Manual lymphatic drainage

Manual lymphatic drainage (ML ) is a form of physical therapy. Their application areas are wide-ranging. It serves primarily as edema and decongestive edematous regions of the body, such as the trunk and extremities (arms and legs), which can occur after trauma or surgery. Especially often this therapy is prescribed by a treating tumors or lymph node removal.

Description

The ML is the appropriate therapy for the treatment lymphostatischer edema. which is characterized by insufficient transport capacity of the lymphatic vessels in normal lymphpflichtiger load (even low volume insufficiency) features. These include congenital (primary ) and secondary lymphedema. The classic indication is the secondary lymphedema of the arm after breast cancer surgery.

The four handles to the Vodder, which were developed in collaboration with Günther Wittlinger, are: standing circle, pumping handle, scoop handle and turning handle, they are adapted to the different body regions. Through various techniques handle the lymphatic system is to be activated by, is improved especially the pumping capacity of the lymphatic vessels, more lymphangion. The frequency lymphangion is at rest about 10-12 contractions per minute, this can be increased to up to 20. The therapist generated by the handles with their changing pressure ( pressure phase with transverse and longitudinal stretching of the skin or zero phase - only skin contact is maintained ) a stimulus for the fabric. The ( involuntary ) muscle smooth lymphangion answer this stimulus with increased pumping frequency. A frequent repetition of the handles results in increased flow rate.

Other effects besides the entödematisierenden are the sympatholytic ( patients are quiet, stimulation of the gastrointestinal tract ), the analgesic ( mechanism of the Gate Control Theory) and the tonussenkende effect on skeletal muscle. The printing direction is determined by the attainable of manual lymph drainage lymph vessels and must always towards the extremities root (arm, leg ) or generally the terminus (end of the lymphatic system in the union of the subclavian vein and the internal jugular vein in the area of the collarbone ) aim. Thus, the lymph is directed to the central major lymphatic trunks. In addition, the therapist can move protein-rich edema fluid through the superficial lymphatic system, the body covers like a network, via the so-called watersheds from a congested area of ​​the body in a healthy area. Manual lymphatic drainage thereby causes no increased blood flow, as in classical massage.

Further indications are all orthopedic and traumatic diseases associated with swelling (eg sprains, strains, sprains, torn muscle fibers ). Even with burns, whiplash, dystrophy, migraine and related conditions, the Manual lymphatic drainage is applied.

In the treatment of scars, the ML, the goal of better mobility of the scar and the Lymphgefäßneubildung ( lymphangiogenesis ) in the severed tissue. Also in the alleviation of pain, before and after surgery (eg after knee or total hip replacements ), they will help to decongest the tissue. Partial painkillers gifts can be reduced and the healing process is faster.

In severe lymphatic diseases ( blockages ), this therapy is combined, skin care and special movement therapy with compression bandaging ( compression bandages or custom -made compression stockings) and summarized under the term Complex Physical decongestive ( KPE ).

In the 1960s, this has become the therapy, which was developed by Emil Vodder relevant, established and has since taught at German massage and physiotherapy schools. The therapists are primarily masseurs and physiotherapists. ( Since 1994 Physiotherapists are referred to as physiotherapists. ) The application is restricted to qualified personnel using the appropriate additional training in manual lymphatic drainage allowed at an approved educational institution. The specialized training takes four weeks ( about 180 lessons ) and is defined in the policies of IKK. In Germany and Austria lymphatic drainage is widespread. In the U.S. it is used less frequently.

Other Therapiemöglickeiten are the AIK ( Instrumental intermittent compression ), the limb is hereby unblocks mechanically with a pressure cuff, the indication for it must be close together and will often only be administered in addition to the ML.

Contraindications

Contraindications (contraindications ) are in this case must be carefully observed. We distinguish absolute and relative contraindications: One of the absolute count untreated malignancies, recent thrombosis or thromboembolism, acute septic inflammation as well as congestive heart failure (NYHA III or IV). Relative contraindications include chronic inflammation, expired thrombosis, hypotension, thyroid dysfunction, pregnancy, or bronchial asthma. The ML can be slightly modified in these cases or applied in accordance with certain precautions.

Contraindications are in particular:

  • (malignant) tumors
  • Pronounced failure, usually stages 3 and 4 ( Cardiac edema)
  • Increased body temperature from 37.5 degrees Celsius
  • Inflammatory processes with unknown origin ( pathogens )
  • Acute deep vein thrombosis ( DVT ), but also acute thrombophlebitis
  • Erysipelas ( erysipelas ) in general
  • Congestive heart failure
  • Acute, febrile or bacterial infections
  • Cardiac edema
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