Breast Lymphedema Management

Lymphedema is a problem that may occur after cancer surgery when lymph nodes are removed. Lymphedema can occur months or years after treatment. It’s a chronic (ongoing) condition that has no cure. Self management steps can be taken to help keep it from starting, to reduce or relieve symptoms. If left untreated, lymphedema can get worse. Getting treatment right away can lower your risk of infections and complications.

Clinic Study- A new indocyanine green fluorescence lymphography protocol for identification of the lymphatic drainage pathway for patients with breast cancer-related lymphoedema.
Hiroo Suami1* , Asha Heydon-White1, Helen Mackie1,2, Sharon Czerniec1, Louise Koelmeyer1 and John Boyages1

MDACC ICG Stage 2 or 3 lymphoedema and occurred in 52-55% of patients respectively. It was apparent that sternal and contralateral pathway groups were found in Stage 4 lymphoedema

Mdacc stage no Ipsilateral axilla Clavicular Parasternal Contralateral axilla Ipsilateral Inguinal Unknown
1 19 95% 21% 5% 0% 0% 0%
2 46 61% 52% 7% 2% 0% 0%
3 20 70% 55% 5% 5% 0% 0%
4 18 50% 17% 17% 17% 0% 11%
total 103 67% 41% 8% 5% 0% 11%

Skin care try not to have vitamin e in the cream as this will damage the garments. Its best to look for these ingredients with glycerol, hyalronic acid, ceramide, glycerin and paraffin. Best to avoid – parabens, fragrances, sodium lauryl sulphate and lanolin.

Exercise- move every day and try to do more everyday and do aerobic and resistive exercise.

MLD- when draining dermal back flow and the lymph is moving through the capillary system a firmer stroke is needed.

SIPC  pump for self massage at home.



Massage doesn’t just make muscles feel better, it makes them heal faster and stronger

Massage has been used to treat sore, injured muscles for more than 3,000 years, and today many athletes swear by massage guns to rehabilitate their bodies. But other than making people feel good, do these “mechanotherapies” actually improve healing after severe injury? According to a new study from researchers at Harvard’s Wyss Institute for Biologically Inspired Engineering and John A. Paulson School of Engineering and Applied Sciences (SEAS), the answer is “yes.”

Using a custom-designed robotic system to deliver consistent and tunable compressive forces to mice’s , the team found that this mechanical loading (ML) rapidly clears  called neutrophils out of severely injured . This process also removed  released by neutrophils from the muscles, enhancing the process of muscle fiber regeneration. The research is published in Science Translational Medicine.

“Lots of people have been trying to study the beneficial effects of massage and other mechanotherapies on the body, but up to this point it hadn’t been done in a systematic, reproducible way. Our work shows a very clear connection between mechanical stimulation and immune function. This has promise for regenerating a wide variety of tissues including bone, tendon, hair, and skin, and can also be used in patients with diseases that prevent the use of drug-based interventions,” said first author Bo Ri Seo, Ph.D., who is a Postdoctoral Fellow in the lab of Core Faculty member Dave Mooney, Ph.D. at the Wyss Institute and SEAS.

A more meticulous massage gun

Seo and her coauthors started exploring the effects of mechanotherapy on injured tissues in mice several years ago, and found that it doubled the rate of muscle regeneration and reduced  scarring over the course of two weeks. Excited by the idea that mechanical stimulation alone can foster regeneration and enhance muscle function, the team decided to probe more deeply into exactly how that process worked in the body, and to figure out what parameters would maximize healing.

They teamed up with soft robotics experts in the Harvard Biodesign Lab, led by Wyss Associate Faculty member Conor Walsh, Ph.D., to create a small device that used sensors and actuators to monitor and control the force applied to the limb of a mouse. ” The device we created allows us to precisely control parameters like the amount and frequency of force applied, enabling a much more systematic approach to understanding tissue healing than would be possible with a manual approach,” said co-second author Christopher Payne, Ph.D., a former Postdoctoral Fellow at the Wyss Institute and the Harvard Biodesign Lab who is now a Robotics Engineer at Viam, Inc.

IF you would like to see this video please click on the link below.
A demonstration of the robotic actuator placing mechanical load on the injured muscle of a mouse. Credit: B.R. Seo, et al., Science Translational Medicine (2021)

Once the device was ready, the team experimented with applying force to mice’s leg muscles via a soft silicone tip and used ultrasound to get a look at what happened to the tissue in response. They observed that the muscles experienced a strain of between 10-40%, confirming that the tissues were experiencing mechanical force. They also used those ultrasound imaging data to develop and validate a computational model that could predict the amount of tissue strain under different loading forces.

They then applied consistent, repeated force to injured muscles for 14 days. While both treated and untreated muscles displayed a reduction in the amount of damaged muscle fibers, the reduction was more pronounced and the cross-sectional area of the fibers was larger in the treated muscle, indicating that treatment had led to greater repair and strength recovery. The greater the force applied during treatment, the stronger the injured muscles became, confirming that mechanotherapy improves muscle recovery after injury. But how?

