Physical Therapy and the treatment of Lymphedema

At Sioux Center Health, we provide treatment and self-management techniques to help lessen the impact of Lymphedema on your lifestyle.

What is Lymphedema
Lymphedema is a swelling of a body part, most often the legs or arms. It may occur in the face, trunk or genital area. It is the result of an accumulation of protein and water in the superficial skin tissue. Lymphedema, if left untreated, can become disabling, making it very difficult for the patient to perform the simplest of tasks. Walking or putting on clothes can become almost impossible. Lymphedema is a chronic condition that progresses. It must be managed appropriately for a lifetime.

How do I know if I have Lymphedema
Lymphedema is characterized by swelling that is unresolved with elevation. The swelling will begin by being soft and pitting, but will with time turn to being hard and fibrotic. It is common for fungal and cellulitis infections to be found, especially in the legs.

Who gets Lymphedema
In the United States, it is most often seen in people who have had cancer following the removal of lymph nodes or damage to other parts of the lymphatic system following radiation treatments.

It is also frequently seen in people who have chronic venous insufficiency. The continual swelling may damage lymph vessels.

Some people are born with lymphatic systems that do not function correctly. This may be present at birth or later in life.

What is Complete Decongestive Therapy
Complete Decongestive Therapy uses four aspects of care to reduce the swelling and to maintain the reduction.

Manual Lymph Drainage – uses hands on techniques to move the lymph fluid up and out of the swollen area

Compression Therapy – short stretch bandages followed by compression garments are made to maintain the removal of edema accomplished in the manual lymph drainage

Exercises – simple exercises assist in moving lymph out of the swollen area

Skin Care – it is important to keep the skin clean and hydrated with a low-pH lotion to prevent infection.

How does it begin
After damage to your lymphatic system, following surgery or radiation for example, lymphedema does not automatically set in. It may take only a small injury or change to your effected limb for the swelling to begin.

Please take extra caution with the following:
• Paper cuts
• Hang nails
• Sunburn
• Bug bites
• Tight clothes or jewelry (rings, bras, elastic cuffs)
• Flying in airplanes
• Massages
• Hot Pack to the area

If you have any questions about these activities, make sure you talk with Julie Bajema a Certified Lymphedema Therapist.

Julie Bajema, DPT, CLT received her Doctorate of Physical Therapy in 2004 from St. Ambrose University. Prior to that, she earned a Bachelor’s Degree in Biology from Augustana College. An APTA member and a Women’s Health Section member, Julie participated in two clinical internships in Women’s Health in Omaha and in Sioux Falls. She has attended several courses by Janet Hulme, MA, PT, a nationally respected educator in Women’s Health. Julie also has attended the Rehabilitation Institute of Chicago’s course on Musculoskeletal Dysfunction for pregnancy and postpartum. Julie attended the Academy of Lymphatic studies in 2007 to become a Certified Lymphatic Therapist.