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Kinesiotape and lymphedema


Breast cancer-related lymphedema (BCRL) is a condition that is often called the "possible dreaded complication” of breast cancer treatment. Lymphedema is an accumulation of protein-rich fluid that rests right underneath the skin in the area of the treatment. Because of the anatomy of the lymphatic system, lymphedema will occur in certain regions of the body only. For example, if you have left-sided breast surgery, even if you do not have any lymph nodes removed, you can develop lymphedema on left side of her chest, breast and into your left arm. It will not migrate to the right side of your body, or spread down into your abdomen or legs. Lymphedema typically starts very slowly, and most women report that they didn’t notice any changes for a long time after treatment. But, other women will report that they feel a heaviness, or that their skin feels tighter and/or drier.

Some women will notice that the skin tends to take on a different appearance as well, sometimes having little dimples (called peau d’orange), or even a stretched out appearance.



Here is an example of peau d’orange which is often seen in those with lymphedema around the breast tissue once lymphedema has set in.


This is an example of the same condition on someone’s face.







Should you see this forming, it is recommended that you see a certified lymphedema therapist.

True lymphedema is caused by a disruption of the lymphatic circulation. Most people have not heard of lymphedema, nor the lymphatic system. It is actually quite finely interwoven within and throughout the body, usually quite close capillaries near the skin. When there is any major disruption, which can include surgery, constriction, or trauma, the body compensates by moving the fluid that normally moves between cells. However, once vessels are broken, and compensation occurs, there is only so much compensation possible to ensure that the fluid is still pulled from the interstitial area towards the skin. When this happens, we tend to see “swelling” and notice that the “swelling” does not go away. There are techniques used by Physical and Occupational therapists that reduce the lymphedema, so that the range of motion and heaviness reduces. It is not only for aesthetic purposes, but also a way to reduce the risk of cellulitis, which is a skin infection. As we have lymphedema for longer periods of time, the skin tends to dry out and form these micro-fissures. These small openings tend to let the bacteria into the body, instead of just resting on the skin. The bacteria find a great food source in the protein rich fluid, quickly multiply and cause an infection. So, the method to reduce this is called Complete Decongestive Therapy (CDT). This includes manual lymph drainage (MLD), a form of light massage to move the lymphatic fluid in a way that correlates with the anatomy to reduce lymphedema. Compression therapy is also used, especially after MLD, so that there is less likelihood of the lymphedema returning in high amounts.

The third component is exercise, and this is important, as it forces the muscle pump action to take place, again reducing the amount of lymphedema that rests in the arm. It also has beneficial affects on the body in general. Lastly, therapists address skin care, and the importance of cleansing and ensuring there will be adequate moisture. When skin is adequately moisturized, it is much less likely to have any micro-fissures, and this reduces the possibility of cellulitis. There are different phases of CDT: intensive and maintenance.


Unfortunately, lymphedema is a progressive disease, meaning that with time, symptoms will continue to get worse, and the lymphedema will continue to increase. This increase makes the arm, breast and that side of the trunk heavier, and limits the function of the woman. However, with continued intensive treatment initially, the lymphedema can be reduced, and with the maintenance phase, the lymphedema can be “better stalled” per se in that phase.

There are times, though, that the regular and daily compression treatment is not permitted or is not advantageous to the woman. What else can be done to help maintain the lymphedema when they are not actively receiving treatment? One of those methods that is being more commonly used is Kinesiotape or K-tape. This was invented by Dr. Kenzo Kase, a chiropractor, in 1973, and has been modified and intertwined into mainstream therapy and gyms of late. The goal of Dr. Kase, was to help his patients maintain the progress outside of the clinic, as well as they had during their session with him.

This is also a problem that those with lymphedema report: maintenance.



The helpful ridges of kinesiotape help "lift” the skin upwards, thereby moving lymphatic fluid.



As Kinesiotape has continued to evolve, practitioners have found additional ways to use the tape to help their clients. Reducing the amount of inflammation present in an area, was identified and then used by physical and occupational therapists. In fact, if Kinesiotape is placed over a bruise or hematoma in a fan-like or spider-web fashion and removed 2-3 days later, you will notice that the area that was underneath the Kinesiotape has begun to look like the normal skin tone. The area that was not covered is still quite bruised.


Why?

What we learned is that the kinesiotape has an influence on the lymphatic flow during movement, by helping open the lymphatic vessels and reducing the amount of lymphedema in an area. The tape’s adhesive side has a woven appearance that helps “pick up” the skin allowing for increased movement of the lymphatic fluid.

But, what does that mean for people with lymphedema?

There is another method available to reduce swelling and pain. There are still standards, which include wearing a compression garment daily. But, there are times when compression is contraindicated and there are women that really can not tolerate the compression.

There are limited options available for these sort of circumstances. Kinesiotape offers the possibility of addressing the flow of the lymphatics without the use of compression. The benefits are that it kinesiotape is flexible, comfortable and waterproof. More research needs to be done on this form of taping, but there is a lot of promise here.

However, there are some issues with kinesiotape as well. Some women present with allergies to the adhesive, or have skin that is very fragile. Some women will develop increased skin irritation, with blister formation. It is still best practice to complete a sample in an area before applying the tape to a larger area. It is also best practice to use adhesive remover to help ease removal.