What is the lymphatic system?
Our lymphatic system is a very important part of our anatomy, with several key roles. Primarily, the lymphatic system (lymph fluid, lymphatic vessels, lymph nodes and lymphoid organs) supports the circulatory system (heart, blood and blood vessels) by returning excess fluid from our tissues into the blood stream, to prevent swelling. It also supports our immune system by fighting infection through the production of lymphocytes (white blood cells).
Image from Lymphatic System Anatomy and Physiology - Nurseslabs
Where does lymph fluid come from?
When our blood goes through our capillaries (the smallest and hair-like blood vessels), plasma leaks out of tiny pores into the space around our cells. This is between 10-20 litres of plasma per day!
Once out of the capillaries, the plasma delivers essential oxygen, proteins and nutrients to our tissues and organs. At the same time, the plasma will collect any excess fluid and unrequired or harmful debris, such as bacteria, viruses and damaged cells.
The plasma will then move into the lymphatic vessels with our lymph fluid, to be carried towards our lymph nodes, which help to filter and destroy any harmful organisms using lymphocytes (white blood cells). The filtered lymph fluid will then be reabsorbed into the bloodstream again, for the cycle to continue.
While lymph fluid is circulated around the body in vessels that are similar to the blood vessels, one of the main differences is the lymphatic system does not have a pump (e.g. the heart) to maintain circulation of fluid. Instead, it is reliant on muscle contraction and internal pressures to push the fluid along the vessels. This is why exercise, deep breathing exercises, compression and manual lymphatic drainage are important elements of lymphoedema management.
What is lymphatic drainage?
If you have had cancer treatment in an area involving lymphatic nodes or vessels, then you may have been told that you are at risk of developing lymphoedema. This means that at any time after your treatment, you may develop swelling in a limb or specific area of the body due to the disruption to normal lymphatic system function, for example, surgical lymph node removal or radiotherapy.
Lymphatic drainage is a medical massage, used to physically move lymphatic fluid from an area of swelling to an area where lymph fluid can drain normally. This can be done by a trained professional (Manual Lymphatic Drainage) or independently (called Simple or Self Lymphatic Drainage).
Self Lymphatic Drainage
Self Lymphatic Drainage (sometimes known as Simple Lymphatic Drainage or SLD) are gentle massage techniques you can use independently, to help manage swelling and to support optimal functioning of your lymphatic system.
Top Tips:
Always remember to complete deep breathing exercises before and after SLD, to help activate the lymphatic system.
The purpose of SLD is to move congestion (swelling) towards an area where healthy vessels and nodes can drain the fluid.
Aim to complete SLD in a place where you can feel comfortable and relaxed.
Aim to complete SLD on dry skin where possible (if skin goes red, you may be using too much pressure).
If you do not have any swelling in the area, then you can start massage at the furthest point (e.g. your hand) and work towards the body (e.g. forearm, upper arm, shoulder) aiming to move fluid to healthy nodes (e.g armpit)
If you do have swelling, then you can start massage in the area of congestion, work away from the body, then work back towards the body again (e.g. upper arm, forearm, hand, forearm, upper arm, shoulder). This helps to clear congestion and provide a pathway that fluid can move through, otherwise you are simply moving more fluid to an already congested area!
Massage techniques can be completed daily for maintenance or more often if required for swelling.
A specialist lymphoedema therapist may be able to teach you the best techniques to suit you.
Remember, exercise and staying active are an important part of lymphoedema management and prevention. Walking, running, cycling and other cardiovascular activities will help with circulation. Strengthening exercises are also supported by evidence to help prevent lymphoedema, but this must be graded (increased gradually) and should not trigger swelling.
Please request referral to a specialist physiotherapist for further support or advice, or contact me at www.strongerthan.co.uk or hannah@strongerthan.co.uk.
Where can I get more information?
Please see the below websites, for more specialised information on managing lymphoedema:
If you would like signposting to private lymphoedema specialists, please get in touch with me at www.strongerthan.co.uk or hannah@strongerthan.co.uk