Working out with the right approach

Ok; so you are fed up and you are on a mission. You are going to lose the weight, even if it kills you. You are working out with weights, you are jogging, and you are even cutting out the desserts. You are drinking less soda and more water. You have drawn that proverbial “line in the sand” and you are going to do it this time.

You have totally dedicated yourself to a more fit, better “you”. You get on the scale three weeks into your new “lifestyle” and the scale has barely budged. You get discouraged and stop exercising consistently. Sound familiar? This is an all too common story that many of us have experienced.

What I have witnessed from selling and servicing over 18,000 personal training sessions in the last 8 years, is that most people are wasting their time working out. Now don’t get me wrong; there are many benefits that can come from working out besides losing fat and gaining muscle. But let’s face it, these are the main two reasons why most people start an exercise program.

The three most common mistakes I see people make are:

1. Too much cardio and not enough resistance training
2. Doing too many sets per exercise
3. Lifting the weight too fast

Mistake #1 -- Too much cardio and not enough resistance training

Go to any gym and you will see that 70 percent of the members are on cardio machines and 30 percent (or less) are lifting weights. This is understandable considering that it is easier to walk on a treadmill than picking up dumbbells and barbells, and do the exercises correctly.

Many people are intimidated by lifting weights, so they stick to what is familiar: cardio.

It’s important to realize that cardio can help you lose weight, but cannot change your body shape. For example, if you start out with a pear shaped body, you will still be pear shaped after losing weight through cardio.

On the other hand, when your fitness / fat loss program is well-rounded with resistance training, cardio training, and a sound nutrition program, you have the ability to actually sculpt your physique. You can increase the size of smaller body parts, and decrease bigger body parts.

Plus, when you build muscle with weight lifting, you become stronger, burn more calories 24 hours per day, build bone density, and give yourself a much better chance at aging gracefully.

 

Mistake #2 -- Too many sets per exercise

Most people believe that they need to do 4 or 5 sets of weight lifting per exercise. This is simply not true. All that is needed is 2 or 3 sets at most. One of the main keys to stimulating your body to lose fat and gain muscle through lifting is “Intensity”.

It is very important that the last three repetitions of most sets are very intense. The last three reps should be ones that you never thought you could get. These last few intense reps, done safely, are the only ones that will cause enough micro tears in your muscle to force your body to repair them, now slightly bigger and stronger.

When you know that you only are going to do two sets, it is easier to gear up and pick up the intensity to a higher level. Make workouts short, but intense. Sixty minutes is plenty long enough, as long as you have a specific plan, and only rest 1-2 minutes between sets.

 

Mistake #3 -- Lifting the weight too fast

Many people think that the more weight they lift and the more repetitions they perform the better. We call it the “how much do you bench” mentality. When you have this mindset, you tend to just throw the weight around with reckless abandon. Worse, with this mindset a lot of the tension of the weights goes to your bones, ligaments, joints, and tendons. This is not good and can lead to an injury.

Your goal should be to make a light weight feel heavy by making slow, controlled movements. This way you can have the ability to squeeze the target muscle during the contraction. Try using a 3-1-3 tempo on your lifts. That is a 3 second positive, a 1 second isometric squeeze in the contracted position, and then a 3 second negative. You may have to lessen your weights, but I promise you that you will increase your ability to focus on the intended muscle groups.

In general, perform two sets of three different exercises per body part.

If you work out with the proper intensity, you only need to exercise each body part once per week. Two to three one-hour work-outs of resistance training per week is all that is needed to entice your body to gain muscle and lose fat. Working out longer or more often per week will not make you reach your goals faster.

Remember, your body does not increase muscle mass while you work out. You are actually tearing the muscles down during exercise. Your body mass increases while your body is at rest.

To improve your body and energy, you need to focus on the three pillars of a sound fitness routine:

1. Your thoughts
2. Your exercise routine (resistance and cardio vascular)
3. Your diet

You do have the power to change; at any age. Now go do it.

Referenced from http://fitness.mercola.com/sites/fitness/archive/2099/12/31/are-you-making-these-mistakes-with-your-workouts.aspx on 5th October 2010

Understanding Pain

WHY ARE YOU IN PAIN?

