By Tara McKenzie, Physiotherapist & Amee Rust, Occupational Therapist
What is lymphoedema?
Lymphoedema is swelling caused by a breakdown, overload or impairment of the lymphatic system – the body’s internal recycling network. This system collects excess fluid, proteins, cellular waste and immune by–products from the tissues and returns them to the bloodstream for processing and removal.
Unlike the cardiovascular system, the lymphatic system has no central pump. It relies on the combined effects of lymphatic vessel contractions, breathing, arterial pulsation and skeletal muscle activity to keep fluid moving. When the amount of fluid requiring transport exceeds the system’s capacity, it begins to accumulate in the tissues.
This fluid is both protein–rich and bacteria–rich because the lymphatic system is the body’s primary filtration network. When it pools, it creates the ideal environment for cellulitis – a serious bacterial skin infection that is a recurring risk for anyone with compromised lymphatic drainage. Each episode further damages the vessels, creating a cycle of swelling, inflammation and progression.
Who gets it?
One of the biggest misconceptions is that lymphoedema only affects people who have had cancer. It doesn’t. Cancer–related lymphoedema is common because treatment frequently involves lymph node removal, surgery and radiotherapy – but it is the treatment, not the cancer itself, that causes the damage. Secondary lymphoedema can develop following surgery, trauma, burns, recurrent infection, chronic venous disease or prolonged inflammatory conditions.
Any break in the skin – a cut, a wound, a bite – acts as a portal of entry for bacteria. Recurrent cellulitis is particularly destructive, causing progressive damage to lymphatic vessels with each episode. However, lymphoedema can worsen without infection – fibrosis, inactivity and increased fluid load all drive progression independently.
Primary lymphoedema occurs when someone is born with an underdeveloped lymphatic system, most commonly affecting girls during adolescence.
Why early detection matters
Early swelling does not always become lymphoedema but persistent oedema should never be ignored. Left unmanaged, protein–rich fluid triggers inflammation and fibrosis, causing structural changes that become increasingly difficult to reverse. Over 70,000 Australians are living with lymphoedema, many of whom passed through those early stages without realising it. Bioimpedance technology such as SOZO can detect fluid changes before visible swelling develops – particularly valuable for anyone who has undergone surgery involving lymph nodes, where baseline monitoring can catch changes before symptoms appear.
Treatment and the 2026 standard of care
Effective management draws on a range of well–researched tools. The four cornerstones of care are Manual Lymphatic Drainage – a specialised, rhythmic skin–stretching technique that stimulates the superficial lymphatic vessels – compression garment prescription, meticulous skin care to protect against infection, and lymphokinetic exercise. Supporting these are pneumatic compression devices and low–level laser therapy, both of which have demonstrated particular value in softening fibrotic tissue and improving fluid clearance.
Research consistently shows that passive therapies perform significantly better when combined with exercise. The lymphatic system is movement–dependent; skeletal muscle activity and diaphragmatic breathing create the pressure changes that drive fluid through lymphatic vessels. This is the basis of lymphokinetic exercise and the foundation of programs like Lymphocise™, developed specifically to turn muscles into internal pumps for lymphatic health.
Why multimodal care works best
The most effective management plans are multi–modal and collaborative – no single discipline owns lymphoedema care. Physiotherapy and exercise physiology lead the movement side, while occupational therapy brings critical expertise in compression garment prescription and Manual Lymphatic Drainage – a skill set that crosses significantly into both disciplines. A working relationship with the treating medical team underpins everything – accurate diagnosis, early infection management and ongoing monitoring are what make every other intervention possible. Lymphoedema is a chronic condition, but with early recognition and the right team, outcomes can be significantly improved.
Tara McKenzie, Amee Rust and Nicole Syphers are the cancer rehabilitation and lymphoedema team at Central Coast Physiolates, Holgate – home of Lymphocise™. Bringing physiotherapy, occupational therapy and exercise physiology together under one roof, they deliver a genuinely collaborative model of lymphoedema care. Central Coast Physiolates – 216 Wattle Tree Rd, Holgate NSW 2250 | Phone: (02) 43655850 Instagram @womenshealthandmovement, @centralcoastphysiolates | FaceBook @centralcoastphysiolates