From puffy eyes, to swollen feet: How this woman's gentle touch can instantly drain the pain of swollen limbs
Anne Schreiber is a trained physiotherapist who can bring instant relief
From puffy eyes in the morning to swollen feet and ankles, they are the everyday problems that can be uncomfortable and unsightly. Known medically as oedema, the symptoms are caused by too much water in the body’s tissues, leading to inflammation, but in most cases the swelling is temporary.
The body naturally processes the extra fluid, which is then passed out via the kidneys.
However, for some, there is no return to normality. It is distressing, painful and often disfiguring as limbs can expand to four or five times their normal size.
This condition, lymphoedema, affects 100,000 Britons. It occurs when the lymph system – a network of vessels and glands that circulate fluid around the body and form part of the immune system – is damaged by infection or injury.
Fortunately, there is relief in the form of a treatment that is simple, safe and painless, yet incredibly effective. Manual lymphatic drainage (MLD) is a highly specialised form of massage carried out by a trained physiotherapist.
Because lymph vessels are situated just under the surface of the skin, it is possible to stimulate them by means of gentle hand movements that direct the flow of fluid away from the swollen area into a part of the lymphatic system that is functioning properly.
Although not a cure, if used alongside the other cornerstones of treatment – compression bandages, exercise and skin care – MLD can reduce it to manageable proportions and bring huge relief.
To see how effective it is, we spent a day with MLD therapist Anne Schreiber at her clinic in Milborne Port, Dorset, observing how she treated a variety of lymphoedema patients.
Each session lasts between 60 and 90 minutes, and the instant results were remarkable . . .
9am Jo’s left arm
The first patient, yoga teacher Jo Waldon, 53, arrives. After discovering a lump in her left breast in 2000, Jo had a lumpectomy and five lymph nodes under her arm removed. Then, in 2004, her left arm swelled.
‘It was very heavy and tight and it was difficult to put on clothes,’ she says.
Jo was referred by her GP to Anne in 2007 and she has MLD twice a month. Even to the untrained eye, MLD looks very different from ordinary massage. There is no firm kneading, pushing or pummelling. Instead, the therapist’s fingers move lightly over the surface of the body, starting at the neck – the ‘M25 of the lymphatic system’, as Anne describes it. ‘It’s similar to a bottle – you have to empty the neck first to drain the fluid out.’
Anne, left, treats Jo Waldon's arm twice a month after she was referred to her by a GP
From there the therapist’s hands move down the body to the armpits, chest and abdomen, and then on to the problem area. Jo removes a compression bandage from her left arm, which looks almost twice the size of the right, and lies on the bed.
Anne starts by treating Jo’s unaffected right chest and arm in order to clear it and make room so that the excess fluid from the swollen arm can move into the healthy area. She then moves across Jo’s upper chest, lightly touching the skin, clearing the passageways for the fluid to move from left to right. Judging by Jo’s expression, it is clearly very relaxing. Finally, Anne moves on to the swollen arm and hand. After treatment, they are visibly smaller and Jo is thrilled.
10.30am Helen’s left leg
Anne’s next patient is Helen Lickerish, 47, an interior designer, who also comes to the clinic twice a month. When she was 32 and with a two-year-old son, she was diagnosed with cervical cancer. She had a hysterectomy with the removal of lymph nodes surrounding the womb.
Seven years later, she noticed her left leg and foot swelling up. ‘It became horrible, really swollen and heavy. It affected my movement and balance,’ Helen says.
When she first visited Anne, Helen’s left leg was 50 per cent larger than her right. Anne bandages Helen’s leg before starting the treatment to encourage the movement of the fluid.
She starts by massaging her from the neck down to stimulate the lymphatic flow and its reabsorption. For the final 30 minutes, Anne works on the front and back of Helen’s leg. At the end of the session, Anne takes her measurements and notes that there is now only a 20 per cent difference between Helen’s left and right leg size.
Helen says: ‘I always notice the improvement. My left leg is definitely thinner and softer than before. It amazes me how something so gentle can be so effective.’
Anne doing the MLD massage on Haran's tennis ankle
12.30pm Richard’s heart surgery scar
theatre director Richard Black, 75, arrives. He seems frail. Richard
suffers from heart and kidney failure and says he has MLD to help his
circulation and ease pain caused by arthritis.
some Primary Care Trusts will provide funding for patients to receive
MLD, not all do. Others fund only cancer-related lymphoedema, yet this
accounts for just 25 per cent of cases. Richard gets his massage on the
NHS. He had surgery after a heart attack aged 39 and has a large raised,
painful scar on his chest. This scar contains large amounts of fluid,
and MLD softens it by dispersing the build-up. He leaves in good
2.30pm Haran’s tennis ankle
Kunapalasingam, 33, is a mature student studying finance and business
at Bournemouth University. He sprained his ankle playing tennis in 2000,
causing it to swell for a while. He thought no more about it until 2008
when, after a series of long car journeys, the swelling returned. He
first came to see Anne early in 2009, and after three sessions a week
the swelling began to subside.
Haran’s enthusiastic sessions at the gym have now made the swelling
increase in size again, so he’s back. He looks healthy and fit but takes
off his trousers to reveal a left leg that is twice the size of the
‘I can sit down for
only an hour before it gets uncomfortable,’ he says. ‘And sometimes I
can’t get to lectures as it’s too swollen.’
treatment Anne measures Haran’s leg. Because of the dramatic increase
in size, he will now have to return for sessions every day for a
fortnight, and weekly after that. She gets to work, moving gradually
down his leg to his swollen foot and toes. After the session, Haran has
to squeeze his leg back into a compression garment. Anne cautions him
not to overdo things, telling him to stick with the gentle exercises
that she has shown him.