Poor posture causes pain as it misaligns your body, strains the spinal cord, stresses the joints, irritates nerves and tighten muscles which leads to poor blood circulation. The following describes some conditions that you may be suffering from which may mean that some immediate attention/treatment is necessary before they become chronic and can affect your lifestyle:

Ankle Pain Ankle Pain can be due to injuries sustained when you sprain your ankles as you miss a step or doing some sports. Most of the time, the sprain is so bad that it tears your ligament and tendon which usually cause severe swelling and inflammation. Reason being: that your ankle is too stiff, weak and inflexible to rebound you back in balance; resulting in you being badly immobilized.

Back Pain / Slipped Disc / Sciatica
		Prolonged sitting in the office and bad postural habits will cause your pelvic to misalign as it tightens and strains your muscles that put lots of undue stress on the spinal discs. With long term abuse, it will result in slipped disc or sciatica which causes the disc to protrude and impinge on your nerve root which will cause you great pain. The degenerated spinal disc hits the nerves and causes tingling sensation and sharp shooting pain down to your buttocks, legs and to the toes. Back pain can also be triggered by carrying heavy things due to weak and tight muscles, accidents, obesity, pregnancy or sports injuries depending on what your body is suffering now.

Bunion Bunion is an abnormal bulging of bony outgrowth that forms at the base of the big toe, causing it to push towards the other toes and cramping them together thus causing pain. Causes of bunions are due to wearing too tight-fitting shoes, high heels or pointy shoes that congest the toes. Flat-footed people can also suffer from bunion as the foot tends to pronate inward while walking that put lots of pressure on the big toe joint which cause swelling and inflammation. The correct walking pattern needs to be learnt in order to re-educate the foot muscles to function properly again.

Carpal Tunnel Syndrome / Wrist Pain
		A common injury that affects most office executives who type non-stop on the keyboard, which normally stress and injure the ligament and tendon of the wrist joint. This will lead to serious tendonitis aside from suffering a wrist fracture. Wrist joint is a much neglected joint as we normally do not stretch or strengthen it. Worst of all, it can lead to Carpal Tunnel Syndrome which causes the median nerve to be compressed and result in tingling, numbness or sense of weakness to your hands. You will feel the pain radiating around the wrist to the elbow or even to the shoulder blade and neck which cause great discomfort. In advance stages, you will also feel loss of feeling in some fingers which affects its function such as the disability to write, drive, hold a cup or read a book.

Cervical Spondylosis Cervical Spondylosis is a condition characterized by wear and tear of the neck as we age. Bones of the neck form bony outgrowth called osteophytes or bone spurs. These bone spurs can irritate the nerves, muscles and ligaments lying beside it eventually causing pain. With these pains, your neck motion will be limited and can cause stiffness and great discomfort while you are moving or turning your head.

Elbow Pain – Tennis Elbow Not necessarily applicable only to tennis players as its name suggests. The term Tennis Elbow (‘Lateral Epicondylitis’) describes pain experienced at the outer bony area of your elbow due to tendon inflammation. Overuse of the forearms or other activities cause repeated micro tear and damage to the tendon. The pain can be very aching, affecting the whole arms eventually causing weakness. It causes great discomfort as the pain gradually becomes a constant and distracts your focus especially when you are using the mouse alot.

Elbow Pain - Golfer’s Elbow Golfer’s Elbow (‘Medial Epicondylitis’) describes a condition where you are experiencing the pain within the inner bony area of the elbow joint due to inflammation of the tendon. It does not necessarily affect golfers. You will feel the pain radiating from the forearm down to the wrist and up to the shoulder area causing dull pain and weakness of the arms. It is an irritating and constant pain that last and would not go away especially when you are typing the whole day.

Foot Pain / Heel Pain / Plantar Fasciitis It describes an inflammatory condition of the plantar fascia which runs under the base of the foot connecting from your heel bone to the base of the toes. It is a chronic pain which results from overly tight calf muscles which inserts into the heel bone and restricts the movement of the foot. You will feel a stabbing pain when you take the first step out of the bed once you wake up in the morning. If left untreated, the pain can become severe and interfere with every step you take so much so that walking becomes a painful task for you.

