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Related Conditions

Certified Lymphedema Therapists (CLT) are trained to address a number of medical conditions that are related to the diagnosis of lymphedema or that inherently increase an individual’s risk for developing lymphedema.  These conditions most commonly include Lipedema, axillary web syndrome (cording), post-mastectomy pain syndrome, radiation fibrosis, and soft tissue restrictions resulting from surgical and/or radiation oncology interventions.  To learn more about how a CLT may be able to help, please contact us.


“Size 8 from the waist up, size 16 from the waist down”, “tree trunk legs”, “saddle bags”, “thunder thighs”, “milk-can legs”, or “piano legs”.  These are all common phrases that women with Lipedema use to describe their body shape.  Lipedema predominantly affects women and is a poorly understood, widely underdiagnosed disorder affecting the body’s fat cells and their blood supply. Though not considered genetic, a family history is frequently reported.  Initial symptoms typically present during a period of hormonal fluctuation (e.g., puberty, pregnancy, and menopause).  Lipedema is considered a diagnosis of exclusion that is based primarily on history and physical findings. 

Common Lipedema Symptoms:
  • Legs and hips are disproportionately large as compared to the upper body
  • Symptoms affect both legs/hips and are generally symmetrical
  • Feet are typically unaffected
  • Fatty tissue is soft, dough-like or rubbery in texture
  • Affected areas are tender or painful when bumped or pressed
  • Affected areas bruise easily creating characteristic “blue spots”
  • Diet and exercise may reduce overall size but abnormal proportions remain
  • There is a tendency to gain weight in affected areas and lose weight in unaffected areas
  • Some swelling that occurs during the day and resolves overnight is common
For many women a consultation with a Certified Lymphedema Therapist (CLT) can be very beneficial.  Components of Complete Decongestive Therapy (CDT) protocols have been shown to benefit many individuals with Lipedema. Depending on the individual’s symptoms, interventions such as manual lymphatic drainage, compression garment recommendations, self-care education, and exercise prescription may be indicated.  These interventions are not expected to cure or fully resolve symptoms, however, can effectively reduce tissue sensitivity, slow or halt the onset of secondary lymphedema and/or tissue fibrosis, and improve general tissue texture.  As with most therapeutic interventions, the individual’s self-management efforts and realistic expectations will greatly impact the overall success of treatment and long term management. 

Oncology Related Conditions:

Axillary Web Syndrome (Cording): The development of cord-like structures in the armpit, inner arm, and/or the crease of the elbow may occur after breast cancer related surgical procedures.  Symptoms may occur soon after surgery or long after the individual’s last follow up appointment with their surgeon.  The cords are typically visible and readily palpated; they may have the appearance of “popping out” depending on the position of the individual’s arm.  One large cord, numerous small cords, or both may develop causing pain and limited range of motion.
Fortunately, axillary cording tends to respond very well to treatment and consultation with a Certified Lymphedema Therapist is strongly recommended. 

Post-Mastectomy Pain Syndrome (PMPS):  PMPS is a recently recognized collection of symptoms which can occur following any surgical breast cancer intervention.  Symptoms may include pain, hypersensitivity, numbness, tingling, and/or a burning sensation in the armpit, chest, or arm.  Limited range of motion, diminished function, and sleep disruptions are also commonly reported.  The cause of these symptoms is typically attributed to nerve damage inherently sustained during surgery.  PMPS has a greater prevalence among younger women and can be further complicated by radiation fibrosis, scar tissue formation, altered movement patterns, and soft tissue dysfunction.  Though the interventions of a Certified Lymphedema Therapist cannot directly alter the damaged nerves, treatment may assist in relieving some degree of PMPS symptoms by improving joint function and reducing the influence of associated soft tissue dysfunction such as scar tissue, muscle spasm, and myofascial restriction. 

Radiation Fibrosis: Radiation fibrosis is a potential side effect of radiation oncology treatments.  Though radiation treatment has been shown to be extremely effective in destroying cancer cells it may, overtime, damage structures adjacent to the targeted area of treatment (e.g., skin, muscle, blood vessels etc…).  Not all individuals receiving radiation treatment develop noticeable symptoms.  Those that do, however, may experience a change in the texture and/or pliability of tissues which may impair joint function, or damage to lymphatic and blood vessels resulting in lymphedema.  A consultation with a Certified Lymphedema Therapist is recommended for those experiencing symptoms of radiation fibrosis in order to limit the potentially negative effects of tissue changes on function and the risk of developing lymphedema.