Recovery is an essential part of the training program for high-level performance and continued improvement (Dalleck, 2019). Lack of recovery, trauma, overuse or prolonged stress of the tissue structures are all common examples of causes of the occurrence of sport injuries (Bahr et al., 2015).
There are several treatments that are usually performed after sports injury aiming to speed up the recovery process. These treatments traditionally include e.g. hot or cold packs, therapeutic exercises, strapping, electrical stimulation and manual therapy techniques such as joint mobilization or massage (Lam et al., 2015). Regarding manual techniques, we usually create positive pressure or stretching to affect soft tissue (Threlkeld, 1992) and nowadays it is rather common to apply Instrument-Assisted Soft Tissue Mobilization (IASTM) to enhance mobilizing effect of tissue e.g. for scars and myofascial adhesions (Cheatham et al., 2015). One innovative approach in sport rehabilitation and muscle maintenance is to create controlled negative pressure and decompression as part of the manual treatment instead to mobilize the tissue and enhance the recovery process.
LymphaTouch® negative pressure treatment was originally developed for healthcare and rehabilitation professionals to enhance lymphatic circulation and to reduce swelling and pain especially in cancer patients who suffer from secondary lymphedema (Vuorinen & Airaksinen, 2009). Lymphedema is defined as a condition in which extra fluid builds up in tissues causing swelling: it may occur anywhere in human body, most commonly in an arm or leg if lymph vessels are blocked, damaged or removed by surgery (National Cancer Institute, 2019). Lymphedema can also develop at birth and in this case it is called primary lymphedema (Rockson, 2001).
However, as a typical symptom of inflammation, swelling is also very common condition after acute trauma or injury such as contusions, muscle-tendon or ligament sprains and related ruptures (Kannus et al., 2003; Szczesny et al., 2003).
Therefore, LymphaTouch® is widely used in other segments outside of lymphedema care, since lymphatic swelling occurs in other conditions too, such as pre- and post surgery, after acute injuries or in some chronic conditions.
Negative pressure treatment is not a completely new way of treatment since traditional cupping is a very common example of this method. Donahue (2019) makes a good comparison between cupping and graded negative pressure treatment. In cupping, it is not possible to evaluate the amount of negative pressure inside of the cup and it may easily cause bruising and swelling especially in hypersensitive tissue. LymphaTouch® treatment, on the other hand, provides an opportunity to control the decompression of the tissue (Donahue, 2019).
The operating principle of the device is rather simple: negative pressure expands and stretches the tissue pulling anchor filaments to dilate the endothelial openings of the lymphatic capillaries; simultaneously, the expansion of fascial and connective tissue structures create space for blood circulation and lymph flow. The device is designed to support lymphatic drainage and to mobilize tissue by creating controlled negative pressure and mechanical high frequency vibration (Vuorinen & Airaksinen, 2009).
The LymphaTouch® has been used in several treatment areas and patient populations, such as: • Sports athletes to reduce perception of DOMS after e.g. heavy resistance training, for muscle maintenance, recovery treatments, in acute conditions to enhance healing process and to reduce pain (Hietanen et al., 2014; Nummela et al., 2013; Tucker, 2014) • Orthopedic patients in pre- and postoperative rehabilitation to reduce swelling and pain (Guangmin et al., 2018; Ping et al., 2014) • Oncologic patients in primary and secondary lymphedema care to reduce swelling, to treat scar- and/or fibrotic tissue and break up adhesions (Gott et al., 2018; Murphy et al., 2018; Vuorinen et al., 2013) • Musculoskeletal and neurologic patients in general rehabilitation to improve range of motion and overall functionality (Airaksinen et al., 2011; Hietanen et al., 2014). Also, fascial treatments are common to perform with LymphaToch®.
Tucker (2014) wrote about his experience of using the negative pressure device mainly from a fascial perspective: he has utilized technology e.g. in acute and chronic local swelling and edema, trigger points, fascial tightness, muscle shortness and deficits in motor activity or control, describing the treatment as an extension of his hands for twisting and pulling the tissue while treating.
LymphaTouch includes the main unit itself and four different sizes of treatment cups. The size of the treatment cup is chosen to fit the treated body part. Negative pressure can be adjusted between 20 and 250 mmHg depending on the treatment indication. In case of sensitive skin, the negative pressure can be adjusted to lower values and when treating tight tissue or scars, the negative pressure can be increased.
It is always good to start with lower negative pressure values and gradually increase it by looking at patient perceptions and tissue reactions.
The SPORT upgrade allows even more intense treatments for versatile tissue mobilization with the possibility to increase the negative pressure up to 350 mmHg.
With LymphaTouch it is possible to choose either pulsating or continuous negative pressure treatments: pulsating mode activates the tissue and it's used for local treatments whereas continuous mode is mostly used in fascial techniques to decompress the tissue efficiently or when redirecting extra fluids in edematous treatments.
In case of tight tissues or scars it is possible to combine negative pressure treatment with mechanical high frequency vibration in the
20-90 Hz range.
Higher frequencies influence the superficial layers of the tissue and lower frequencies take the effect deeper into the tissue.
The possibility to combine all different kind of settings with different treatment techniques makes the device highly versatile to use in various indications.
The battery lasts up to 8 hours of continuous use and it can be used while plugged in too.
LymphaTouch promotes overall wellbeing and it can help to speed up the recovery process by accelerating the lymphatic flow and creating decompression to the tissue (Vuorinen & Airaksinen, 2009). Negative pressure treatment gives professionals the opportunity to mobilize the tissue in an opposite direction to what is possible to create with our hands and hence, provides a three-dimensional treatment (Donahue, 2019). It also allows practitioner to assess for interrupted fascial gliding, to improve fascial flexibility and to enhance lymphatic flow (Tucker, 2015).
