Episode 011: What is the Lymph System?
In Shake It Off Episode 11, Lauren and Kendra speak with special guest Sarah Paxford.
Sarah is an experienced Occupational Therapist and Pilates Practitioner with an open heart and a passion for holistic wellness and corrective movement and specializes in working with post-cancer women and those with lymphoedema to increase their holistic health, movement, and recovery.
During this episode, Lauren, Kendra, and Sarah talk about how intricate the lymphy system is. They discuss just how important the lymphatic system is and what we can do to maintain a healthy lymphatic system.
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Lauren Hodge
Welcome back to the Shake It Off podcast. Today Kendra and I are speaking with Sarah Paxford from the Gold Coast in Australia, where we used to live.
Kendra Till
Yes, Sarah, welcome. Sarah is an experienced occupational therapist and pilates practitioner who has an open heart and a passion for holistic wellness and corrective movement. In 2016, Sarah opened the doors to Recover Wellbeing, which is a boutique pilates and holistic health studio based in Currumbin on the Gold Coast. The Studio offers a range of health and wellbeing services, including studio pilates, manual lymphatic drainage, lymphedema assessment and treatment, physiotherapy, breath retraining, and hypnotherapy, as well as post-breast cancer rehabilitation.
Sarah has also expanded Recover to be a supportive online community that offers wellness tips and movement. Sarah specializes in working with post-cancer women and those with lymphedema to increase their holistic wellness, movement, and recovery. I was fortunate to have met Sarah back in 2011 when we attended our pilates training together. Sarah has an absolute heart of gold, and her passion for wellness is super inspiring. So Sarah, again, thank you so much for joining us. We are so excited about today’s topic, which is the lymphatic systems. So I believe that this is a topic we should be talking more about when it comes to our health and wellness.
Lauren Hodge
I am so curious about the lymphatic system. Kendra has been telling me about what she’s learned about the lymphatic system, and we’re wanting to hear from you. What is it, and why is it important?
Sarah Paxford
Thanks ladies. This is a system that probably doesn’t get enough credit for how important it is in the body, and even when we went through our OT training, I remember doing a lot on anatomy and physiology, but you barely scratched the surface on the lymphatic system. So it’s a very intricate, yet robust system of the body, it’s essentially a transport system. It works closely with the immune system and the circulatory system, but essentially, it’s made up of organs, vessels, nodes, and fluid to transport lymph around the body.
So lymph is a fluid that we have in our body, and the lymphatic system is mostly known for its ability to transport toxins and detoxify the body. There’s a lot of people kind of talking about that now. But it also plays a really vital role in absorbing and transporting fats, maintaining fluid levels in the body, and then has this really important role in our immune system so helps to produce immune cells and identify pathogens throughout the body. And I think that’s the side that gets overlooked quite a lot, but it’s obviously super important.
Kendra Till
Yes, absolutely I agree. It’s not given enough credibility, I suppose in the grand scheme of things. So my question is, where does lymph come from?
Sarah Paxford
So the lymph fluids like a clear sort of fluid, similar to blood plasma, and then originates in the interstitial fluid in the body, and then it drains from there into capillaries, and then sort of more into the other transport in the body. So eventually, it transports back to our thoracic duct and back into the main circulation gets filtered by the heart again.
Kendra Till
Okay, interesting. So what actually gets what moves the lymph essentially?
Sarah Paxford
Yeah, I love this question, because it’s not pumped by the heart, and I think a lot of people just assume that it’s like the blood and it gets pumped around the body by the heart, but it’s not. The lymph really relies on the movement of our muscles to move it. I don’t know if this is a known thing in America, maybe it’s an Australian thing, but that’s why they say “don’t run if you get bitten by a snake”. I don’t know if that’s just an Aussie thing, because the venom.
Lauren Hodge
You’re supposed to lay down to try to extract it right?
Sarah Paxford
Stay really calm really still, because if you panic run, it pumps the lymphatic fluid more. So it relies on the movement of our muscles. As well as that, one of the best sort of muscular pumps that we have that some of us don’t even think about is the diaphragm. So it’ll be pumped by our breathing as well. So that’s why breathing becomes really important: how we breathe, the rate we breathe. So if we’re trapped a little bit more in that sort of sympathetic fight or flight, not breathing very well, not activating the diaphragm super well, we’re not going to be pumping the lymphatic fluid well either. It really relies on that sort of nice posture, opening through the diaphragm and allowing that to move when we breathe. So a nice calm sort of parasympathetic state.