Frozen Shoulder Frozen shoulder is an irritable condition where there is constant pain in the shoulder upon movement which is known as adhesive capsulitis. Muscles around the shoulder joints are inflamed and tender which restrict your movements. People with frozen shoulders will have difficulty with their daily activities such as combing their hair, putting on their shirt and particularly brasserie for women and even scratching their backs. The shoulder joint is the most unstable joint in our body system that is prone to injuries.

Knee Pain
		Knee pain can be due to osteoarthritis, meniscus injuries, cartilage tears, ligament sprains and leg length discrepancies that cause wear and tear to the knee joints. Also, prolonged walking or running with misalignment of the knee will cause further stress to the knee joint. That explains no matter how much glucosamine you are taking seem to be of temporary help. Weakness in the leg muscles also cause knee pain as they cannot support the structure of the entire leg as well as the weight of the upper body. Unstable knee joints cause pain too when you walk up and down the stairs as the ligaments are weak and cannot stabilize your legs in motion. Most of the time, you will feel the pain below the front of the knee, back of the knee, inner or outer side of the knee, depending on which supporting muscles are not functioning properly.

Neck Pain / Shoulder Pain / Headache / Migraine / Whiplash Injury
		Long hours of hunching over the computer and poor working ergonomics will cause rounded shoulders and forward head posture which gives rise to neck and shoulder pains, migraines and headaches. Pain can also be due to whiplash caused by accidents which usually jerk the neck violently and over-stretch the soft tissues beyond their limits. These conditions compress your neck vertebrae, strain the neck muscles as it push your head forward; impinging on your nerve which cause pain, numbness and tingling sensation down towards your arms and fingers. Long-term hunching will also lead to shortness of breath and heart palpitations as it congest your chest, lungs and thoracic area.

Osteoporosis Osteoporosis also known as ‘Brittlebone’ is a condition when the bone rapidly loses its density. The bones become very brittle and subject to fracture easily as it becomes less dense at the core. Symptoms of osteoporosis can manifest as lower back pain, loss of height and in most drastic cases, developing humpbacks. Weakening of the bone especially affects women at their menopausal stage which leads to decreased production of estrogen, a female hormone that keep the bones strong.

Osteoarthritis Osteoarthritis (OA) describes a condition which the joints are inflamed due to the wearing out of cartilages in the joints that cushions the bones. It is the most common form of arthritis (‘ageing disease’) which can lead to swelling of the joints, stiffness and serious pain. It also affects women more than men especially after menopause.

Rheumatoid arthritis Different from Osteoarthritis, Rheumatoid Arthritis (RA) is an autoimmune disease that causes unknown inflammation in the body that results in joint pain, swelling, stiffness and possibly other organ damage. In serious cases, it can cause joint deformity, discoloration of the skin and gradual loss of motion.

Rotator Cuff Injury Rotator Cuff muscles are shoulder blade muscles that support the arm on the glenohumeral joint. Injuries to rotator cuffs include: falling on an outstretched arm, lifting with faulty body mechanics and repetitive arm activities especially those done overhead like throwing a basketball or placing items on overhead shelves. Signs and symptoms of the injury include pain and tenderness in the shoulder area, weakness of shoulder muscles and limitation of shoulder motions.

Scoliosis An abnormal curvature of the spine to the side which causes uneven height to the shoulders, waist and hip which results in severe back, shoulder and neck pain if left untreated. When the curvature gets worse, the spine will be rotated and twisted and will eventually cause the ribs to stick out to one side and creates a hump on your back. In the long term, it will stress and crush the internal organs that will lead to poor circulation, breathing problems and chronic pains.

Temporomandibular Joint (TMJ) Syndrome Temporomandibular Joint Syndrome refers to an acute or chronic inflammation and disorder of the temporomandibular joint (jaw joint) which connects the mandible to the skull. Causes of pain are due to trauma, repetitive unconscious jaw movement (bruxing: grinding of teeth) misalignment of occulusal surfaces of the teeth, excessive gum chewing or nail biting, size of food eaten and degeneration of joint cartilages. Signs and symptoms include headaches, toothaches, ear aches or ringing in the ear, neck, shoulder and back pain, pain behind the eyes, swelling, and limitation in opening the mouth during eating or talking. Referenced from https://mail.google.com/mail/?hl=en&shva=1#label/a_KAF/12b51696ccb8d5ea on 28th September 2010

ELECTROMEDICINE: THE OTHER SIDE OF PHYSIOLOGY

Western drug medicine limits itself to our understanding of chemistry to heal and control pain. Microcurrent electrical therapy (MET) is distinct in that it is based on the concept that the biophysics underlying the chemistry also plays a significant role in regulating all of life's processes.

