MLD question

AnnetteS

I have read several places and was told by a therapist that the manual lymphatic drainage massage should be very light on the skin.  I have heard "like petting a kitty" or "just enough to move the skin" or " like brushing something off"

I am in the process of my therapy where they teach me how to wrap, skin care, etc.  My first therapist stroked my skin very softly.  The second one did more like a massage. Not DEEP muscle massage, but definately a LOT harder than I expected.  I asked her why the difference and she said that the two therapists went to different schools and learned different techniques.  She said that her way (the harder one) was a newer method. She knew exactly how the first one did it.

I saw huge improvements in my arm after the first treatment (with the light touch) and no improvement after three of the harder treatments.  I am not sure if it is because you would expect more improvement in the beginning or if this new girl isn;t going it right.

Also. when I take off my bandages, I have areas where the swelling is down, but then it goes right back up after a half hour or so.

I'm I missing something? Is it okay for it to be either soft or hard?  I will have a third therapist for my last three sessions, but I have no idea how she will do it.

kira66715

Annette, the superficial lymphatics are in the skin, so deeper masage will actually shut them down and can potentially harm them. I've never heard of a "new method" that recommends deeper massage.

I think the proof is in the results.

JoAnn Rovig has a series of on-line videos--and yes, she does demonstrate over her clother, and she only shows the "sweep" stroke, but she talks about the superficial lymphatics and how you could damage them with too much pressure.

You only want to move the skin, not muscle, and never cause redness

Here's the link to the Nortwest LE center self-care videos

http://www.nwlymphedemacenter.org/

You can be too hard, very difficult to be too soft.

I had a "weekend wonder" therapist knead me like bread dough: I was out of there after a session.

Good for you to question her--now, Il'd let her know that her new method doesn't work, or just avoid her.

Kira

Binney4

Annette, there's a local therapist here who also believes she's doing something "new" with her rougher massage technique. She prides herself on doing things differently and thinks it's ridiculous to be so gentle with such a troublesome condition. But her patients do very poorly, and the better therapists in our area often end up having to undo the damage. I agree with Kira: the proof is in the results. It's great that you had that first session as a comparison. Can you get the first therapist back again?

When you take off the bandages and get quick return of swelling it could be from several causes. Most likely is that the bandages were too tight, and the swelling you get when you remove the wraps is rebound swelling -- your body's over-reaction to the too-tight compression. Another cause could be uneven wrapping, with an area of tighter compression or more layers of wraps higher up your arm, which is the opposite of what it should be. When that happens it can create areas of swelling below the constriction that may not appear until the wraps are off. A third reason could be that you just happen to be a person whose LE needs constant compression, but since that's pretty rare it's more likely a wrapping problem.

Good for you for raising these questions! Don't be afraid to insist on answers from the therapist team that's treating you.

Let us know what you discover. Gentle hugs,
Binney