Specializing in Products for Lymphatic/
Vascular Disorders, and Soft Tissue Injuries


559 High Street, Suite #1
Pottstown, PA 19464

Accredited by the Joint Commission On
Accreditation of Healthcare Organizations

Management and Treatment Program for Lymphedema

Tips of the Week:

We get calls every week here at Advanced Rehab about equipment that is not functioning correctly. One of the things we tell people to look at is the connection of the hoses to the actual sleeve or boot. The picture here shows a hose that has come off of a sleeve in a bad way. If the hose gets pulled off of the sleeve like this, the sleeve is finished. This kind of damage is not repairable. We have seen people try to fix them using glue, caulking, etc. But they never work. The only answer is a replacement sleeve or boot. So, be careful when pulling the boot or sleeve on. NEVER pull it up by the hoses. If you boot or sleeve is damaged like this, call us, we can help you get a replacement.

Patients who have developed lymphedema can and should be active. Over the years, after thousands of patient, we have seen that it is very easy to fall into a sedimentary lifestyle. The more you sit around the bigger you will get. Those who never exercised before should consider starting that daily walk, swim or spending twenty minutes on a stationary bicycle. The right type of physical activity helps to reduce the swelling by improving the flow of lymph, and presents a vital tool for patients to stay in shape and continue with normal activities of daily living.

Many patients ask if they can continue their pre-lymphedema activities, or if they should adjust, or replace them. The answer to that question depends on the kind of activity. Tennis or golf for example does not rank very high on the list of beneficial activities for individuals with upper extremity lymphedema. For patients with lymphedema of the leg, activities that damage the leg should be avoided. Any activity that can cause a break in the skin should stopped. Wearing your compression garment during these physical activities in important. Along with an exercise regimen does not cause discomfort or pain. It is fine to continue with these activities.

However, if the affected limb hurts, feels strained, or increases in volume during and after the activity, the patient should adjust as necessary and consult with their lymphedema therapist or physician. The keywords here are caution and moderation; gradual progression is imperative while trying to accomplish an improved return of lymphatic fluid without adding further stress to an impaired lymphatic system.

Aerobic conditioning is generally performed in a repetitive fashion using large muscle groups. Some long-term benefits include decrease in resting heart rate, improved muscular strength, weight control and increased return of venous and lymphatic fluids. It is important to understand that certain aerobic exercises and recreational activities could trigger an increase in swelling, or contain higher risks of injury. Ideally, such high-risk activities should be avoided by patients suffering from lymphedema. Examples of these high-risk activities include soccer, kick-boxing or step-aerobics for lower extremity lymphedema, and tennis/racquet or golf for lymphedema affecting the arms.

Beneficial activities for upper and lower extremity lymphedema include (but are not limited to): Swimming/water aerobics – with the body weight reduced by about 90% in chest-deep water, exercises performed in the water improves mobility and enhances strength and muscle tone. In addition, the pressure exerted by the water on the body surface contributes to lymphatic and venous return. Hot water (temperature above 94 degrees F) usually found in hot tubs and Jacuzzis must be avoided. High water temperature definitely has a negative impact on lymphedema

Walking – a 20-minute walk outdoors, or on a treadmill (10-15 minutes, slow walking speed) while wearing the compression garment, will stimulate the circulatory system and contribute greatly to the individual’s general well-being. Key points: walk with a normal gait; do not drag the affected leg and avoid limping

Easy Biking – 25-20 minutes either outdoors or at the gym, using a comfortable and wide saddle. Legs are placed in a higher position on recumbent bikes, which makes them a better choice for individuals affected by lower extremity lymphedema

Yoga – the combination of stretching, deep breathing, relaxation and the positive impact on the venous and lymphatic return, makes yoga a perfect choice of exercise. Strenuous yoga practices should be avoided, and if certain poses seem uncomfortable, they should be altered, or skipped. Many cancer centers and support groups have contacts for yoga classes specifically tailored to cancer survivors and lymphedema patient

In general, exercises and activities should always be performed with the compression garment in place; intensity and duration of any exercise should be gradually increased; movements that over-strain, cause discomfort or pain should be avoided, and the extremity should be carefully monitored for any changes in size or shape.

