced Swelling and Fluid Retention
-Enhanced Immune System
-Improved Detoxification
-Faster Recovery Post-Surgery-Often used to reduce swelling, bruising, and discomfort after surgeries like liposuction or breast cancer surgery
-Pain Management & Relaxation
-Improved Skin Health: Can result in reduced puffiness and a healthier, glowing appearance.
500
After a fat transfer, full body weight (lay prone/supine unsupported) can be used at around this amount of time post procedure?
What is at least 6-8 weeks
500
Bolster for comfort and drainage
DO!
500
A client with both lymphedema and congestive heart failure requests treatment. What is your BEST course of action?
What is require medical clearance and proceed cautiously or refer out?