Effects of massage therapy on the skin of patients with lymphedema

The difference between normal massage techniques and manual lymphatic drainage techniques is that the strokes used in normal massage therapy are applied with slightly more pressure than the strokes in manual lymphatic drainage therapy. The basic strokes used in normal massage therapy are petrissage, effleurage, tapping, vibration, and friction.

It should be noted that the effects of the massage blow are not limited to suprafascial tissues such as the skin. These strokes also cause reactions in subfascial areas. The subfascial tissues are muscles, tendons, and ligaments.

Local arterial blood flow may increase with massage strokes and there is venous and lymphatic return. Normal massage strokes can also loosen subcutaneous adhesions.

There are several publications on massage therapies that list edema as one of the indications for these techniques. This is a correct statement, but it is also misleading if the distinction between edema and lymphedema is not established or clarified.

Actually, edema is related to suprafascial tissues and can be the result of various problems such as inflammation or impaired venous return. Examples of impaired venous return are valve regurgitation, pregnancy, or prolonged sitting and / or standing.

In edema, the lymphatic system is overloaded but remains intact. This causes water to accumulate in the tissues. This condition is called dynamic failure.

Massage therapy may benefit some forms of edema but is contraindicated for others. That is why normal massage therapy should not be used in patients with edema without first consulting with a doctor.

Lymphedema, on the other hand, is always the result of a mechanical failure of the lymphatic system. This, in turn, ends with the accumulation of water and protein in the tissues. When the lymphatic system becomes mechanically insufficient, the transport capacity of the system decreases below the required physiological level of water and protein loading. So the system is not able to respond adequately to an increase in lymphatic load.

There are also several negative effects of massage therapy on lymphedema. As mentioned above, massage strokes generally lead to an increase in arterial blood flow (also called active hyperemia) in areas of the skin to which normal massage techniques are applied. This active hyperemia is accompanied by an increase in capillary blood pressure. This leads to a subsequent increase in ultrafiltration of water in the area of ​​the blood capillaries. The result of this process is that more water accumulates in the interstitial spaces. As the lymphatic system is mechanically insufficient, the lymphatic system is unable to handle this additional water load and there is increased swelling.