Using waveforms at a level of current similar to the body's own, MET bridges cellular communications reestablishing the normal electrical flow. The concept of a bioelectrical control system is common to every form of healing ever developed in recorded history except drug medicine. The Chinese named bioelectricity ch'i, the Japanese called it ki, and the Indians referred to it as prana. The Russians spoke of the same thing under the name bioplasma.

All doctors in every discipline are taught that there are about 75 trillion cells in a human body, each one having an electrical potential across its cell membrane, just like a battery. It is amazing that Western physiology books do not even bother to speculate on the staggering significance of these facts.

Western medicine acknowledges a limited concept of homeostasis, defined as a tendency to uniformity or stability. Unfortunately it does not yet fully appreciate the natural healing powers of the body or the bioelectrical systems that control them. In our most rudimentary education we were taught that chemicals can be broken down into elements, then atoms and subatomic particles such as electrons.

TENS works by moving electrons through the body at a variety of frequencies. By using two frequency generators per channel TENS actually uses a very broad band of frequencies collectively know as harmonic resonance. This insures that the right frequency will be delivered to reestablish homeostasis within the bioelectrical system. The other frequencies pass harmlessly. 

Two contemporary scientists have proposed new comprehensive models to explain how our physiology is controlled by bioelectrical control systems. Robert O. Becker, M.D. of New York has done over 30 years of research and concluded that all biological systems have a primitive direct current electrical extraneuronal analog data transmission and control system to regulate all life's processes.

Dr. Becker was able to test his theories by studying regeneration. Using low level electrical currents, he completely regenerated frogs limbs and achieved partial regeneration in rats. His book, The Body Electric: Electromagnetism and the Foundation of Life (William Morrow and Co., New York, 1985) is the most important book in electromedicine. It includes a fascinating history of the development of science as it relates to the constant struggle between those who prefer to believe we have a "vital" life force and those who insist that we are just a collection of chemicals without a soul.

Bjorn Nordenstrom, M.D. is another leading pioneer in electromedicine. Dr. Nordenstrom, who recently served as Chairman of the Nobel Assembly, proposed a theory that a controlling bioelectrical system is closely integrated both structurally and functionally with the circulatory system. Dr. Nordenstrom successfully treated terminal patients at the prestigious Karolinska Institute in Sweden to prove his theories. His complete paradigm, including the experimental proof is published in his book, Biologically Closed Electrical Circuits: Clinical, Experimental and Theoretical Evidence for an Additional Circulatory System (Nordic Medical Publishers, Stockholm, 1983).

WHAT TO EXPECT

Many people will experience results during or directly following the very first treatment. Some will not achieve an effect until the morning following treatment. Others may require five to seven or more sessions before the effects will be noticed. If there is no change after ten treatments, and several electrode placement sites have been tried, the use of the Alpha-Stim 100 should be reevaluated. Although a slight tingling sensation is sometimes felt under the electrodes, it is not necessary to feel this in order to achieve results. Most people feel nothing at all except positive results. The current should never be raised to a level that is uncomfortable. Alpha-Stim treatment often leaves the user feeling relaxed, but, unlike with drugs, the mind remains alert. Frequently people report an increase in their energy level. For people who are having trouble falling asleep, Alpha-Stim should be used at least three hours before going to bed or the increased alertness may prevent sleep.

INDICATIONS

Microcurrent electrical therapy (MET) is continuously being subjected to rigorous study and evaluation by the international medical community. Findings to date indicate that the Alpha-Stim 100 is an effective treatment with broad applications for a variety of syndromes involving pain. In many cases it is the sole therapeutic method required. Effective results have been seen during and/or subsequent to stimulation over effected body parts, adjacent areas, and even areas removed from those in pain. As with any therapeutic intervention, not all patients will respond to the Alpha-Stim 100. The degree of efficacy will vary with the nature of the problem being treated and with the method of treatment. Accordingly, a trial evaluation is recommended on each patient to determine the best possible electrode location and to ascertain the long-term benefits of treatment.

