Different MLD methods

There are differences in the methods our LE therapists learn, depending on which school they go to.  There are several very reputable LE therapy schools, so 'different' does not necessarily translate to 'wrong.'  I watched a Joanne Rovig video, for example, and she does not seem to do any stationery circles, just sweeps.  My therapist (and some other videos I've seen) uses a method of circles moving toward trapped fluid first, followed by sweeps to move fluid away from the trapped area. Sometimes I read descriptions that include the term 'scoop.'  I've never heard 'scoop' from my therapist, and I've never heard the word on a video. No wonder this is so confusing!! 

Do we know how the various schools differ in their MLD training?  If watching a YouTube video, how can we tell good technique from bad technique, if there are so many differences in what are accepted as effective MLD methods?

Lots of us have trouble finding therapists who are adequately qualified. Could knowing something of the range of 'correct' MLD techniques help us tell the difference between the poorly qualified and the truly qualified?

Purple, there's a book called "Lymphedema: A Breast Cancer Patient's Guide to Prevention and Healing" by Burt and White that has good illustrated instructions (and a lot of other good information as well). It doesn't pertain to bilateral surgery, but it's clear and reliable.

Hope that helps!
Binney

Binney, I was interested in purple's comment that her CLT told her that an MLD method was not good, and that got me thinking that there seem to be many different, but effective methods (not that I believe for a minute that all the youtube demos are based on legitimate, effective technique).

How do we know if a method we learn is 'wrong' vs. simply 'different'? True, MLD patterns should be customized to our specific LE needs, but do you think it's likely that one CLT who learned, say Vodder, might criticize what I was taught by another CLT who learned her technique from a different school?  Just because she does not recognize its elements?

Carol

Purple, what video was your therapist talking about?

Carol, the schools used to be pretty snooty about talking down the others' methods. As a result of that attitude there are still bad feelings among some therapists regarding those from other schools. But in the 8+ years I've had LE I've seen most of them soften on that issue. The one exception would be the Chickley therapists, who claim to "feel" the lymph moving beneath our skin with their hands, and use that to sense the pattern each patient should use. They still tend to look down on other therapists and keep themselves apart from them. Which is not to say they're not effective therapists, only that it'd be better for both public and professional awareness if all our providers could play nice together. (Please, guys?!!!)

Last year four of the major therapist schools joined together to form an organization called The North American Lymphedema Education Association (NALEA). The four schools are Academy of Lymphatic Studies (ACOLS), Dr. Vodder School International, Klose Training and Consulting, and Norton School of Lymphatic Therapy. One of the forces that finally brought them together was the need to jointly off-set the lobbying power of the PT and OT organizations who wish to prevent legislation requiring full training for LE therapists. Another factor was the need to provide some kind of oversight of therapists once they're trained and out in the field working (which LANA does not do in any way.)

All that just to say that the scorn with which an individual therapist may treat the MLD methods of others MAY have more to do with this long-standing competitiveness than with any superiority of one method over another. The major schools (including Chickley's) all agree on the physiology of the lymph system and the principles of physics that apply to MLD. They move fluid in the same order and direction, and they all agree CDT involves the four aspects of MLD, compression, exercises, and skin care.

The problems come from a few sources, like:

--therapists who short-cut from what they've learned, or use methods they've developed individually that are not grounded in the physiology of the lymph system

--therapists who have never been adequately trained and are not properly supervised

--pop-lymphatic "detoxification" practitioners who use methods created and passed on by people with only a superficial understanding of the lymph system

Does any of that help?
Hugs,
Binney

Exactly. And once you pass the test you're "LANA certified," whether you apply what you've learned and been tested on or not. There is no way, as a patient, to appeal to LANA when one of their certified therapists diverges from standard practice. Makes me a little crazy just thinking about it--grrrrrrr!

One of my "soapbox" issues, so I'll step down now before I get all ruffled!
Binney

Carol - you asked about the word "scoop" in relation to MLD.  My last two LET use the "scoop" when doing deep abdominal work and I do it with my own MLD.  Basically the motion is like scooping sand, cupping your hand and putting the pinky side of the hand against the skin.  If your belly button is the center of a clock, you do deep scoops from 10, 2, 4, and 8 on the clock (basically above each hip bone and under each side of the ribs), pushing the fluid towards the belly button which is the site of that cisterna lymph drain.  (Too lazy to look up the proper word.) It's a fairly firm pressure because you're trying to clear the lymph vessels deep in the abdomen - much firmer than you'd use in the rest of MLD.  Once you've "scooped" the fluid, then you do deep breaths while pressing on the abdomen is a sort of "M" pattern.  I think that's the Vodder method, though it might be Klose - my LET told me last time, but I forgot.  It's been effective for me in trying to manage my truncal LE. 

Purple, I am not able to see the video at this time, but I suspect that pumping under the arms is node stimulation, which is a part of my MLD routine. Fifty sounds like a lot. I do twenty on each side.