Getting coverage for a Lymphedema Pump has been getting harder every year. In order to make it easier for yourself, there are some things to remember. Insurance companies, including Medicare look at the Clinical Records of the prescribing doctor. So, it is very important to make sure that all the issues you have with Lymphedema are in his notes for your condition. Most insurance companies follow Medicare guidelines for getting a pump. One of the biggest things that Medicare wants to see is your use of a compression stockings or wraps. It is crucial that the doctor have notes concerning use of a compression stocking. Even if you can't use one for what ever reason, your records need to show that it was tried. Even if the notes say that you tried and failed with a stocking, that will help. Without it, your equipment could be denied

From the publication JAMA Dermatol 2015, "Patients with lymphedema may reduce their risk of cellulitis, as well as the number of outpatient visits, by using an advanced pneumatic compression device (APCD), according to a new study.

"Our study demonstrates, for the first time, that receipt of an advanced pneumatic compression device is associated with significant improvements in key clinical endpoints for lymphedema patients, both for those with cancer and those without," Dr. Pinar Karaca-Mandic of the University of Minnesota School of Public Health in Minneapolis told Reuters Health by email.

"This finding has important implications for the patients who suffer from the disease, especially for those who have high rates of cellulitis. These devices serve as a viable self-management option and can reduce the need for more intensive outpatient care in rehabilitative settings," she added.

Advanced devices have more garment chambers and greater adjustability than earlier devices, the researchers wrote."

We are always getting calls about the boots / sleeves not feeling up with air. Usually, the main problem is that the connector bar has become dislodged because there was tension on the bar. It is an easy fix. Just squeeze the ends and push it back on to the pump.

Sometimes the hose will come off the nipple, the hose can be pushed back on sometimes and it will work fine. If you cannot get the hose on the nipple again or the nipple itself has snapped off, we have a fix for that. A replacement connector bar. The hoses can be cut off the old connector bar and placed on the new connector bar. We can walk you threw the process if necessary. Just call for the connector bar kit, and or advice.

A Lymphedema Compression Pump is one of the best ways to control edema. However, it works better when used in conjunction with other methods. In addition to a pump, elevation of the limb(s) is very important. Getting the limb above the level of the heart is a good way to reduce the limb size and preserve the goals achieved by the Compression Pump. Compression Garments are also very important. Standard Jobst or Juzo stockings are very good at helping you keep a limb down in size. BY themselves, the limb will not go down much. Once reduced, the stocking helps to keep the limb from getting large again. Many people have issues with putting a stocking on. In these cases, a Circ-Aid, or Farrow Wrap or Comprefit will help.

Lymphedema Compression Pumps have been used for years to treat edema and chronic venous insufficiency. When the insufficiency gets out of hand, it can lead to a venous ulcer. They are very hard to heal as the wound has problems getting enough oxygen from the blood to properly heal. Compression pumps have been known for a long time speed the healing process. This is evidenced by an old study ( it can be found on our clinical studies page ). From the Journal, Surgery, published in 1990, they showed that a compression pump regiment added to standard treatments results in much faster healing. The study included a control group who got a placebo treatment vs. the active therapy group. The patients in the control group showed poor results with only 1 of 24 persons healing up during the study. The treatment group had complete healing of all ulcers in 10 of 21 patients. This shows that compression therapy is a great tool to speed the healing of difficult to treat ulcerations.

Some Bio Compression sleeves use a Black and White Pin Connectors. To properly connect them to a Bio Compression 2004 or 3004 Pump, they need to start in the open position. If they are in the closed position, they will not go in..

Match the black pin to the black colored hole, and the white pin to the white colored hole. Using the black connector bar, push it flush to the face of the pump. Once put in the open holes, that are colored black and white, push the pins forward until they click into place. Now the hose bundle is connected firmly to the pump.

Remember to avoid taking the connectors in and out of the pump. The pins can break and will not hold firmly once broken. However, we have a kit to repair these if necessary.

One of the best ways to combat Lymphedema is to elevate the affected limb. If you sleep in a standard mattress and box springs, try putting an every day red brick under the foot of the bed. A square piece of a 2 X 4 also works well. This will raise the foot end of the bed up only a few inches. Usually not enough to give you a headache, but it will help the edema in your legs drain out. Many patients of mine have said they use pillows under their legs. But pillows move around during the night, and if they end up end up under your knees, that will not be helpful.

559 High Street l Suite #1 l Pottstown, PA 19464 l Office:1.800.876.3563 l Fax:1.800.908.3554

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