Evicting neutrophils to enhance regeneration

To answer that question, the scientists performed a detailed biological assessment, analyzing a wide range of inflammation-related factors called cytokines and chemokines in untreated vs. treated muscles. A subset of cytokines was dramatically lower in treated muscles after three days of mechanotherapy, and these cytokines are associated with the movement of immune cells called neutrophils, which play many roles in the inflammation process. Treated muscles also had fewer neutrophils in their tissue than untreated muscles, suggesting that the reduction in cytokines that attract them had caused the decrease in neutrophil infiltration.

The team had a hunch that the force applied to the muscle by the mechanotherapy effectively squeezed the neutrophils and cytokines out of the injured tissue. They confirmed this theory by injecting fluorescent molecules into the muscles and observing that the movement of the molecules was more significant with force application, supporting the idea that it helped to flush out the muscle tissue.

To pick apart what effect the neutrophils and their associated cytokines have on regenerating muscle fibers, the scientists performed in vitro studies in which they grew muscle progenitor cells (MPCs) in a medium in which neutrophils had previously been grown. They found that the number of MPCs increased, but the rate at which they differentiated (developed into other ) decreased, suggesting that neutrophil-secreted factors stimulate the growth of muscle cells, but the prolonged presence of those factors impairs the production of new muscle fibers.

“Neutrophils are known to kill and clear out pathogens and damaged tissue, but in this study we identified their direct impacts on muscle progenitor cell behaviors,” said co-second author Stephanie McNamara, a former Post-Graduate Fellow at the Wyss Institute who is now an M.D.-Ph.D. student at Harvard Medical School (HMS). “While the inflammatory response is important for regeneration in the initial stages of healing, it is equally important that inflammation is quickly resolved to enable the regenerative processes to run its full course.”

Seo and her colleagues then turned back to their in vivo model and analyzed the types of  in the treated vs. untreated mice 14 days after injury. They found that type IIX fibers were prevalent in healthy muscle and treated muscle, but untreated injured muscle contained smaller numbers of type IIX fibers and increased numbers of type IIA fibers. This difference explained the enlarged fiber size and greater force production of treated muscles, as IIX fibers produce more force than IIA fibers.

Finally, the team homed in on the optimal amount of time for neutrophil presence in injured muscle by depleting neutrophils in the mice on the third day after injury. The treated mice’s muscles showed larger fiber size and greater strength recovery than those in untreated mice, confirming that while neutrophils are necessary in the earliest stages of injury recovery, getting them out of the injury site early leads to improved muscle regeneration.

“These findings are remarkable because they indicate that we can influence the function of the body’s immune system in a drug-free, non-invasive way,” said Walsh, who is also the Paul A. Maeder Professor of Engineering and Applied Science at SEAS and whose group is experienced in developing wearable technology for diagnosing and treating disease. “This provides great motivation for the development of external, mechanical interventions to help accelerate and improve muscle and tissue healing that have the potential to be rapidly translated to the clinic.”

The team is continuing to investigate this line of research with multiple projects in the lab. They plan to validate this mechanotherpeutic approach in larger animals, with the goal of being able to test its efficacy on humans. They also hope to test it on different types of injuries, age-related muscle loss, and muscle performance enhancement.

“The fields of mechanotherapy and immunotherapy rarely interact with each other, but this work is a testament to how crucial it is to consider both physical and biological elements when studying and working to improve human health,” said Mooney, who is the corresponding author of the paper and the Robert P. Pinkas Family Professor of Bioengineering at SEAS.

“The idea that mechanics influence cell and tissue function was ridiculed until the last few decades, and while scientists have made great strides in establishing acceptance of this fact, we still know very little about how that process actually works at the organ level. This research has revealed a previously unknown type of interplay between mechanobiology and immunology that is critical for  tissue healing, in addition to describing a new form of mechanotherapy that potentially could be as potent as chemical or gene therapies, but much simpler and less invasive,” said Wyss Founding Director Don Ingber, M.D., Ph.D., who is also the Judah Folkman Professor of Vascular Biology at (HMS) and the Vascular Biology Program at Boston Children’s Hospital, as well as Professor of Bioengineering at SEAS.

lymphatic health and well-being exercises

Move Lymph and De-stress

Looking for a way to de-stress and move lymph? The lymphoedema dance and  Robyn Gant’s  breathing exercises could be what you are looking for.

Robyn has found using de-stress breathing provides fast relief from stress and also helps the lymph move. This audio clip is a simple way to breath in order to quickly and easily accomplish a relaxed state and move your lymph in any situation.

