Interesting article on how to combine Lymphatic Drainage with other techniques and the benefit. I work at times very similar to the author. Terra Rosa e-magazine, No. 12 (June 2013) Venolymphatic Drainage Therapy Guido Meert We often forget that our cells are, in a matter of speaking, swimming gel-like living structures in an ocean of interstitial fluids. The concentration quotients of salts (NaCl, KCl, CaCl2) in the interstitial fluid and in the water of an ocean are astonishingly nearly identical. In our body, we are quasi carrying an ocean around with us and actually we have to keep the chemical composition of the oceans fluid constant (5). Anyone who owns an aquarium knows that if one wants to keep the fish healthy, one has to clean the tank, to clear out the drain and to filter and drain the water regularly. Just as the fishes, the cells of a living being need those cleaning arrangements. Furthermore they need food and oxygen and have to get rid of waste products. For example many proteins are too large to simply diffuse, therefore flow in the interstitial space is necessary for the transport of those proteins from the blood to the cells, and vice versa. Both cleaning and nutrimental processes proceed logistically by the venous and lymphatic fluids. The lymph nodes, the spleen, the liver and the macrophages (leucocytes) try to fish out the waste materials and anti-gens out of the body fluids. Unfortunately, the connective tissue is often being abused as storage for waste products or to make things even worse used as a dump-site. It is absolutely necessary that one needs to read-just his/her life-style and looks after a balanced diet, moderate sport and exercise and a reasonable stress-management. The battle between infections and the body´s defenses is mostly fought in the connective tissue, leaving be-hind remains and fragments (5). It is not for nothing that Andrew Taylor Still instructed us: “Let the lymphatics always receive and discharge naturally. If so we have no substance detained long enough to produce fermentation, fever, sickness and death” (11). To enable the defence cells to attack antigens and to start the immunologic communication, it is useful to loosen and to soak through the connective tissue. After all, leucocytes have to crawl out of the vessels and penetrate the collagenous network to find the battle-field. Myofascial techniques allow us to break up fascial adhesions. Subsequently, it makes sense to irrigate and purify the connective tissue by some venolymphatic drainage techniques. By stretching or compressing the tissue, water is being extruded out of the connective tissue and makes the tissue more pliable and supple. Afterwards water is re-adsorbed and the tissue search for new equilibrium. In connective tissue we are dealing with interfascial and bulk water. Via hydrogen bonds, the interfascial water molecules seem to interact with the folding and therefore also with the function of the proteins (1). Water in bulk seems to behave differently from water in confined spaces (f.e. in interfascial spaces), but more research is needed into this (13). The extracellular matrix builds a gelatinous network, containing collagenous and elastic fibers and matrix-molecules (proteoglycans, glycoproteins, glycosaminoglycans), who bind the containing water. In fact, we can make out three “populations” of water molecules in the connective tissue (9): • water molecules, bound within the triple helix of the collagen molecules, • water molecules, bound on the surface of the triple helix or bound with matrix molecules • water molecules, free-running in the space between the fibrils and fibers. Biochemical reactions take place in the confined spaces with interfascial water and bigger and smaller inter-faces are built, with a hydrophobic or hydrophilic char-acter for the interstitial fluids. It is fascinating to study the mechanical properties of the connective tissues in combination with the dynamics of the water molecules and hydrogen bonds (2). But more research is certainly needed into this. Therapists can first try to “dissolve” adhesions of the collagen network and thereafter they try to “wash out” pro-inflammatory substances and waste products by venolymphatic pump-techniques. However it is absolutely necessary before starting a venolymphatic drainage - to be aware of some contraindications: acute inflammation, heart failure, infectious diseases, thrombosis, embolisms, malignant diseases and other acute diseases (5)! Unlike the blood circulation, the lymphatic system has no cardiac pump to make the fluid circulate. However, the mechanisms responsible for keeping the interstitial fluid in motion include the intrinsic pumping move-ments of the lymphatics and vessels (vasomotion) as well as the intrinsic mobility of the tissue (3). Fibroblasts exert tensile forces on collagen fibers of the extracellular matrix (ECM) via integrins and thereby squeeze the ground substance. Afterwards they decrease their tension upon the collagen fibers and allow the ECM to take up fluids and swell up (10). Pro-inflammatory cytokines (prostaglandin E1. interleukin-1, interleukin-6, TNF-α) seem to trigger the relaxation of the fibroblast-collagen network and lower the interstitial fluid pressure. Substances that provoke the squeezing of the ECM and increase the interstitial fluid pressure are for example platelet-derived growth factor or β1 integrins (4). There are several body-rhythms (rhythm of the heart, respiration, peristalsis…), which interfere with each other and ultimately produce a slow rhythm in the hu-man body, unique for that person and that moment. Beside the pumping activity of the fibroblast-collagenous network, one of the most interesting rhythms that promote this body- or tissue-rhythm, is the active vasomotion of lymphatics and vessels (7). Thereby the endothelial cells seem to be able to “feel out” the flow or the absence of flow of the interstitial fluids and react to it by secreting chemokines and sev-eral cytoykines (8). The vessels are even able to regu-late the frequency and amplitude of their pumping ac-tivities and in a manner of speaking to interact with their environment. It is a fascinating experience to learn to palpate, stimulate and channel those individual and subtle waves of “swelling, straightening oneself and exorotation of the extremities” and “detumescing, slumping down and endorotation of the extremities” through the tissues of the patient. I prefer to call those waves, “inspiration and “expiration waves” of the “breathing” of the tissue rhythm. If we are able to manage it to reinforce those body waves, we can amplify the milking and nourishing effects of the ground substance, without exerting any aggressive force on the tissues. Therefore it is helpful to apply some pumping drainage-techniques first, which complement a lymphatic drainage. I am grateful, to be able to develop some venolymphatic drainage-techniques and a general treatment schedule (6): 1. Myofascial release 2. Treatment and stimulation of the organs responsible for excretion and detoxification 3. Lymphatic + venous + intraosseous pumping (perfusion of the tissue) 4. Treatment and stimulation of the diaphragms 5. Release of articular restrictions 6. Active exercises and general lifestyle/attitude changes For more information on venolymphatic drainage, may I invite you to read my book “Venolymphatic Drainage Therapy” (Churchill Livingstone, 2012), and my book “Venolymphatic craniosacral osteopathy”, which unfor-tunately is only available in German at the moment. Perhaps, we will meet each other between the lines… References (1) Bellisent-Funel M.C.: Hydrophylic-hydrophobic interplay: from model systems to living systems. 2005 – Comptes Rendus Geosciences, 337, 1, 173 – 179. (2) Fenn E.E., Wong D.B., Fayer M.D.: Water dynamics at neutral and ionic interfaces. 2009 – Proc. Natl. Acad. Sci. U.S.A., 106, 36, 15243 – 15248.
Posted on: Sat, 15 Jun 2013 23:04:49 +0000
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