• Jeanine Mewburn

What's new with the 13th ALA Conference

The 13th virtual ALA Conference is packed with a diversity of practical topics. The treatment of Complex Lymphatic Therapy for the management of lymphoedema has not changed and is still the treatment of choice. The good news is that research has made it easier for therapists and lymphoedema patients to implement it. The products have evolved and some new exiting compression garments are available. I am only summarizing the content of the conference and may discuss and compare some products in the future.

Patterns of lymphatic drainage in head and neck lymphoedema and other areas of the body were identified with Indocyanine Green Lymphography (ICG) by Amanda Pigott and others, which help visual the superficial lymph flow in various areas. I was very pleased to note that it shows patterns similar to those identified by Dr. J&J Casley-Smith who developed a method of manual lymphatic drainage massage I learned, based on the mapping of the lymphatic system.

Following a thorough assessment, an experienced massage therapist would use their palpation skills to identify tissue texture to notice the degree of congestion and where to drain it to. They would also identify poor draining areas and areas where drainage is not possible. They can by-pass them to direct the fluid flow towards a different pathway. Over the years, therapists can develop terrific palpation skills to do the job. Today, a drainage pathway can be identified with the ICG. Isn’t it amazing!

Ina Farelly from Accelerate CIC in London presented her findings on “Altered biomechanics and its impact on those with lymphoedema and lipoedema”. Biomechanics are the mechanics of your body in motion. Should you have altered your body structure over the years, due to poor posture or repetitive movements, your body biomechanics would also change. The muscle pump may not be working efficiently to assist the blood and lymph return towards the heart and could create or exacerbate swelling. We all defy gravity after all. Some of you would remember conversations we have during the consultation about wearing adequate footwear, having a good posture and performing deep breathing. Those are elements that need to be addressed in the management of lymphoedema, Ina says.

This takes us to exercising for lymphoedema “Can it prevent lymphoedema following ovarian cancer?” by Tamara Jones and others. This study concluded that exercise during chemotherapy neither causes nor prevents

lower leg lymphoedema in women with ovarian cancer. As such, participation in individualized progressive moderate to high intensity mixed mode exercise should be encouraged without fear of adverse LLL outcomes.” However, I would add that exercise addressing poor biomechanics, good posture and breathing can assist patients undergoing cancer treatment to keep a positive outlook on life because following these simple advice can make a workout more pleasant and efficient. It also assists patients with lymphoedema to keep their muscles pumping and the lymphatic fluid congestion down.

There is so much more information to discuss. I have a few phone calls to make regarding new products and I may be ready to discuss them in my next blog. Until then, keep up the good work with whatever you are doing to manage lymphoedema or lipoedema.

PS: just a quick follow-up from the Q&A session from Professor Sandi Hayes in relation to Tamara Jones presentation regarding LLL and exercise. She said that exercise can possibly increase patients' life following cancer treatment.





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