The risk/reward ratio for the Alpha-Stim 100 ranks exceedingly high when compared to pharmacological management and other brands of TENS. Typically, one 10 to 20 minute treatment session every other day is sufficient to manage the conditions for the Alpha-Stim 100 is prescribed. However, some people will benefit from more (or less) treatment time. The Alpha-Stim 100 is safe enough to be used continuously if necessary.

CONTRAINDICATIONS

No contraindications have been established.

PRECAUTIONS

For external use only. TENS may affect the operation of cardiac pacemakers particularly demand type pacemakers; it is not recommended for use by these patients. Do not stimulate directly on the eyes. Do not stimulate directly over the carotid sinus (upper side of neck). Do not allow children to use or handle this device without adult supervision. Do not operate potentially dangerous machinery or motor vehicles during periods of stimulation. Safety of stimulation has not been established during pregnancy. Caution is advised in cases where other forms of analgesia would not be used; such as to retain the beneficial aspects of pain for diagnosis or in cases where patients may overuse pain-controlled areas. Use only for the purpose for which it is prescribed.

ADVERSE EFFECTS

No clear documentation of adverse effects exists to date. No death or serious injury has ever been reported following the use of the Alpha-Stim or any other TENS. The most common area of concern is skin reactions at the electrode sites. To minimize this problem, clean the skin prior to use. Cleaning the skin will also assure better electrode contact. If skin irritation occurs, consult your physician.

Lymph System in Health & Disease

Your body has two circulatory systems, one for blood and another for lymph. There are twice as many lymph vessels as blood vessels, and the volume of lymph in the body is twice that of blood.

Red blood cells carry oxygen from the lungs to tissues. However, blood cells do not actually contact the tissues. All the cells in the body are bathed in interstitial fluid (also know as extracellular fluid). Proteins in the interstitial fluid pull oxygen and nutrients through the capillary wall and carry them to the cells.  

 

The interstitial fluid provides oxygen and nutrients to the cells and carries waste away. Carbon dioxide and acid wastes are carried back through capillary walls into the blood. Larger wastes such as dead cells, bacteria, viruses, and other material are too large to pass through the capillary walls. These larger materials are carried away as the interstitial fluid moves into lymph vessels, eventually to be filtered and cleansed at the lymph nodes. From the lymph nodes the fluid is released into the blood as blood plasma.

The pumping action of the heart moves the blood. However, the lymph is propelled by the skeletal muscles through movement and respiratory pumps through breathing. If the body does not move then the lymph does not move.

When the flow of lymph is hindered, then cellular wastes accumulate and the area becomes toxic and irritated. To cleanse the area, the body increases the blood flow by creating new blood vessels and new lymph vessels to the area. The result is inflammation and swelling.

If the inflammation becomes chronic, then we have a situation that is ripe for disease. Stem cells migrate to the area to help with the repair, but in a situation of chronic inflammation these undifferentiated cells are not able to fully differentiate. These stem cells have the capacity for unlimited growth, the ability to avoid apoptosis (programmed cell death) signals, and an altered requirement for growth factors. Here we have an origin of cancer.

The inability of the lymph to remove waste has also been linked to many other diseases.

 (Referenced from http://www.alkalizeforhealth.net/Llymphsystem.htm on 29th July 2010)

Functions of the Lymphatic System

The lymphatic works in close cooperation with other body systems to perform these important functions:

• The lymphatic system aids the immune system in destroying pathogens and filtering waste so that the lymph can be safely returned to the circulatory system.
• The lymphatic system removes excess fluid, waste, debris, dead blood cells, pathogens, cancer cells, and toxins from these cells and the tissue spaces between them.
• The lymphatic system also works with the circulatory system to deliver nutrients, oxygen, and hormones from the blood to the cells that make up the tissues of the body.
• Important protein molecules are created by cells in the tissues. Because these molecules are too large to enter the capillaries of the circulatory system, these protein molecules must be transported by the lymph to the bloodstream  at the terminus.
• In lymphedema affected tissues, the lymph is unable to drain properly. Instead within these swollen tissues the protein-rich lymph becomes stagnant. When bacteria enter this fluid through a break in the skin, they thrive on this protein-rich fluid. It is for this reason that lymphedema affected tissues are prone to infections.

