What is Lymphedema?

Our body has a huge “highway system” located directly under the skin called the lymphatic system, it is so close to the skin that very tight compression can reduce the flow of this system. Lymph fluid contains white blood cells which are part our body’s defense mechanism again infectious disease and foreign bodies.  Lymph fluid is passed through lymph capillaries into vessels, then into lymph nodes and finally to the right or left subclavian veins and ultimately mixes back into our blood stream.

Lymphedema occurs when a large amount of high protein fluid collects just under the skin, usually on arms or legs. It can occur around breasts or the trunk, head neck and genitals, as these are areas that have a high number of lymph nodes present.

Primary edema occurs when lymph vessels are missing or impaired due to a hereditary condition.

Secondary edema occurs when lymph vessels are damaged or removed.

Once an area fills with high protein fluid, it attracts more fluid from the body and worsens the swelling. In response to the swelling the body has an inflammatory reaction of scar tissue in the area called fibrosis. Once this occurs on a cellular level, it makes oxygen and nutrient flow to the area more difficult, which creates a predisposition to infection in the area, delays wound healing and a condition called cellulitis.

Other conditions that can cause inflammation are venous insufficiency (leaky or obstructed veins), cardiac conditions like heart failure or sleep apnea, kidney failure, or other inflammatory processes. These are not Lymphedema and are treated differently.

Manual Lymphatic Drainage (MLD) Therapists

Manual lymphatic drainage was pioneered by Danish Drs. Emil Vodder and Estrid Vodder in the 1930s.

Today, therapists learn these techniques through specific MLD courses and schools. As the lymphatic system is so sensitive to external pressure, there is a specific routine of very light touch that is used to stimulate the lymph flow.

There are governing bodies who train and certify therapists who have been adequately trained to treat this condition. They are the Lymphology Association of the North and National Lymphedema Network. Practitioners treating these patients should have completed a minimum of 135 hours of Complete Decongestive Therapy coursework.

Please use the following resources to find a certified practitioner in your area.



Chiropractor Kailua

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