Lymphatic Exercises 

Looking for a way to help move more lymph and have fun while doing it? Then lymphoedema dance is for you. These dances can be done by anyone that wants to move their lymph. The dances are safe for people with lymphoedema as they have been developed for lymphoedema. Please watch the videos below and have fun while effectively moving your lymph.

These exercise can be done everyday or before you normal gym routine to help move more lymph.

Post Lipo Lymph exercise that are safe for a BBL 

These lymph exercise are safe for someone that has had a brazilian butt lift and anyone that has had liposuction.

Bloating, joint pain, fatigue? A guide to lymphatic health The Sydney Morning Herald

The Sydney Morning Herald atrtical by Jessica Harris on July the 10th

lymphatic drainage massage was first promoted as a therapy in the ’30s by Dr Emil Vodder, a Dane who discovered that working on the swollen lymph nodes on the face and neck of his patients had a dramatic effect in decongesting the sinuses, eliminating inflammation, reducing headaches and even improving facial blemishes.

The lymphatic system also needs a little self-help to move in the right direction. “The lymphatic vessel walls contain smooth muscle tissue, which contract to push lymph fluid towards the lymph nodes,” explains Tom Cowan, an exercise physiologist.

“However, unlike the cardiovascular system for which the heart acts as the pump, the lymphatic system doesn’t have anything to push lymph fluid through the vessels.”By relying on nearby muscles to contract and pass the fluid along, Cowan says moving the body is vital. “Obesity has been linked to lymphatic dysfunction, so following a healthy diet and exercise plan is vital.”

Jules Willcocks, the co-founder of Body Ballancer Systems UK, whose specialist lymphatic massage system is used in outlets such as Harrods. Warns that ignoring our lymphatic wellbeing could lead to myriad problems. “Lifestyle causes such as stress, not enough exercise, dehydration and poor diet are just some of the reasons why your lymphatic system can become blocked or overrun. Add to this the exposure of pollutants and toxins that are part and parcel of modern human life and it’s easy to see why a system designed to manage mostly metabolic waste can easily be overburdened. This can then lead to swelling, cellulite, bloating, joint pain and fatigue and potentially put you at risk of serious disease.”

My Massage Clinic is OPEN- NSW Government-CORONAVIRUS UPDATE


Current as at: 14 April 2020 CORONAVIRUS UPDATE

The NSW State government has now made it clear as of the 14th of April that Remedial Massage is part of essential health services.  In this current environment this could change and the status will be checked every day and this page will reflect any new changes.

Hygiene is a top priority at the clinic.

Your therapist at My Massage Clinic Kara Martin has completed the Infection control training in relation to COVID-19 and has a Certificate of acknowledgement.

My massage clinic is using an Air Purifier with a microbe Shield that uses shortwave light to help target bacteria and viruses.

At my massage clinic all clients will be screened before booking and treatment, first over the phone and then in person.  All effort is being made to maintain absolute hygiene in the clinic. To ensure this, new practices are now implemented for the clinic and clients.

Hand sanitizer is at the reception desk and must be used by the client upon entry and I will be washing hands before and after every client as I normally do. There will also be a 30 minute gap between clients. This will be for cleaning and to reduce contact between clients.  There will be only one chair at reception.

Information taken from the NSW Government website:

Statement from The Australian Traditional-Medicine Society  -What you can and can’t do under the rules
The individual decision to practice remedial and therapeutic massage services is now a personal risk assessment. The personal risk assessment must follow all social distance requirements as far as practicable, infection control procedures and individual client screening. There are some premises, for example gyms, health studios, beauty salons and massage parlours that must stay closed. It follows therefore that remedial and therapeutic massage services have been relaxed when delivered in a clinic setting.
The personal risk assessment for remedial and therapeutic massage services should also be guided by the sensible restrictions in place for hairdressers: the 4 square metre rule applies within the premises and personal contact with the client should be minimised. A client should attend the clinic alone or with one other person.
ATMS also reads these new guidelines as relaxing ingestive practice in a clinic
setting. Audio-visual consultations can be offered, with consultations now within the same personal risk assessment for ingestive practice.
The relevant extracts for NSW practitioners are as follows.

Healthcare is OPEN
Clients / patients should call ahead if they are experiencing any COVID-19
symptoms or are feeling unwell.
• Chemist
• Doctors and medical centres
• Hospitals
• Pathology
• Physiotherapy
Remedial or therapeutic massage services

Personal services are CLOSED
• Massage parlours
• Nail, beauty, waxing and tanning salons
• Spas (including where they are part of a hotel)
• Tattoo parlours
• Strip clubs and sex services premises

Sport and recreation are CLOSED
• Indoor sporting events
• Local sporting competitions
• Public swimming pools
• Indoor recreation facilities (squash courts, indoor swimming pools, gyms,
table tennis centres, health studios, bowling alleys and ice rinks)
• Outside gym equipment in public places
• Outdoor playgrounds
• Skate parks