Lymphedema: what it is and what if it stays untreated

Lymphedema, which is also spelled lymphoedema, is abnormal swelling of the tissues, due to the presence of excess protein-rich fluid known as lymph. This swelling occurs when the lymphatic system malfunctions or is damaged and lymphatic fluid cannot drain as quickly as it is produced. It affects an estimated 100 million men, women, and children around the world, including at least 3 million Americans. Lymphedema of the arm occurs often as a result of treatment for breast cancer. Breast cancer is only one of the many causes of lymphedema. It most commonly occurs in the extremities (arms or legs); however, it can also affect the trunk, breast, abdomen, neck, head, and or genitals.

The fluid that causes the swelling of lymphedema is protein-rich and this makes the tissues easily susceptible to infections. Each infection damages lymphatic structures and places the area more at risk for developing lymphedema. Once the lymphatic systems malfunctions or lymphatic structures are damaged and lymphedema has developed it can be treated but not cured. Early treatments can usually effectively control the swelling. Without treatment, the lymphedema symptoms become progressively more serious. Left untreated, lymphedema is much more serious than the inconvenience of a swollen limb. It is a progressive condition in which frequent infections cause serious pain and may require hospitalization. Skin changes, like benign papillomas may develop. Eventually, lymphedema can lead to the loss of mobility and total disability. In rare occasions malignant skin cancer develops, like lymph-angiosarcoma (Stewart-Treves-Syndrome.)

Alma Vinjé-Harrewijn PT CLT-LANA

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Why all this fuss about Postural Restoration?

In 20 or 30, maybe 50 years Physical Therapy will be Postural Restoration. The more traditional techniques will not disappear, but they will have to adapt to the basic insights of Postural Restoration.

I can say this easily because I am not a physical therapist and certainly not a Postural Restorationist. I don’t know all the details of Postural Restoration. However, it is clear that Postural Restoration provides us with a paradigm shift in the short history of Physical Therapy. It is not just another technique that will be added to the many other techniques. Postural Restoration is a revolution.

The basic insight is as simple as Newton’s apple falling from a tree: We are asymmetrical beings by nature and it is good that we are asymmetrical because we probably could not move well at all if we were symmetric. We are reaching out with the right arm or  leg because it is easier and more powerful. We are made that way.

We see the application of it for instance in sports. To give one example: In all track and field activities we always run around the field in the same direction, opposite clockwise. There is no culture and no individual that prefers to run the opposite way. It is because we are faster this way. The reason is our basic asymmetry.

There are many other examples. The point, however, is that based on the insight into our fundamental asymmetry and on a sound understanding of bio-mechanics, the founder, Ron Hruska, developed what we call now Postural Restoration, a growing canon of hundreds of exercises.

The exercises can be used to either enhance performance in movement or sports, to avoid injuries or to correct painful imbalances like back pain, neck pain, hip pain, knee pain and so on. A couple of sport teams have been using the exercises successfully, as do a couple of physical therapists.

Unfortunately, there are limitations. The exercises are so precise and difficult that they are not easy to learn. It is an effort.For physical therapists also, Postural Restoration is not easy to learn and challenging intellectually. To slap on a hot-pack and use the ultrasound machine is a lot easier for both the therapist and the patient. Much easier also to do the same exercises first twice to the left, then twice to the right as it is done almost everywhere, ignoring our basic asymmetry. It is easier, but it does not always help.

Once the exercises are understood, which may take a couple of sessions, progress should be immediate.

Welcome to the Blog

Finally our expansion and renovation has been almost finished and we can focus on other things again like welcoming you to this blog. Of course, this blog started in December 2008 when Susan and Joe went through the process of being certified as Postural Restoration Practitioners. We just did not write it down at that time. However, we thought about it and about the necessity to spread the word about the new concepts of Postural Restoration. This blog is supposed to help with that. Our patients spread the word too and have been our principal referral source over the years, but the blog, we think, can add to it. We have been using Postural Restoration principles for several years already, but now that we are a Certified Postural Restoration Center, we do have some added responsibility. This is what the blog will be about.

In addition to Postural Restoration we also use a variety of more traditional physical therapy methods, manual techniques, etc. and we may talk about it.

In addition, Alma is offering Lymphatic Drainage, which has been used successfully in Europe for decades and is only slowly becoming known here. Alma is from Holland and has written widely about Lymphatic Drainage Massage. She might add to it here.

Lastly, Katie and Josh are working with stroke recovery and brain injuries. Their concept, Neuro IFRAH, is very similar to Postural Restoration in that it is truly holistic, working with the whole person in their respective environment. Josh is trained in both Neuro IFRAH and Postural Restoration. We hope they will write here too.