Certified Lymphedema Therapists (CLTs) are healthcare professionals, such as physiotherapists, occupational therapists, massage therapists and, in some settings, speech-language pathologists, who have completed specialized education in lymphedema assessment and treatment.

This additional training helps them understand why swelling is occurring, how advanced it may be, and which treatments are most appropriate. This is important because not all swelling is the same, and treatment needs to be tailored to the individual.

Treatment Is More Than Massage

Manual Lymph Drainage (MLD) is a specialized technique using gentle, light movements designed to encourage lymph fluid to move toward areas where it can drain more effectively. It is very different from traditional massage.

MLD can be one part of lymphedema treatment, but MLD alone is usually not enough to control ongoing swelling. When reduction is needed, treatment may include:

• Manual Lymph Drainage when appropriate
• Multilayer compression bandaging or adjustable Velcro compression wraps
• Exercise and movement
• Skin care
• Properly fitted compression garments for ongoing management

Once swelling has been reduced as much as possible, an appropriately selected and fitted compression garment can help maintain the reduction and prevent fluid from building up again.

We Need a Team Approach

In B.C., we would like to see more collaboration between Certified Lymphedema Therapists and compression garment fitters. Ideally, patients should have access to assessment, swelling reduction and expert compression fitting as part of a coordinated treatment plan.

A CLT can assess how the swelling is responding to treatment, while a knowledgeable compression fitter can ensure the garment provides the appropriate compression, fit and comfort. When therapists and fitters communicate and work together, patients receive more coordinated care.

Fortunately, more clinics and retailers in B.C. are beginning to offer this collaborative approach.

What If Your Swelling Isn't Improving?

Not all swelling is caused by excess lymph fluid alone. Over time, lymphedema can lead to changes in the tissues, including fibrosis and increased fatty tissue, which may make the swelling less responsive to MLD and compression.

If your swelling is not improving despite appropriate treatment and consistent compression, talk with your healthcare provider or Certified Lymphedema Therapist. Further assessment may help determine what is contributing to the swelling and whether additional testing or specialist care is appropriate.

In B.C., patients with more complex cases may be referred for specialized assessment, including evaluation through the UBC/VGH lymphedema program, when appropriate.

(LE&RN also has a link that says what to look for when going for a therapist_ https://lymphaticnetwork.org/living-with-lymphedema/find-a-lymphedema-therapist/