Massage & Bodywork

January/February 2013

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education Pathology perspectives | body awareness | functional anatomy | somatic research Edema and lymphedema are topics of great relevance to massage therapists and bodyworkers. While I have avoided writing about it because it involves a tiny bit of—gulp—biochemistry, it seems time to visit the edema/ lymphedema conversation. Lymphedema and Massage What You Need to Know By Ruth Werner 42 massage & bodywork january/february 2013 Picture for a moment what it's like in the interstitial spaces between our cells. When everything works well, the environment is moist and slick, and the fluid here is not stagnant; it is always moving and changing. Circulatory capillaries connect, weblike, throughout every part of us, and every living cell is within close proximity to one of these supply lines. Capillary walls are so thin that oxygen, carbon dioxide, certain white blood cells, and other substances can easily cross in and out. As the heart pumps blood through increasingly tiny vessels, the force of blood pressure pushes some plasma (the liquid that suspends our blood cells) out through the capillary walls and into the interstitial spaces. Fortunately, osmotic pressure pulls most of it back into the circulatory capillaries, leaving about 10 percent to stay between the cells as interstitial fluid (ISF). What happens to that leftover 10 percent? It can't just accumulate. Instead, we have an overflow system: lymphatic capillaries that also completely permeate our tissues. Along the length of these tiny vessels, the endothelial cells that form the walls are hooked by tiny filaments to other nearby cells. This feature means that as ISF pushes cells apart, our lymphatic capillaries open up to draw fluid in, with the assistance of

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