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Middlesex Health Physical Rehabilitation is an affiliate member of the National Lymphedema Network.

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Evidence-based best practices and compassionate, supportive care for long-term management of lymphedema.

At Middlesex Health, we undertand that lymphedema creates challenges each and every day. The goal of our program is to provide exceptional care through a treatment plan designed especially for you. Each patient works with a certified Occupational or Physical Therapist who has extensive training in the gold-standard lymphedema management techniques.

Each of our staff of highly trained Certified Lymphedema Therapists has received at least 135 hours of continuing education training in the Foeldi Method of Complete Decongestive Therapy (CDT) through The Norton School of Lymphatic Therapy or through Klose Training and Consulting. The Foeldi Method is regarded as the "gold standard" for the treatment of lymphedema by the International Society of Lymphology (ISL).

What is lymphedema?

Lymphedema is defined as an accumulation of protein-rich fluid in the soft tissues caused by insufficiency, blockage, or removal of lymphatic vessels or nodes. It is characterized by swelling in one or more of the following extremities:

  • head and neck
  • arms
  • legs

Over time, this leads to chronic inflammation and fibrosis in the affected region. Individuals with lymphedema are also at increased risk for infection and wounds in involved areas, if not treated properly.

Types of Lymphedema

There are two types of lymphedema:

  • Primary lymphedema may be present at birth or in adolescence and can involve any part of the body, often for unknown reasons.
  • Secondary lymphedema is caused by damage or injury to the lymphatic system, most often through cancer treatments involving lymph node removal or radiation. Secondary lymphedema can also be caused by infection or by untreated venous edema, which is most common in the lower extremities.

Although lymphedema is not a reversible condition, long-term management is possible with effective treatment by a trained Occupational or Physical Therapist.

At Middlesex Health, our expert therapists use a technique called Complete Decongestive Therapy (CDT). Your CDT treatment plan will be unique to you, depending on your needs and goals, and can be maintained with a home program once the swelling is under control.

What does Complete Decongestive Therapy (CDT) consist of?


  • Manual Lymph Drainage (MLD): A gentle, non-invasive manual technique to improve the activity of the lymphatic system and re-route lymph flow around blocked areas.
  • Compression Bandaging: The application of short stretch bandages over affected areas to assist in fluid return and breakdown of fibrous scar tissue.
  • Therapeutic Exercise: Various exercises that are performed with bandages or support garments on to increase venous and lymphatic return.
  • Instruction in Self-Care:
    • skin and nail care
    • infection prevention
    • lifestyle modification
    • self or caregiver bandaging
    • compression garment fitting and use
    • exercise
    • self-Manual Lymph Drainage
    • need for follow-up treatment

Who is appropriate for lymphedema treatment?

Any individual who has been diagnosed with lymphedema - of any type or for any reason - is a candidate for evaluation. Duration and intensity of treatment depends on the severity of your lymphedema and your personal lifestyle goals.

A physician's referral is necessary for evaluation and treatment.

Are there any contraindications to lymphedema treatment?

Yes, some people are not good candidates for lymphedema treatment. Lymphedema treatment may not be appropriate if you have been diagnosed with:

  • an active infection
  • blood clots (DVTs)
  • cardiac edema (CHF)
  • kidney insufficiency

Smart Tip

Middlesex Health Physical Rehabilitation is an affiliate member of the National Lymphedema Network.

Learn More