Blood capillaries allow fluid to leave, and enter, the circulatory system.

The Origin of Lymph

Lymph originates as plasma, which is the fluid portion of blood. The arterial blood that flows out of the heart slows as it moves through a capillary bed (see figure above). This slowing allows some plasma to leave the arterioles and flow into the tissues where it becomes tissue fluid.

• Also known as intercellular fluid, or interstitial fluid, this tissue fluid delivers nutrients, oxygen, and hormones to the cells.
• As this fluid leaves the cells, it takes with it cellular waste products and protein cells.
• Approximately 90 percent of this tissue fluid flows into the venules. Here it enters the venous circulation as plasma and continues in the circulatory system.
• The remaining 10 percent of the fluid that is left behind is now known as lymph.

Blood Flow Vs Lymphatic Flow

Lymph returning to the subclavian veins. © Lymph Notes

The bloodstream is pumped by the heart. It circulates throughout the body and is cleansed by being filtered by the kidneys. 

The lymphatic system does not have a pump to aid in its flow, instead this system is designed so that lymph only flows upward through the body traveling from the extremities (feet and hands) and upward through the body toward the neck.

As it travels through the body, lymph passes through lymph nodes where it is filtered. At the base of the neck, the lymph enters the subclavian veins and once again becomes plasma in the bloodstream. 

Lymphatic Capillaries

In order to leave the tissues, the lymph must enter the lymphatic system through specialized lymphatic capillaries. Approximately 70 percent of these are superficial capillaries that are located near, or just under, the skin. The remaining 30 percent, which are known as deep lymphatic capillaries, surround most of the body’s organs.

Lymphatic capillaries begin as blind-ended tubes that are only a single cell in thickness. These cells are arranged in a slightly overlapping pattern, much like the shingles on a roof. Each of these individual cells is fastened to nearby tissues by an anchoring filament.

As shown in the animation below, pressure from the fluid surrounding the capillary forces these cells to separate for a moment to allow lymph to enter the capillary. Then the cells of the wall close together. This does not allow the lymph to leave the capillary. Instead it is forced to move forward.

Lymph entering a lymph capillary. (Courtesy of John Ross).

Lymphatic Vessels

The lymphatic capillaries gradually join together to form a mesh-like network of tubes that are located deeper in the body. As they become larger, these structures are known as lymphatic vessels.

A functioning lymphangion (Courtesy of Laura Niklason)

• Deeper within the body the lymphatic vessels become progressively larger and are located near major veins.
• Like veins, lymphatic vessels, which are known as lymphangions have one-way valves to prevent any backward flow.
• Each angions is a segment created by the space between two sets of valves.
• Smooth muscles in the walls of the lymphatic vessels cause the angions to contract sequentially to aid the flow of lymph toward the thoracic region. Because of their shape, these vessels are previously referred to as a string of pearls.

Lymph Nodes

There are between 600-700 lymph nodes present in the average human body. It is the role of these nodes to filter the lymph before it can be returned to the circulatory system. Although these nodes can increase or decrease in size throughout life, any nodes that has been damaged or destroyed, does not regenerate.

Lymph nodes kill pathogens and cancer cells. They also remove debris and excess fluid..© Lymph Notes

• Afferent lymphatic vessels carry unfiltered lymph into the node. Here waste products, and some of the fluid, are filtered out.
• In another section of the node, lymphocytes, which are specialized white blood cells, kill pathogens that may be present. This causes the swelling commonly swelling known as swollen glands.
• Lymph nodes also trap cancer cells and slow the spread of the cancer until they are overwhelmed by it.
• Efferent lymphatic vessels carry the filtered lymph out of the node to continue its return to the circulatory system.

Lymphatic Drainage Areas © Lymph Notes

Drainage Areas

Lymphatic drainage is organization into two separate and very unequal drainage areas. These are the right and left drainage areas and normally lymph does not drain across the invisible lines that separate these areas. Structures within each area carry lymph to its destination, which is to return to the circulatory system.

