Lymphatic and Fascial System Treatment: Time to De-Compress
By Jeffrey Tucker, DC, DACRB
Within professional boundaries, I'm sure most of you are looking for ways to improve the efficacy of treatment just that bit more than would otherwise be expected. Can we improve the speed of getting someone out of pain? Can we improve muscle soreness faster? How can we improve the quality of movement patterns? Sometimes we do things because, anecdotally, it seems to work. This is the art of the chiropractic – having the creativity and openness to try new methods or use new technology in patient care. This article series explores a variety of recent and new technology, techniques, skills and practices. Like you, I am always looking for a "way in" to our client's body that will help decrease pain, improve outcomes and release poor patterns of movement and posture.
Lymph therapy is a compliment to your hands-on method of lymphatic drainage and fascial therapy that incorporates techniques from general chiropractic, acupuncture, myofascial therapy, ART, Graston, scar massage, etc., but it adds the dimension of pulling the skin and fascia away from the body. I refer to this treatment method as "fascial traction" which is clearly different from fascial compression which is what I see most practitioners perform. There has not been a place on the body "fascial traction" is not useful.
Lymph therapy technology incorporates a negative pressure device designed to work on the lymphatic system. The lymphatic system takes care of our immune system and dead cell removal; if there is injury, or tissue damage, even from surgery (a controlled trauma) there will be an extra accumulation of proteins, such as the GAGs (glycosoaminoglycans) that may be handled improperly by the tissue. The lymphatic system will participate in taking care of it. Even manipulation will produce body waste and the lymphatic system will take it away. The lymphatic system follows the fascial system. The fascia requires movement and the PhysioTouch offers a dimension I was not normally incorporating into my treatments. Chiropractors, PT's, massage therapists and acupuncturists spend the majority of treatment pushing into the body. The device pulls tissue away from the body (fascial traction).
Other than the adjustment, what is your current approach to treat the lymphatic system? Proper functioning of the lymphatic system is critical to our body's ability to detoxify and regenerate tissues, filter our foreign substances and maintain a healthy immune system. If lymph circulation stagnates, toxins accumulate and cellular functioning is compromised, opening the way to physical ailments and hastening the aging process.
The lymphatic system follows the fascial system. Fascia has an essential role in hemodynamic and biochemical processes, and provides the matrix that allows for intercellular communication. After injury, it is the fascia that creates an environment for tissue repair.
The devices are similar to manual lymphatic drainage massage with added benefits. The therapy device uses negative pressure to absorb and then release the skin in adjustable intervals, using a hand held treatment head. This stretches tissue to relieve tension and improve fluid exchange, muscle tone, tissue length and tissue hydration. The suction intensity can be adjusted and varied between 10 and 250 mmHg. The device includes changeable mouthpieces in different sizes for different body parts. The unit itself is small and compact with a touch screen and a 12 to 20 hour rechargeable battery.
I have used the device on various soft tissue abnormalities:
Why would you use a lymphatic device:
Over the course of my career, I have not seen most manual therapy techniques address the dimension of pulling the skin away from the body. Some practitioners perform Chinese "cupping" and some perform "skin rolling," but the negative pressure performed by this device is worth experiencing. If you work on fascia, you understand how it interpenetrates and surrounds muscles, bones, organs, nerves, blood vessels and other structures. One of the ways I like to use the device is to go along the center of the spine (top to bottom) to visually observe the effects of the suction on the fascia close to the spine. If the paravertebral fascia is restricted or the movement appears asymmetrical, this can indicate tightness in muscle slings (proximal or distal). We know how valuable pre- and post-treatment active and passive range of motion is for our therapy – this device offers a way to observe range of motion of the fascia that connects adjacent to the spine.
The fascia has its own metabolic system. It has a blood supply in addition to a nerve supply. Connective tissue and fascia are richly innervated1,2 and the fascial layers may thus play an important role in proprioception and nociception. Fascia is densely innervated with many sensory nerve endings including mechanoreceptors and nociceptors, which can become the source for acute myofascial pain. As far as the vessels go, we want to activate the capillary network. If a patient has inflammatory congestion (blockage from a protein problem), for example a chronic pain patient with low grade inflammation, we can treat the vessels in all axis of motion, not just horizontal and vertical. Swelling is a collection of protein amino acid combinations; it can become a problem if the protein stays stagnant more than two weeks because at this point in time fibrotic tissue will be created. Some people heal fast and others slow, and this may depend on the degree that these small vessels are flowing and the degree of protein's blocking the tissue. Touching skin activates proper protein filaments repair. If a person has tissue damage with inflammation that keeps cycling, you can help them change the reaction in this area by flushing away the waste products. It's pretty simple to see the after-effects of too much swelling or inflamed tissue, the fascia becomes tight and there is a loss of function. The device will help activate the lymphatic system and carry away the damaged tissue into the nodes to clean up body waste.
At this time, it is becoming more popular and certainly appropriate for chiropractors to check the fascia as an important integrative element in human posture and movement organization (locomotor apparatus). Schleip refers to fascia as the "organ of form."2 The lymphatic system should take care of the nutrition, hydration and oxidation of the fascia. The value in using this device is that it pulls the tissue up away from the skin. If you are using Kinesio taping and seeing results with this technique, you will understand that it's important to activate the fascia and with this machine we can do both systems at the same time. The device is an extension of my hands in that I use a twisting and pulling motion while treating. It allows the practitioner to assess for interrupted fascial gliding and provides a three-dimensional treatment to the web of lymphatic tissue that extends from head to toe, from front to back, from interior to exterior.
Taking care of the lymph system will help clients feel better before they need to get better.
Dr. Jeffrey Tucker is a rehabilitation specialist, lecturer and healer best known for his holistic approach in supporting the body's inherent healing mechanisms and integrating the art and science of chiropractic, exercise, nutrition and attitudinal health. He practices in West Los Angeles and lectures for the National Academy of Sports Medicine and the American Chiropractic Rehabilitation Board. For more information, please visit www.drjeffreytucker.com.