|
Is Lymphatic
Balancing the Missing Ingredient
to Success in Your
Practice? |
Many
manual practitioners think of lymphatic drainage
techniques as an area of specialty that may not
factor into their practice and is only for patients with
lymphedema. The belief that working with the lymphatic
system will require taping techniques or complicated draping
may have prevented practitioners from incorporating specific
lymphatic work into their treatment. In fact, adding a
principle based approach to lymphatic system support and
balancing may be easier than thought and may be the answer
to getting lasting results for some difficult cases that
don’t seem to respond to current treatment protocols. The
ability to incorporate lymphatic balancing into treatment
will also promote healing from the inside out by helping to
create an internal environment that is conducive to healing.
Within the hierarchy of healing, the principle that the
movement of fluids is essential to the maintenance of health
is one of the basic tenets of osteopathic medicine. Perhaps
even more important is the concept that drainage must
precede supply. This could be understood to be referencing
the drainage of venous blood as a preparation for the
delivery of arterial blood flow but we must not forget the
incredibly important role that the lymphatic system plays in
the purification of tissues, fluid balance, immunity and
digestion. Dr. Andrew Taylor Still, the father of
Osteopathy, emphasized that the treatment of the lymphatic
system was vital for the treatment of disease and the
maintenance of health and homeostasis. He stated “We strike
at the source of life and death when we go to the
lymphatics”.
The Lymphatic System
On a daily basis approximately 30 liters of fluid filters
out of the capillaries with oxygen and
nutrition into the
interstitial spaces. Of that only 27 liters will return to
circulation. The remaining 3 liters drains into the
lymphatic system. The lymphatic system is made up of a
network of thin tubes that run throughout the body called
lymph vessels and oval-shaped organs called lymph nodes
which collect and filter lymph. Before passing into the
capillaries of the lymphatic system, the fluid cleans the
extracellular spaces of particulate matter, exudates and
bacteria. Lymph vessels collect and filter this fluid in
lymph nodes before directing it toward blood vessels near
the heart. It is here that lymph re-enters blood
circulation.
Returning lymph to the blood helps to maintain normal blood
volume and pressure.
It also prevents edema, the excess accumulation of fluid
around tissues.
The proper functioning of the lymphatic system is critical
to our body's ability to detoxify and regenerate tissues.
The lymphatic system filters out toxins and foreign
substances, recovers crucial substances that have escaped
from the blood, and helps maintain a healthy immune system.
If the lymph circulation stagnates due to injury or
infection, toxins accumulate, and cellular metabolism is
significantly compromised. The result is an increase in acid
and toxins within the tissues causing pain, tension, and
edema. These substances, along with the edema, need to be
removed quickly from the interstitial fluid, in order to
promote proper tissue healing and restore proper pain-free
movement.
History and Development of Lymphatic Balancing
The history of lymphatic drainage techniques dates back to
the late 1800’s when the faculty at the first osteopathic
college in Kirksville, Illinois began research on
distribution within the vascular and lymphatic systems.
Frederic Millard, DO, one of Still’s students, published
Applied Anatomy of the Lymphatics in 1922, which led the way
for further research and development of specific techniques
aimed at treating the lymphatic system. J. Gordon Zink, DO,
FAAO, inspired by the work of Millard, expanded the concepts
to include the Respiratory-Circulatory model placing a
special emphasis on the influence of fascial restrictions on
the flow of venous and lymphatic return and the importance
of creating pressure differentials in the cavities of the
body to encourage the ease of flow.
Lymphatic Balancing was designed by Dr. Kerry D’Ambrogio to
treat excess fluid or swelling, fluid stagnation or
lymphedema in the cranium, spine, rib cage, visceral system,
and the upper (shoulder, elbow, wrist and hand) and lower
extremities (hip, knee, ankle and foot). Lymphatic Balancing
expands on the work and teachings of Dr. Emil Vodder (Vodder
Method), Bruno Chikly MD (Lymphatic Drainage Technique), Dr.
Albert Leduc PT, PhD (Leduc method) and osteopathic
lymphatic pumping techniques. These techniques can be
applied to a wide range of clientele within the orthopedic
community.