Right Drainage Area
Right drainage area landmarks
Drains lymph from the right side of the head and neck The right arm Upper right quadrant of the body. Lymph from this area flows into the right lymphatic duct. This duct empties the lymph into the right subclavian vein. Left Drainage Area Left lymphatic drainage landmarks Drains lymph from the left side of the head and neck The Left arm and the left upper quadrant The lower trunk and both legs The cisterna chyli temporarily stores lymph as it moves upward from the lower areas of the body. The thoracic duct transports lymph upward to the left lymphatic duct. The left lymphatic duct empties the lymph into the left subclavian vein.

Why This Information is so Important

1. Damage disturbs the flow. Major surgery damages the lymph vessels, lymph cannot drain normally from the affected area. When this happens excess lymph accumulates and results in the swelling that is characteristic of lymphedema.
2. Exercise is important in the treatment of lymphedema because the movements of the muscles stimulate the flow of the lymph into the capillaries. 
3. If a part of the body is immobilized or constricted e.g. by tight clothing, then the flow of lymph is obstructed. 
4. Dehydration and other factors may cause the lymph to thicken, hindering its flow. 
5. Deep breathing moves the lymph, shallow breathing is less effective. 
6. Drainage areas. The treatment of lymphedema is based on the natural structures and the flow of lymph. The affected drainage area determines the pattern of the manual lymph drainage (MLD) and for self-massage. Although lymph does not normally cross from one area to another, MLD stimulates the flow from one area to another. It also encourages the formation of new lymph drainage pathways. 
   

References

[1] About the Lymphatic System in The Lymphoedema Handbook by Professor N. Piller and M.O. O’Conner, P.T. Hill. Content 2002.

[2] Anatomy Fundamentals by W. Weissleder, and C. Schuchhardt in Lymphedema Diagnosis and Therapy 2nd ed. Kagerer Kommunikation, Bonn 1997

[3] Atlas of the Human Body by T. Takahashi. Harper Perennial 1994,

[4] Foundation of Manual Lymph Drainage 3rd ed by M. Földi and R. StröBenreuther. Elsevier, 2003.

[5] The Human Body Explained by P. Whitfield. Henry Holt and Company.

[6] Living Well with Lymphedema by A. Ehrlich, MA, A. Vinjé-Harrewijn PT, CLT-LANA, and E. PhD. Lymph Notes, 2005.

[7] Lymphatic Vessels by A. Gashev in The Lymphatic Continuum Revisited ed by S.G. Rockson, 2008.

[8] Lymphedema Caregiver’s Guide by M. K. Kearse, PT, CLT-LANA, E. McMahon, PhD, and A.Ehrlich, MA. Lymph Notes 2009.

[9] Lymphedema Management: The comprehensive Guide for Practitioners, 2nd ed. by J.E. Zuther. Thieme, 2009.

[10] Lymphedema Therapy in a Vascular Anomaly Patient: Therapeutics for the Forgotten Circulation by S. G. Rockson in Lymphatic Research and Biology, Vol 3, No 4," 2005.

[11] The Lymphatic System Pathology by B. Lasinski in Implications for the Physical Therapists 2-Ed by C.C. Goodman, W.G. Boissonnault, and K.S.Fuller. Saunders, 2003, pages 477-508.

[12] The Way We Work by D. Macaulay and R. Walker. Houghton Mifflin Company, 2008.

[13] Unlocking the Drains by P. Brown. Nature Publishing Group, 2005, pages 459-458.

© LymphNotes.com 2009. This information does not replace the advice of a qualified health care professional.

 (Referenced from http://www.lymphnotes.com/article.php/id/151/ on 29th July 2010)

Lymphatic Self-Massage

Introduction

The primary purpose of self-massage, which is also known as lymphatic massage, is to improve the flow and drainage of lymph by stimulating the lymphatic vessels. Your lymphedema therapist will instruct you in a program of daily self-massage. This is an important part of managing your lymphedema and should be performed regularly as directed.

• If you have an infection, or any indication that you are developing an infection, you may need to modify or skip your self-massage until the infection is under control.
• Self-message is not recommended for those with medical conditions such as certain malignant tumors

Understanding the Self-Massage Strokes

To understand self-massage strokes, pay close attention to the instructions provided by your therapist. These are the similar in sequence, and strokes, as used by in manual lymph drainage.

