1 Provider Disclaimer • Allied Health Education and the presenter of this webinar do not have any financial or other associations with the manufacturers of any products or suppliers of commercial services that may be discussed or displayed in this presentation. • There was no commercial support for this presentation. • The views expressed in this presentation are the views and opinions of the presenter. • Participants must use discretion when using the information contained in this presentation.
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Provider Disclaimer
• Allied Health Education and the presenter of this webinar do not have any financial or other associations with the manufacturers of any products or suppliers of commercial services that may be discussed or displayed in this presentation.
• There was no commercial support for this presentation.
• The views expressed in this presentation are the views and opinions of the presenter.
• Participants must use discretion when using the information contained in this presentation.
Axillary node stimulation/And corresponding area of the trunk. Shoulder ROM-Three planes of motion 5x each, deep belly breathing with inhale on exertion and full/forceful exhalation on relaxation phase
Arm Sequence
Upper ArmElbow, nodes-then ROMLower Arm Sequence-Stretching strokes upward
Wrist and hand, strokes-then ROM
Whole arm sweepsRepeat axillary nodes
Same sequence other side, or continue to leg
Deep belly breathingInguinal nodes
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General Exercise Principles Relating To Integrated Lymphatic
Drainage1. Active movement increases the re-absorption of protein (Leduc, 1990)
2. Increased muscle tone can correlate with a decrease in adipose tissue
and increased stamina. Helps to mobilize joints and strengthens the muscles.
3. Abdominal breathing helps the transport of lymph into the thoracic duct.
At the beginning, slowly increase the number of exercises in the routine. Start with just the neck and face routine, or the upper extremity. Following
the progression of LDT/MLD sessions, you may add the lower body
sequence if there are no adverse effects, i.e. extreme malaise, low grade fever, shortness of breath, difficulty urinating, or flu-like symptoms.
Stop if you get tired or short of breath. Perform each exercise in a slow manner. Start with 5-10 repetitions of each. Avoid movements that are
painful.
ARM EXERCISES
Exercises without tools:__ Shrug shoulders, first right then left then together.
__ Lift both shoulders together toward the ears.
__ Turn head left/right.__ Keep affected arm straight and move in all directions while
pumping hand.
__ Straighten arm and make a fist; bend elbow and make a fist; open hand in extended position, palmar surface up then down. Repeat,
making a fist.
__ Do wrist circles.__ Spread fingers and make a fist.
__ Fold hands (prayer) and circle wrists.
__ Place hands together over head and lean to the side, first right then left.
__ Place hands over head and make the motion of turning a light bulb
in and out of the socket.__ Place hands out in front of chest and push hands together.
__ Bring thumb to every finger.
__ Do the breast stroke in the air.__ Lift the opposite knee and push down with flat hand.
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Dear:
Thank you for using Lymphatic Care Specialists in the past for your medical care. We have great news. I am now also practicing at Heritage Hall in Blacksburg, which now has outpatient facilities.
This means if you have future needs for care, we can now directly bill Anthem or Medicare and your secondary payer.
Please consider us for your future outpatient and lymphedema therapy needs. Call 540-951-7000 or 540-357-2084 for an appointment. You will need a new prescription from your physician for physical therapy for “lymphedema”. Please have them fax your prescription to 540-301-0750.
Remember that maintaining routine checkups and replacing stockings and/or garments is crucial to your vascular and lymphatic health.Thank you, I look forward to continuing your care.
Carmen Thompson, LPTA, LLCC, CMT, B.S.
Dear: Orthopedist
Thank you for using Lymphatic Care Specialists in the past for your patient’s medical care. Please consider us for your future outpatient or inpatient lymphedema therapy needs.
We treat edema due to lymphedema status post orthopedic surgery, lipidema, venous edema and support fragile tissue to aid in the healing of stubborn chronic wounds. This can significantly impact the ROM and results your patients achieve.
We also provide a complete program of preventative lymphedema care for oncology patients, as well as provide compression garments and stockings.
Call 540-951-7000 or 540-357-2084 for a patient appointment. Please fax prescriptions to 540-301-0750.
Thank you, I look forward to continuing care for your patients.
Carmen Thompson, LPTA, LLCC, CMT, B.S.
Dear Dermatologist, Plastic Surgeon:
Thank you for using Lymphatic Care Specialists in the past for your patient’s medical care.
Please consider us for your future outpatient or inpatient therapy needs. We treat edema and pain related conditions. Manual Lymph Drainage has been proven to support fragile tissues and aid in the healing of edema, stubborn chronic wounds, burns, acne and traumatized tissue.
We also provide a complete program of preventative lymphedema care for oncology patients, as well as provide compression garments and stockings.
Call 540-951-7000 or 540-357-2084 for a patient appointment. Please fax prescriptions to 540-301-0750.
Thank you, I look forward to continuing care for your patients.
Carmen Thompson, LPTA, LLCC, CMT, B.S.
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Dear: Primary Care/General Practice physician:
Thank you for using Lymphatic Care Specialists in the past for your patient’s medical care.