By combining the expertise and knowledge of the practitioners with other manual techniques and active exercise therapy, graded negative pressure treatment can provide a great potential for sports athletes’ injury prevention, muscle maintenance, faster recovery and overall performance.
References
Airaksinen O, Vuorinen VP, Raittila S. (2011). Influence of LymphaTouch-treatment method for pain and edema in context of active physiotherapy. Internal Research Report.
Bahr R, Alfredson H, Järvinen M, Järvinen T, Khan K, Kjaer M, Matheson G, Maehlum S. (2012). Types and Causes of Injuries. In. R. Bahr, P. Mccoey, R. F. Laprade, W. Meeuwisse, L. Engebretsen (editors) The IOC Manual of Sports Injuries: An Illustrated Guide to the Management of Injuries in Physical Activity. The International Olympic Committee: Pp 1-24.
Cheatham SW, Lee M, Cain M, Baker R. (2016). The efficacy of instrument assisted soft tissue mobilization: a systematic review. The Journal of the Canadian Chiropractic Association, 60(3), 200.
Dalleck LC. (2019). The Science of Post-Exercise Recovery. American council of exercise. Cited 18.6.2019. https://acewebcontent.azureedge.net/SAP-Reports/Post-Exercise_Recovery_SAP_Reports.pdf.
Donahue, P. 2019. Manual Strategies: Optimizing Patient Outcomes in the Clinic. Performance Health Academy. Cited 19.6.2019. https://www.performancehealthacademy.com/articles/manual-strategies-optimizingpatient- outcomes-in-the-clinic.html.
Gott FH, Ly K, Piller N, Mangion A. 2018. Negative pressure therapy in the management of lymphoedema. Journal of Lymphoedema, 13 (1).
Guangming X, Xuemeng X, Wengang L, Yanyan L, Guocai C. (2018). Observation on short term curative effect of PhysioTouch based on infrared thermography technology in postoperative treatment of TKA. Chongqing Medicine, (19) 11.
Hietanen S, Puustinen T, Jouhki I, Palomäki K, Taskinen T. (2014). LymphaTouch® and PhysioTouch treatment as a part of Active Physiotherapy: Effect on Pain and Swelling. Internal report.
Kannus P, Parkkari J, Järvinen TLN, Järvinen TAH, Järvinen M. (2003). Basic science and clinical studies coincide: active treatment approach is needed after a sports injury: A short review. Scandinavian journal of medicine & science in sports, 13(3), 150-154.
Lam KC, Snyder Valier AR, Valovich McLeod TC. (2015). Injury and treatment characteristics of sport-specific injuries sustained in interscholastic athletics: a report from the athletic training practice-based research network. Sports health, 7(1), 67-74.
NIH National Cancer Institute (2019). NCI Dictionary of Cancer Terms, lymphedema. Cited 18.6.2019. https://www.cancer.gov/publications/dictionaries/cancerterms/def/lymphedema.
Murphy SL, Barber MW, Homer K, Dodge C, Cutter GR, Khanna D. (2018). Occupational therapy treatment to improve upper extremity function in individuals with early systemic sclerosis: a pilot study. Arthritis care & research, 70(11), 1653-1660
Nummela A, Mikkola J. (2013). Effect of PhysioTouch treatment on perception of DOMS and recovery after heavy resistance exercise. Research Institute for Olympic Sports -KIHU, Jyväskylä.
Ping W, Yindi S, Nong W. 2014. Clinical observation of postoperative swelling of lower limb fracture. The 21st national symposium on integrated traditional Chinese and western medicine orthopaedics and traumatology and the compilation of papers of the general meeting of the new branch of the orthopaedics and traumatology 2014.
Rockson SG. (2001). Lymphedema. The American journal of medicine, 110(4), 288-295.
Szczesny G, Olszewski WL. (2003). The pathomechanism of posttraumatic edema of the lower limbs: II—changes in the lymphatic system. Journal of Trauma and Acute Care Surgery, 55(2), 350-354
Threlkeld AJ. (1992). The effects of manual therapy on connective tissue. Physical therapy, 72(12), 893-902.
Tucker J. 2014. Lymphatic and Fascial System Treatment: Time to De-Compress. DC Practice Insights. Cited 19.6.2019. http://www.dcpracticeinsights.com/mpacms/dc/pi/article.php?id=56846
Vuorinen VP, Airaksinen O. (2009). A new vacuum suction device for management of lymphedema. 22nd International Congress of Lymphology, Program & Abstract book pp.121. September 21st-25th 2009. Sydney, Australia.
Vuorinen VP, Iivarinen J, Jurvelin J, Airaksinen O. (2013). Lymphatic therapy using negative pressure. A clinical study with the LymphaTouch device. Research Report #5320003/221, Finnish Funding Agency for Technology and Innovation, August 2013.
Mira Väyrynen works as a clinical specialist at LymphaTouch Inc. She graduated as a physical therapist from Lapland University of Applied Sciences and also holds master’s degree in Health Science from University of Jyväskylä. She has a versatile experience from working with various patient populations from children to elderly, including patients with stroke, cancer, musculoskeletal-, neurological-, cardiovascular- and lung disorders. She has worked in both private clinics and public hospitals, such as Helsinki University Hospital. On her daily basis, Mira coordinates research projects, collects and shares information and experience with clinicians worldwide and provides trainings and workshops related to LymphaTouch negative pressure device.