John Mulligan, RMT, CLT-LANA,  Lymphedema Therapist.gif


      John Mulligan, RMT/CLT-LANA

           Lymphedema Therapy, Education & Consulting


      Lymphedema Treatment – Before & After





Before & After – 1




Before & After – 2



Before & After – 3









Manual Lymph








News &




Contact Info



See Treatment

Before & After





Lymphedema before
treatment, seven years post cancer surgery.



After two months of treatment,

arm is normal.




The woman at left had undergone a mastectomy seven years prior to this photo being taken. The swelling in her arm was causing impingement of the median nerve, resulting in numbness, tingling and decreased function in her hand. Her arm was periodically weeping lymph fluid.


She was treated with complex decongestive therapy (CDT), which is the standard of care for lymphedema. CDT is a two phase protocol.  The intensive phase is the clinical treatment phase where the therapist is directing the therapy. The management phase comes next, where the patient learns to manage their lymphedema on their own.


The components of CDT are manual lymph drainage, compression therapy, exercise, hygiene and self-care. Manual lymph drainage is a specialized massage technique which is based on the anatomy and physiology of the lymphatic system. The gentle, rhythmic massage increases the flow of lymphatic fluid through the body and can be used to redirect lymph flow around obstructed or low-functioning parts of the lymphatic anatomy.


Compression therapy consists of the application of specialized multi-layered bandaging to the swollen limb. This preserves the effects of the manual lymph drainage treatment and prevents refilling of the limb with fluid. It also creates an environment for the limb where appropriate pressures encourage proper functioning of the lymphatics and the circulatory system.


During the intensive phase, compression bandaging is worn at all times except showering and during the manual lymph drainage treatment. Each treatment is followed by the reapplication of the compression bandaging.


During the management phase, the patient transitions into wearing a compression sleeve during the day and multi-layered compression bandaging only at night.


The patient is given exercises to perform while wearing compression and is instructed in recognizing the signs of infection and the importance of excellent hygiene in preventing infection. The patient is also taught to apply the multi-layered bandaging herself.




After eight weeks of treatment the swelling was gone and this patient was able to care for her arm so that swelling was managed and did not return.



Click to see next example of before & after treatment




©2014 John Mulligan  |  All rights reserved  | Start Feeling Better Today!  |  Privacy Policy