Kitsap Physical Therapy and Sports Clinics

Lymphedema Management

Lymphedema is swelling caused by obstruction or damage in the lymph drainage system.  It sometimes occurs naturally and sometimes is secondary to trauma. It may also be a result of surgery or radiation, but often it can be prevented when patients are taught precautions after surgery.

Lymphedema is an abnormal accumulation of lymph fluid between the skin and muscles of the body that causes swelling, most often in the arm(s) and/or leg(s), and occasionally in other parts of the body. Lymphedema can occur when lymphatic vessels are missing or impaired (primary), or when lymph vessels are damaged or lymph nodes are removed (secondary).

Lymphedema should not be confused with edema resulting from venous insufficiency, which is not lymph-edema.  However, venous insufficiency can progress into a combined venous/lymphatic disorder which is treated in the same way as lymphedema.

Most Common Reasons for Lymphedema:

  1. Post Cancer
  2. Surgery combined with radiation therapy for cancer is a common cause of secondary lymphedema.  Our treatment and management program will control & reduce these symptoms.
  3. Chronic Venous Insufficiency
  4. This occurs due to the failure of the valves in the veins to fully shut — causing the legs to chronically swell which, in turn, leads to thickening and hard tissue fibrosis.
  5. Orthopedic Edema
  6. The lymphatic system can be overloaded in some injuries leading to edema problems
  7. Other
  8. Lymphedema can also result from scarring, excision of lymph nodes, repeated infections, or paralysis with dependent limb positioning.

We offer post-operative care with individually designed exercise programs, education regarding the prevention and/or risk management with lymphedema and self-treatment for home care of these situations.  Typically, treatments utilize compression therapy, manual lymphatic mobilization, drainage techniques, exercises, and education in skin care to better manage the lymphedema.

Axillary Web Syndrome or Cording

This condition sometimes occurs following mastectomy, lumpectomy or lymph node dissection and can be exacerbated following radiation treatment. It involves fibrosis and adhesion’s (probably of the vessels – lymphatic or circulatory) which causes tight bands in the underarm and arm.

Physical therapy treatment involving manual stretching, fascial release and range of motion and stretching exercises can alleviate this problem and reduced pain and restore mobilty and function.

Signs and Symptoms

With lymphedema, you may have:

  • Dull ache in affected limb
  • Feeling of tightness in the skin
  • Difficulty moving a limb, bending at the joint
  • Pitting-small indentation left on the skin after pressure is applied
  • Shoes, rings, or watches suddenly fit too tightly
  • Repeated infections in your arm or leg
  • Joint Pain
  • Difficulty doing your daily activities

If you notice persistent swelling, it is very important you seek immediate medical advice as early diagnosis and treatment improves both prognosis and the condition.

How Can Kitsap Physical Therapy Help?

We have 4 therapists who are trained in evidence-based protocols for lymphedema management.  Our cancer patients are gently supported in regaining strength and endurance both during and after their cancer treatment.  Our therapists will work closely with you to design a treatment program to help control the swelling and meet your goals for returning to your activities.  We help our patients feel more comfortable, gain independence and prevent potential complication with lymphedema.
Typically, treatments utilize Complete Decongestive Therapy (CDT), which consists of manual lymph drainage, compression therapy, and exercise.  Education regarding prevention and/or risk management with lymphedema and self-treatment for home care of these situations is also addressed.  All components are integral parts of a lymphedema treatment program.

is swelling caused by obstruction or damage in the lymph drainage system. It sometimes occurs naturally and sometimes is secondary to trauma. It may also be a result of surgery or radiation, but often it can be prevented when patients are taught precautions after surgery.

The 3 most common causes of Lymphedema:

  1. Post Cancer
    Surgery combined with radiation therapy for cancer is a common cause of secondary lymphedema. Our treatment and management program will control & reduce these symptoms.
  2. Chronic Venous Insufficiency
    This occurs due to the failure of the valves in the veins to fully shut – causing the legs to chronically swell which, in turn, leads to thickening and hard tissue fibrosis.
  3. Orthopedic Edema
    The lymphatic system can be overloaded in some injuries leading to edema problems.

We offer post-operative care with individually designed exercise programs, education regarding the prevention and/or risk management with lymphedema and self-treatment for home care of these situations. Typically, treatments utilize compression therapy, manual lymphatic mobilization, drainage techniques, exercises, and education in skin care to better manage the lymphedema.

Axillary Web Syndrome or Cording
This condition sometimes occurs following mastectomy, lumpectomy or lymph node dissection and can be exacerbated following radiation treatment. It involves fibrosis and adhesion’s (probably of the vessels – lymphatic or circulatory) which causes tight bands in the underarm and arm.
Physical therapy treatment involving manual stretching, fascial release and range of motion and stretching exercises can alleviate this problem and reduced pain and restore mobility and function.

We have 6 therapists who are trained in evidence-based protocols for lymphedema management. Our cancer patients are gently supported in regaining strength and endurance both during and after their cancer treatment. We help our patients feel more comfortable, gain independence and prevent potential complication with lymphedema.

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