Remedial Massage Therapy and Manual Lymphatic Drainage Management on an Amputee’s Arm

When meeting a client for the first time it is a good practice to be very open minded, as there is a lot to cover in a short visit. This particular client presented with a long history of a number of cancers, chemotherapy and radiation therapy treatments over many years. Currently undergoing terminal chemotherapy with first stage lymphoedema developing in the left arm. Management for the lymphoedema was wearing an arm sleeve however; this became difficult to be placed on over time.

A terminal tumour was found in the junction site of the left arm and chest. Movement in the left arm was restricted due to chemotherapy treatments and thick scar tissuing. The left arm itself was heavy, cumbersome and “just hung there”. Lifting the left arm required the aide of the right arm. Overall, the left arm had become redundant and burdensome.

An agreement was made to work on improving circulation in the left arm with Remedial Massage Therapy and Manual Lymphatic Drainage. The client was very aware that full range of movement in the left arm might not be possible to achieve due to the amount of scar tissuing and chemotherapy damage to the site. Over months of treating the left arm pustulated blisters began forming on the left hand. This created distress within the client as doctors were unable to find the cause of the blistering or able to suggest any form of treatment.

Discussions about the left arm and what would be the best plan of management in the future was conducted over a long period of time. The client had considered amputation many years prior to the initial introduction meeting. Part amputation became the final result. The left arm was now above elbow to shoulder length, thick scar tissuing and lymphoedema problems where still very relevant.

The left arm required post-operative care as well as Manual Lymphatic Drainage for the lymphoedema. A new treatment program was put into place and implemented for some months. Throughout this period the client often spoke about feeling the whole arm as if never amputated and could feel the treatment being performed in the upper part of the arm sending messages to the lower part of the arm even though not present. The wound site healed well and treatment continued as planned.

Over 90 percent of the scar tissue has been broken up and the left arm has approximately 30-40 percent range of movement. The client has become more confident and has found joy in many aspects of life. The client’s treatment plan is reviewed and adjusted as needed.

Be open minded when meeting a client for the first time.
Be confident in your scope of practice.
Be clear on the working agreement for improving health and health outcomes.
Remember you are part of a team even though you may not know the other team members.