Please consider us for your future outpatient or inpatient lymphedema therapy needs. We treat edema due to lymphedema, lipidema, venous edema and support fragile tissue to aid in the healing of stubborn chronic wounds.
Manual Lymph Drainage has also been proven effective in tissue healing due to burns or other skin impairments including acne. We also provide a complete program of preventative lymphedema care for oncology patients, as well as provide compression garments and stockings.
Call 540-951-7000 or 540-357-2084 for a patient appointment. Please fax
prescriptions to 540-301-0750.
Thank you, I look forward to continuing care for your patients.
Carmen Thompson, LPTA, LLCC, CMT, B.S.
Lymphatic Care Specialists, LLC540-357-2084
Fax 540-301-750www.lymphedemahope.com
Swelling Disorders Clinic: NOW OPEN!!
Welcome to Lymphatic Care Specialists, LLC. We are a premier outpatient therapy facility of physical therapists highly trained and certified to treat a variety of swelling disorders from lymphedema, CVI, burns, lipidema, and swelling from orthopedic and aesthetic procedures.
We provide a complete manual lymph drainage program as well as skin care, edema specific exercise programs, compression garments and compression bandaging for volume reduction.
Please call today for more information, or visit our web site.
Carmen Thompson, B.S., CMT, LPTA, LLCC
Fax patient prescriptions with their phone number to: 540-301-0750.
• CHF, Acute renal failure, Cold/Flu• Any aortic aneurysm, internal bleeding• Active Cancer or undiagnosed spot or suspicious area
• DVT• Acute asthma attacks
• Any compromisation of the cardiovascular or renal system
Relative Contraindications to IMLD
• Edema of any systemic nature-unless you have been fully trained
and certified in MLD/CDP therapy.
• Edema due to trauma and orthopedic would be indicated if client is free from all other absolute contraindications. If they are under a
physician’s care currently, you would want to obtain a physician’s prescription.
• Recent asthma attack
• New/freshly healed skin
• Carotid stenosis• Avoid working directly over the neck if there is a history of thyroid
disorder
• Menses/avoid direct work over the abdomen• Medications: Especially chemotherapy agents
This is a general routine for MLD and is a reminder of the massage routine you learned. The purpose of this routine is to increase the natural rate at which lymph fluid is moved through the system, creating a detoxifying effect. Remember these strokes are very light and slow with a dragging motion on the skin. Be cautious of the direction of your strokes.1. Collarbone: Place your fingertips in the hollow above the collarbone (shrug your shoulders up to find this space). Gently, with your fingers stationary stretch the
skin toward the collarbone, when you hit a soft barrier, slide fingers until they meet and release. This stimulates the lymph flow back to the blood system. Repeat 5 times. 2. Neck: Place your whole hand flat under each ear, gently letting them curve around the neck. Stretch the skin down, toward the collarbone. 5x3. Armpit: Place your left hand with flat fingers and palm in the armpit of your right side. Slowly and gently stretch and release the skin in a half circle motion toward the heart. This stimulates the nodes and prepares them to receive fluid. 5x Repeat on the opposite side.4. Across the chest: Slide/Stretch skin from the affected side to the unaffected
side across chest toward the armpit that you worked in step 3. 5. Deep breathing: Do deep breathing exercises taught by your therapist. 5x6. Groin Nodes: With hand flat over the area where the leg meets the trunk, (groin), pump in and up toward navel 5x (on affected side).
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7. Side: On each side, stroke from just below the each armpit down towards the groin. 5x8. Elbow to shoulder: On the outside of each arm, stroke from the elbow up over the top of the shoulder into the hollow above the collarbone . 5x Repeat on the inside of the arm, to the shoulder.
9. In elbow crease: Place the flat of your fingers on the elbow crease. Gently press/pump upward to drain these lymph nodes. 5x10. Wrist to Elbow: Stroke from wrist upward toward the elbow. Repeat 5x, front and back. • Hand: Stroke front and back of hand up toward wrist. Use fingers or
fingertips as needed, depending on the size of your client.• Fingers: Front, back and sides of fingers, if they are swollen• Sweep: Sweeping strokes over the whole arm, from hand to collar- bone 5 x• Clear nodes: Clear 5 x groin nodes, armpit, and lastly the neck. ORRepeat in reverse order
Deep Belly Breathing/Abd work
Groin Nodes: With hand flat over the crease of the leg (groin), pump in and up toward navel 5x.
Knee to Groin: Starting at the knee of your right leg, stoke up the
outside of your thigh toward the groin 5x. Repeat with inside of thigh and back of thigh. Stoke should be one direction toward the heart
ONLY!
Behind the knee: Place flat fingers of both hands behind the knee and gently stretch and release the skin in an upward fashion to drain
these nodes.
Ankle to knee: Stroke from the ankle to the knee 5 x front and back Foot: Front and back of foot, 5x each
Toes: Front, back and sides of toes.
Sweep: Sweeping strokes over the whole leg, from foot to groin, 5 xClear nodes: Clear 5 x groin nodes, armpit, and lastly the neck. OR