• Self-massage is a gentle technique taught to the patient by the therapist and the resulting massage should never hurt or make the skin red.
• Self-massage to encourage lymph drainage is not the same as conventional muscle massage. For this reason, it is important that you do not allow anyone, other than a qualified lymphedema therapist, to massage lymphedema affected tissues using deep strokes.
• Most self-massage strokes use very little pressure and the hands do not slide over the skin. Instead they move and stretch the skin to stimulate flow of lymph through the lymphatic capillaries that are located just under the skin.
• Oils and lotions that make the skin slippery are not ordinarily used during self-massage. If the skin is very dry, a lotion can be applied, and allowed to absorb, before continuing with  the massage.
• When massaging fibrotic tissues, use only the pressure and strokes recommended by your therapist to soften these hardened tissues.

Rhythmic Pumping Motion

A rhythmic pumping self-massage motion is used to stimulate areas such as the terminus and major lymph nodes. This motion is performed by very gently pressing with the fingers, moving the skin in a circle the size of a coin, and then releasing the pressure. 

Stretch-Twist-Release Motion

• The stretch-twist-release motion is used to stimulate the flow of lymph through the tissues of the skin.
• This motion is performed by gently placing three fingers on the skin. The fingers gently stretch the skin for about an inch (2.5 cm) without sliding and then twist slightly to the right or left.
• This stroke is completed by lifting the fingers.

Sweeping Motion

• A sweeping motion, also known as effleurage, is used at the conclusion of a massage as a final stimulation of the lymph flow through the skin.
• This motion is performed as a gentle sweep of the fingers across the skin as if brushing bread crumbs from a table.

Overview of Self-Massage

• The information provided here will help you remember the sequence and strokes your therapist has instructed you to use.
• It is also a helpful guide for a caregiver or helper who is assisting you with self-massage.
• You will find it beneficial to review the article Understanding the Lymphatic Systemwhile learning to perform self-massage.

The Rhythm of Flowing Lymph

• The subtle pumping motion of the lymphatic vessels moves the lymph upward toward the terminus in a rhythm of five-to-seven pulsations per minute.
• To match these pulsations, each self-massage movement should be repeated from five-to-seven times in the same position.
• By following this pattern, you enhance the effectiveness of your self-massage as you work with the natural pattern of the flow of lymph.

Preparing for the Flow of Lymph

• Lymph flows from the tips of the extremities toward the trunk. Within the trunk, lymph flows upward toward the terminus where it returns to the venous blood circulation via the subclavian veins.
• In contrast to this pattern of flow, self-massage begins with the terminus and moves down to clear the major groups of lymph nodes and the trunk.
• The final area to be massaged is the affected limb. The purpose of this massage sequence is to clear space within the lymphatic ducts to receive the lymph as it flows out of the affected limb or area.
• The axillary and inguinal lymph nodes give the greatest resistance to the flow of lymph and these nodes must be cleared before, during, and after massaging the limbs.
• If these nodes overfill after they have been cleared, they can feel hard and sore. If this happens, clear the terminus and then clear these lymph node groups again. This makes room for the lymph as it drains from the impaired area.

Preparing for Self-Massage

• Select a room for your self-massage that is quiet and at a comfortable temperature.
• Perform your massage in the positions that work best for you. Most commonly this is lying on your back in a comfortable and relaxed position. You may want to remove your glasses, jewelry, and any restrictive clothing.
• Each self-massage begins with a few quiet moments of deep breathing to help you relax and focus on the task at hand. This breathing pattern should be maintained throughout the massage session.
• Self-massage is best performed first thing in the morning, before bandaging or exercising, and at other times as specified by your therapist.
• Never stimulate the flow of lymph from a normal area into a lymphedema affected area.
• The length of time devoted to self-massage depends on your condition and the instructions provided by your therapist.
• Once practiced in self-massage, many individuals find that this massage takes only a few minutes.

Preparing to self-massage the inguinal lymph nodes. © Lymph Notes.

References

[1] Living Well with Lymphedema A. Ehrlich, A. Vinjé-Harrewijn PT, CLT-LANA, and E. McMahon, Ph.D. Lymph Notes, 2005.

[2] Lymphedema Management: The comprehensive Guide for Practitioners 2-E, by J.E. Zuther. Thieme, 2009.

© LymphNotes 2009.This information does not replace the advice of a qualified health care professional.

 (Referenced from http://www.lymphnotes.com/article.php/id/313/ on 29th July 2010)