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Standard Treatment of Lymphedema--Breathing


Breathing, a Component of Self-Care: The Overlooked Exercise

by Ellen Gordon Poage

Just as the heart is the pump for the circulatory system, the diaphragm is the pump for the lymphatic system. As a therapist, I was originally taught to use abdominal breathing, or what is known as abdominal work, for lower extremity patients. I was told it wasn't necessary for upper extremity patients. Yet with experience and time I have come to realize that unless I actively teach my patients deep breathing, all of them, even those who don't have lymphedema but are frightened that they might develop lymphedema, I wasn't doing my part as a therapist. So now all my patients get more instruction in deep breathing than any other component of self care.

The major problem with poor breathing is poor oxygenation. If there is poor oxygenation there is no energy. Poor oxygenation causes listlessness and depresses mood. Furthermore poorly oxygenated systems are stressed. The body doesn't care where the stress comes from, but it always responds in the same way, by tightening muscles, including the diaphragm. The end result is lower oxygen levels, poor circulation, increased muscle tension and decreased metabolic activity at the cellular level - no wonder it's difficult to lose weight!

The neat thing is this stress response can be changed both mentally and physically. Change the mind and the body responds, i.e., change your attitude about worries or your responses to events in your life and you reduce your stress. Or, change your body - practice deep breathing, exercise and stretching and reduce your stress.

The lymphatic system needs a relaxed body to operate properly. Just like relaxation helps digestion, it also helps the lymphatic system. Deep slow abdominal breathing helps you to take in large amounts of oxygen. From the lungs the oxygen moves into your blood stream where it binds to red blood cells and is transported to all the cells and tissue in your body.

Oxygen is essential at the cellular level in the production of energy. Exhalation reverses this order as the waste product of oxygen metabolism, carbon dioxide, is exhaled from your lungs. Don't wait another minute! The brain uses 20 percent of the oxygen in your body. As your body heals it requires all the oxygenation possible. In addition to oxygenation, the beauty of deep breath work is its effect on the lymphatic system. As the body goes from inhale to exhale there is a change in intra-abdominal pressure. This change creates a vacuum which helps push sluggish lymph fluid up the Thoracic Duct on its return to the Venous Angle where it will connect with the venous system.

Lets begin with an analysis of your breathing: while standing, with one hand on your belly and the other on your lungs, take a breath, inhale and exhale. Did you suck in your gut, open up your chest and bring your shoulders up to your ears? When you exhaled, did the belly come out and the chest deflate? Most people breathe like this. This is what is meant by the term chest breathing. This type of breathing is known as paradoxical breathing, but it is more aptly referred to as breathing backwards. Proper abdominal breathing corrects this.

To do abdominal breathing begin by lying down. After you've learned the technique you can do it in any position, but it helps to be supine and comfortable. Place a pillow under your knees. Now put a book on your abdomen right below the rib cage. Inhale slowly and deeply through the nose and allow the belly to fill up. The book on your abdomen should move. The abdomen needs to be relaxed. Don't force the abdomen to move, soften it.

Visualize a glass filling up from the bottom. Visualize a balloon inflating. Now let the air fall, press the air out with your abdominal muscles. The book should go down. Begin again and breathe correctly ten times. You will feel wonderful! Practice this breathing technique at every opportunity. The exercise may be difficult at first, but this is merely an indication you have been chest breathing - for a long time!

About the Author: Ellen Gordon Poage

Ellen is a nurse massage therapist with an extensive health background. She is a registered nurse with a Bachelor's of Science degree in Nursing and a Master's degree in Public Health in Health Education.

Ellen is a certified in Manual Lymph Drainage/Complete Decongestive Therapy. She completed the 135 hour training course with Joachim Zuther, Director of the Academy of Lymphatic Studies in Miami, FL in May 1995.

Presently, Ellen owns her own practice in both CDT and Massage. She is a member of the NLN and ONS and is active in her community in developing Lymphedema services and education the community about this disease and its treatment. Ellen runs a bimonthly Lymphedema support group in Ft. Myers, LEE County Florida and is a member of the
Lymphedema Resources, Inc. Board of Directors.


I had a conversation with a masseuse yesterday. He mentioned how most of his clients have compromised lymphatic movement, and the first thing he teaches them is therapeutic breathing. So I asked him about breathing, specifically We know about breathing in through the nose, out through the mouth, getting a good tummy breath, right? What he added was the importance of a full abdominal tightening/crunch which includes the butt and a kegel squeeze at the end of the exhale. Then the inhale is started by abdominal relaxation, then filling the lungs. I found it to be helpful. - kcshreve


Page Last Modified 09/29/2015

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