Mar 20, 2008

This is bit of a refresher - but it's always good to keep a focus on the root of a problem if you are looking for solutions, so here it is again . . .


Many have never heard of the Lymphatic System, let alone Lymphedema. So before talking of Lymphedema we need to take a look at what the Lymph System is and how it works.

When we take a look at the body from the outside in, we have our skin, just below that is our layer of fat, and then under that is our Lymph System (comprised of lymph collectors/capillaries, vessels that lead to the deeper lymphatic vessels along which pathway are the lymph nodes), and this over lays our muscles. The blood capillary system comes into the area between the fat layer and the lymph capillaries and releases the nutrients to the skin and surface tissues of the body. It is a clear fluid including a lot of proteins. As the blood leaves, it takes back 90% of what it dropped off- most of the clear fluid and the smallest particles. The other 10% of clear fluid (with the larger particles of proteins/cell debris/medications we’ve taken/etc.) makes up the lymph fluid. The human body produces approximately 2 liters of lymph fluid every day.

The Lymph Nodes are the “garbage disposals” of the system that filter and breaks down all those particles, balancing the solid to liquid consistency. Also, they manufacture white blood cells for our immune system. The last tube of the lymph system goes up through the chest and dumps the lymph fluid into the blood system just above the heart. There the lymph fluid joins the blood, being further filtered through the liver and kidneys, and then passing out of the body through urine.

In brief, the Lymphatic System is a network of vessels, tissues, and organs in vertebrate animals that helps the body regulate fluid balance and fight infection.

Lymphedema is when an area of the body swells due to the collection of lymph fluid. This can be any part of the body: arm, foot, leg, breast, abdomen, head, face, chest wall, genitals…The lymph fluid builds up when the lymph system has in some way become impaired. Causes of an impaired Lymph System include:

  • Treatment of lymph node removal and radiation for cancer: this reduces the amount of fluid the lymph system is able to transport per unit of time, and can lead to Lymphedema right away, or years down the road.
  • Scar tissue from trauma or surgery: Trauma from injury or surgery if it blocks or affects the lymph flow.
  • Congenital malformation: some people are born with a lymphatic system that was not developed fully. This can show up at birth, within the first year of life, in the teen years, or as an adult fallowing a somewhat minor injury.
  • Venus insufficiency: if the veins are not returning the blood as efficiently as they should, then the blood system is not taking bake its 90% of the clear high protein fluid it releases to nourish the skin and surface tissues as the blood pools, and that means more than 10% is remaining for the lymph system to transport. The lymph system can step up to the plate for a while, even years, but over time it gets tired and gradually is unable to keep up. Veins can become stressed to insufficiency due to obesity, pregnancy, blood clots, or simple genetics.

The cause of the lymphedema, and other medical conditions the person may have, need to be taken into consideration during treatment, but the basic treatment is the same for all.

Sonja M. Maul PT, CLT-LANA
National Board Certified Lymphedema Therapist

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