The Lymphatic System is a vitally important system that is directly linked to health and immune function in the body and thus is a primary area to address with managing any condition that involves pain. Swelling is directly linked to lymph fluid and the lymphatic system and this component alone is why the lymph system is vital to understand and target when dealing with pain and chronic conditions.
The lymph system is the system that transports an all important and vital fluids the interstitial fluid that transports wastage products out of the body. Much like the its big brother, the circulatory system, the lymph system is every bit as much a a part of the super highway of transport that ensures efficient removal of wastage product from the body and removal of toxins and potentially harmful cells within the body. Lymph has a major influence on oedema and swelling in the body so in terms of acute injury recovery as well as post traumatic recovery, it is vital to understand its relationship and ensure promote its proper function. It also has large implications on continual health and vitality and can create many issues if it isn't maintained and kept in primary function. It works very closely with the blood vessels and in a way, is like the housekeeper, cleaning up and removing the waste and potential toxins that can be left around after the myriad of chemical reactions that occur in the body's other systems.
Whenever blood transports molecules to the numerous organisms in the body, a chemical transfer occurs, for example the delivery of oxygen and the uptake of carbon dioxide. In this transfer, fluid from the tiny capillaries with very permeable walls, gets pushed out of the blood vessels and into the space between the cells = the extracellular space. In this space exists three types of fluid, interstitial fluid, blood plasma and transcellular fluid. The interstitial fluid is the one concerned with lymph activity. Macrophages (pac-men of the immune system) exist exist in this fluid, searching for potential pathogens and upon contact, act like a messenger not only attacking the pathogen but issuing a 'red flag' to take back to the 'command centre', the lymph nodes. The lymph nodes house the B/T and immune cells which act on generating the immune response to deal with the foreign cell. To get to the node, the macrophages must be transported via the lymph fluid.
The Lymph System is made up of a system of channels that mimic the blood vessels in that they provide a network of capillaries that transport fluid around the body, depositing their contents into Lymph Nodes that are located in the groin, armpits and neck (primarily). These nodes act as the cleaning and filter stations, filtering and neutralizing any pathogens or harmful substances in the lymph fluid. The cleaned fluid is then returned to the blood stream near the heart and enters the circulatory system again.
The big difference between the circulatory (blood) and the lymphatic system (lymph) is that lymph is NOT propelled through the body via a pump (the heart in the circulatory system). Lymph capillaries are a series of one way valves that transports fluid in a constant one way direction to the lymph nodes. The system relies on movement, stretching and massage to assist with the flow of lymph fluid. Hence this system is vitally important to massage therapists as we can greatly affect the flow and transfer of this very important system.
Lymph and Swelling
When everything works well with the system, the lymph fluid is kept in balance in a constant interchange of deposit and withdrawl of fluid (Starlings Equlibrium). A backup anywhere in the system creates issues of blockage and fluid accumulation. This is swelling. Lymph fluid needs to keep moving. Stagnant fluid hinders chemical processes of osmosis and diffusion and creates a negative environment for fluid transfer and usually results in oedema, improper cell function and even ineffective organ function. When there is swelling, you do not want to over tax an already compromised system. Thus movement, exercise and even some massage are NOT to be performed in a general rule. This is where specific types of massage come into their own as gentle and light techniques unique to Lymphatic Drainage are particularly beneficial in helping to remove stagnant fluid rather than adding to it. Hence it is very important to understand where and when particular massage can be performed.
A skilled therapist understands the various effects that watershed areas can have on lymph flow and also where to work and where not to work when it comes to dealing with oedema and compromised lymph activity. Lymph is so intrinsically part of the immune system that when clients present with compromised organ functions or conditions, this has a huge impact on how you are able to treat a client with oedema or compromised systemic fluid flow. Liver, kidney and heart issues all have an influence on fluid control throughout the body so taking care to undertake bodywork with these persons is most important to understand the particular indications of their condition. Miriam Bunder, a well known lymph specialist explains it best,
Strong Swedish style massage can sometimes not be the most appropriate treatment as an overtaxing of the lymph system can lead to creating more interstitial fluid than a compromised system can process. A body-worker has to undertake specific techniques (Manual Lymphatic Drainage) to influence the lymphatic flow and assist with moving it through whilst not overstimulating the system.
When considering the effects of bacterial infection and the process of common illnesses such as colds and flus, lymph fluid is greatly indicated in processing and promoting the effective bodily defence of such infections. By manner of promoting efficient and primary lymph flow, and at times increasing the volume of lymphatic flow by up to 20 times, you are able to promote a more efficient immune response to the pathogens and effectively battle the onset of infectious conditions. If the flow is efficient, obviously the system is able to process more pathogens and remove them from the system more effectively.
Oddly enough, when considering sub acute trauma or ‘injury’ oedema, skilled massage to the area is actually of great benefit to the injury. Helping to move the fluid through the compromised area can greatly assist with recovery and increase effectiveness of other treatment. Usually fluid is there to form a natural splint of sorts. Chronic inflammation needs to be moved and not allowed to become stagnant as mentioned previously. In injury recovery, once the need for a reduction in movement is past, moving that stagnant fluid becomes a great priority. Hence massage to shift fluid is a great way to assist with speedy recovery. Getting movement back post injury is one of the vital stages of a good recovery process.
So understanding the lymph system and how it operates can bring about a great deal of pragmatic and efficient function in a system. Understanding how best to utilise the system and address it really does make a long difference to ongoing health and vitality. Understanding the subtle differences and shifts can make all the difference to treating chronic and acute conditions. Good therapists understand this role and know what to apply and when. Trust in your therapist to help you do the best for your body.