Lymphatic Balancing builds on the principle- based concepts
of Dr. Still while incorporating the use of gentle,
rhythmical pumping techniques, both long and short levers,
to encourage the healthy flow of lymph. First developed by
Earl Miller DO, the lymphatic pump is a manual technique
that makes the use of both long and short levers to
re-establish the rhythmical flow of lymph. Pumping
techniques can be easily integrated into a multitude of
manual treatment approaches without the need for special
draping or taping. It is a non-invasive approach in which
the risk to benefit ratio is exceptional.
Benefits of Lymphatic Balancing
The outcomes of a Lymphatic Balancing include the
restoration of proper joint biomechanics, functional range
of motion and optimal postural alignment. This gentle,
hands-on approach is efficacious in the treatment of back
pain, sciatica, neck pain, headaches, rib pain, upper and
lower extremity orthopedic dysfunctions, swelling, and
postural asymmetry.
The Lymphatic Balancing courses at the D’Ambrogio Institute
topics include:
• How to first decide if lymphatic balancing is a priority.
• The history, principles, and neuromuscular basis of
Lymphatic Balancing and the significant anatomy of the
lymphatic system and supporting structures.
• How to conduct a thorough specific orthopedic evaluation
using ARTS (Asymmetry, Range of Motion, Tension Tests and
Special Tests) of the cranium, spine, thorax, abdomen
(viscera), and upper and lower extremity.
• Charting results of the evaluation and formulating a
treatment plan
• How to determine the proper sequence of treating the Total
Body Lesion
• Performing Lymphatic Balancing on the nodes, vessels, and
tissues of the cranium, spine, thorax, abdomen, and upper
and lower extremity.
• The clinical importance of Lymphatic Balancing for the
treatment of excess fluid, swelling, or lymphatic stagnation
in relation to muscular skeletal dysfunctions.
• Integrating Lymphatic Balancing with other treatment
modalities taught at the D'Ambrogio Institute.
Lymphatic Balancing is taught as three courses (Total Body
Approach and a Local Approach for the Upper & Lower
Quadrant).
The courses can be taken in any order.
Lymphatic Balancing; Total Body Approach (LBTB): This course
teaches you how to perform a Total Body Evaluation (ARTS),
and treat excess fluid or swelling in the body. This class
teaches you a total body approach to lymphatic balancing.
LB
is a useful place to start for new patients before
performing specific LB on local regions of the body, or as
maintenance for the patient.
Lymphatic Balancing; Local Approach - Upper Quadrant (LBUQ):
This course teaches you how to perform a local evaluation
(ARTS), and treat excess body fluid or swelling in the
cranium, cervical spine, thoracic spine, thorax, upper
abdomen (viscera), and upper extremities (shoulder, elbow,
wrist and hand).
Lymphatic Balancing; Local Approach - Lower Quadrant (LBLQ):
This course teaches you how to perform a local body
evaluation (ARTS), and treat excess body fluid or swelling
in the lower abdomen (viscera), lumbar spine, pelvis,
sacrum, and lower extremities (hip, knee, ankle and foot).
LB helps reduce swelling in the cranium, spine, rib cage,
visceral system, and the upper (shoulder, elbow, wrist and
hand) and lower extremities (hip, knee, ankle and foot).
LB helps to restore proper joint biomechanics, functional
range of motion, and postural alignment.
LB is appropriate with the following patient populations:
pediatrics, adolescents, young adults, adults, and
geriatrics.
For more information regarding Lymphatic Balancing, how it can benefit your
patients, and training seminars, please go to
Dambrogioinstitute.com.
Last revised: August 20, 2016
by Dr. Kerry D’Ambrogio, D.O.M., A.P., P.T., D.O.-M.T.P.
Kerry
D’Ambrogio is a physical therapist, osteopath and
board-certified acupuncture physician. He is the president
and director of the D’Ambrogio Institute and Therapeutic
Systems, Inc., in Sarasota, Fla. He is the co-author of
Positional Release Therapy (Mosby). D’Ambrogio is a
graduate of the physical therapy program at the University
of Toronto (Canada), the osteopathic program at the Canadian
Academy of Osteopathy (Hamilton, Ont.), the John Wernham
College of Classical Osteopathy (Maidstone, England), and
the acupuncture program at the Academy of Chinese Healing
Arts (Sarasota, Fla.).
