ARE PERIPHERAL LYMPHATICS DAMAGED BY HIGH PRESSURE MANUAL MASSAGE?

Abstract

Massage of the foot in men and the hindpaw in dogs was performed by applying externalpressures of 70-100 mmHg for a period of one, three, five, and ten minutes with a frequency of 25 strokesper minute. This protocol was performed on individuals without edema, on dogs with experimentallymphedema and men with post-thrombotic venous edema. After ten minutes of forceful massage, focal damage of lymphatics was present. In a groupof dogs with lymphedema and men with post-thrombotic venous edema, the alteration of lymphatics wasgreater than in normal individuals and evident only after 3 to 5 minutes of massage. At first, the forcefulmassage affected the endothelial lining of the initial lymphatics. Alterations of lymphatic collectors werevisible later. The fluid in lymphedema was translocated by massage using high pressure from theinterstitium into the lumen of lymphatics by means of the open junctions and by artificial cracks thatdevelop from injury to the lymphatic wall. Vigorous massage in lymphedema also produces loosening of subcutaneous connectivetissue, formation of large tissue channels and release of lipid droplets that enter the lymphatics. By thismechanism, massage helps reduce the amount of fat cells in the lymphedematous leg