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      John Mulligan, RMT/CLT-LANA

           Lymphedema Therapy, Education & Consulting


      Lymphedema Treatment – Before & After





Before & After – 1




Before & After – 2



Before & After – 3









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Before & After






Before Treatment





After Treatment




The client shown at left was an overweight, sedentary gentleman who had experienced a blunt trauma to his shin, damaging already overworked lymphatics and resulting in the swelling seen here. The injury was sustained when he slipped on the ice and the shin of his leg struck a concrete parking bumper with force. Although the injury was painful, it was the swelling that developed afterwards that was the real problem.


The swelling seen in the first photo developed over a period of several months, which is too fast for pure lymphedema. When there is trauma, problems can develop more quickly. In this case, the problem was compounded by the man’s overweight condition and sedentary work and lifestyle. You can see that the foot and ankle are spared from swelling. This is due to the fact that he continued to wear his work boots every day, thereby applying compression to the foot and ankle and preventing the swelling from developing there.


When he was first seen in the clinic the swelling was proteinized and firm. In fact, the swelling was quite hard. It was difficult to make an indentation in the swelling. To do so required persistent firm digital pressure for more than 30 seconds.


This patient was treated with complex decongestive therapy. The emphasis was on finding bandaging strategies to soften and decrease the fibrotic protein accumulation. The intensive phase of treatment lasted for eight weeks. At that time the leg appeared normal except for the discoloration seen here, which is permanent. After the intensive phase of treatment the patient is required to maintain his reduced swelling through exercise, compression and other means of self care.





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