Marie-Anne Hisem RMT, CLT

More Than "Just Swelling": Understanding the Skin-Lymph Connection

Does a "heavy" feeling in your legs ever turn into redness, itching, or leathery skin? You aren't just dealing with tired legs, you might be seeing the signs of Phlebolymphedema.

When your veins struggle to pump blood back to your heart (Venous Insufficiency), the "overflow" puts massive stress on your lymphatic system. Over time, this protein-rich fluid builds up, leading to the clinical signs seen here:
🔴 Stasis Dermatitis: That signature redness and scaling isn't just a "rash." It’s an inflammatory response to trapped fluid breaking down your skin barrier.
🧱 Fibrosis: Notice a leathery or hardened texture? Chronic swelling can lead to tissue scarring, making the skin feel thick and "woody".
⚠️ The Infection Risk: This skin is fragile! Even a tiny crack or scratch can become a doorway for bacteria, leading to serious infections like Cellulitis.

How I treat this in the clinic:
• Manual Lymphatic Drainage (MLD): A specialized, light-touch technique to reroute trapped fluid.
• Compression Therapy: The "gold standard" to support your veins and move fluid out of the tissues.
• Meticulous Skin Care: Using low-pH moisturizers to keep that barrier strong and infection-free.

Don't wait until it "weeps" or turns into an ulcer. Early intervention is the key to maintaining mobility and skin health.

💬 Have you noticed your skin changing with your swelling? Let’s talk below.

CompressionWorks LymphaticDrainage WoundCare

Cording isn’t just in the armpit… and it’s often misunderstood.

Most people have heard of axillary web syndrome (AWS) after breast cancer treatment, but what about cording along the torso?

Axillary Web Syndrome (AWS):
Typically shows up in the armpit after surgery (like lymph node removal)
Feels like tight “cords” or bands under the skin
Can limit shoulder movement and cause pulling pain down the arm

Torso Cording:
Extends beyond the armpit into the chest wall, ribs, or even abdomen
Often missed or mistaken for muscle tightness or scar restriction
Can impact posture, breathing, and trunk mobility

Key Difference:
AWS = primarily armpit + arm restriction
Torso cording = deeper, wider spread along the body

Why this matters:
If you’re only treating the armpit… you’re missing part of the problem.

Effective treatment may include:
✔️ Manual Lymphatic Drainage (MLD)
✔️ Gentle fascial release
✔️ Targeted mobility exercises
✔️ Gradual stretching (not aggressive!)

Cording is treatable—and the sooner it’s addressed, the better the outcome.

Cupping & Surgical Incisions: What You Need to Know

After surgery, healing isn’t just about the surface—it’s about restoring lymphatic flow and fascia mobility underneath.

When an incision forms, scar tissue can create restrictions in the fascia (the connective tissue surrounding everything in your body).

These restrictions may:
• Slow down lymphatic drainage
• Lead to swelling or fluid buildup
• Cause tightness or pulling sensations
• Limit proper movement and healing

💡 This is where cupping therapy can help—when used correctly.

I use a gentle, therapeutic cupping technique that:
✔ Lifts the skin and fascia (instead of pushing down)
✔ Encourages healthy lymphatic flow
✔ Helps reduce swelling and congestion
✔ Improves mobility around scar tissue

🚫 No fire used
🚫 No big circular bruises

This is NOT the aggressive style of cupping you may have seen online. My approach is controlled, targeted, and designed specifically for post-surgical and lymphatic clients.

⚠️ Important: Cupping is never applied directly on a fresh incision. Once healed, working around the area can safely support recovery and improve outcomes.

Healing is more than closing a wound—it’s about restoring movement, flow, and function.

💬 Have questions about swelling, scars, or recovery?

Send me a message. I’m happy to help.

I had such a full circle moment today while on vacation in Orlando.

Two years ago, I graduated as a Lymphedema Therapist, and today I had the opportunity to visit my teacher’s clinic and observe her in action. Watching her treat patients again reminded me exactly why I chose this path. Her skill, precision, and the way she connects with each patient is truly something special.

What stood out even more was hearing her patients speak about her, more than once I heard, “she’s the best therapist around.” And honestly, I couldn’t agree more.
As a former student, it’s incredibly inspiring to see the level of care and expertise she continues to bring to her practice. Experiences like this reinforce my passion for what I do and the standard of care I strive to provide to my own patients every day.

Grateful for the opportunity to learn from the best💛

March is Lymphedema Awareness Month 💛

As a Certified Lymphedema Therapist, I work with individuals experiencing swelling after cancer treatment, surgery, radiation, or due to primary lymphedema.

What I wish more people knew:

✨ Lymphedema is chronic but manageable
✨ Early treatment matters
✨ Compression is not optional — it’s essential
✨ Education empowers patients

My goal is always to educate, problem-solve, and create individualized plans that help my clients feel confident managing their condition long-term.

If you’ve been told “it’s just swelling,” let’s have a conversation.

Early intervention makes a huge difference.
If you or someone you love is living with persistent swelling, know that help is available. You deserve proper assessment and care.

Let’s raise awareness, reduce stigma, and support those living with lymphedema 💛

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