Lauren Hodge
So like deep slow breaths in and out type thing, that type of breathing is what helps, and then moving your body moves it too.
Sarah Paxford
Absolutely, yeah. And it doesn’t even need to be that deep, but just effective with the diaphragm. So time is working effectively.
Lauren Hodge
What happens if the lymph system is clogged? Or the lymph fluid gets clogged?
Sarah Paxford
It’s a really interesting question, because there’s a few different levels to which this can happen. It’s a really robust system, it can take up to 10 times the amount of fluid that it needs. So it’s designed really well. But the funny thing is, it is kind of different for different people. So you can be born with a different amount of lymph nodes, we can all have different amounts of capillaries and vessels and all of that kind of thing. So some of us will have sort of a more naturally robust system than others, and it’s not so much that it gets clogged, but it might be sluggish, it might not be running as effectively as what it could. So for a mild sort of case, we’re looking at sort of lowered immune function, feeling sluggish, lethargic, less than energetic, having a lowered immune response, fluid retention, edema, cellulite, skin changes even, bags under the eyes, stuff like that.
It’s morning here, and I feel like mine are a little bit like that. Like fatty deposits, so you can have infections, swollen glands, things like that. But on the more severe scale, which is where I tend to see a lot more of where we see people that have had lymph nodes actually removed and we see lymphedema start to kick in. That looks a lot more serious in terms of swelling and persistent edema that doesn’t necessarily go down. So there’s sort of two ends of the spectrum. You can have a sluggish immune system and stuff with some of those more mild effects, or if there’s actual damage to the lymphatic system, that’s when we see conditions like lymphedema kick in.
Lauren Hodge
I’m just curious, what would happen if you saw someone who had their lymph nodes removed, and then they’re swelling, what do you do to help them?
Sarah Paxford
Yeah, so if someone’s had lymph nodes removed, generally, we look at a few different things. So we look at manual lymphatic drainage, like a lymphatic massage, that becomes quite specific when people have had lymph nodes removed, because you have to sort of redirect the fluid in a different pathway. So that’s where you have to really seek out someone who’s done the specialized lymphedema training. I’m not sure what it’s like in the States, but in Australia, there’s a lot of lymph massage therapists, but not a lot of lymphedema specialists, and there is a difference. If someone doesn’t have a damaged lymphatic system or an impaired and lymphatic system, you can go and get an lymphatic massage, that’s fine. But you wouldn’t if you had lymphedema, you’d really need someone who can redirect that fluid and know what pathway to take it. We’d also look at things like compression elevation exercise prescription, managing the skin because they can have a lot of skin changes and things like that.
Lauren Hodge
Discoloration in the skin kind of thing?
Sarah Paxford
Discoloration, that actually changes in the texture as well, sort of fungal infections and changes to the texture in the feel too, because the circulations are not so great. The fluids cause a barrier so they don’t get that fresh circulation to the skin so it starts to harden and thicken and change.
Lauren Hodge
Is that usually in a certain area of the body where you see the build up?
Sarah Paxford
Mostly in the arms or legs, but depending on whether lymph nodes have been removed, it’ll be a localized effect. So mostly I see women post breast cancer, and the lymph nodes have been removed under the arm. So we’ll see lymphedema, but it can also happen in the legs, genitals, face, neck, torso, it can actually happen anywhere where lymph nodes have been removed, or where they might have been damaged to the lymphatic system.
Kendra Till
Interesting. So I’m curious, how can we maintain a healthy lymphatic system? I know you mentioned obviously, the importance of breathing in particular with the diaphragm, you mentioned your posture, which exercise would be important as well. So are you able just to touch on some of those useful tools and tips to help keep and maintain a healthy lymph system?
Sarah Paxford
Definitely, and I think that’s the beauty of it. These things are really simple that we can put into our day to day and it might not be things we necessarily think about for the lymphatic system, but they’re really important. So any type of movement exercise is going to be great. In particular, swimming and rebounding like trampolines and stuff like that are amazing for the lymphatics. But I say to people, just anything you enjoy to do, as long as you get your body moving, that’s the most important thing, walking is great, pilates is great, and that’s a personal favorite for me. Anything that you like that gets you moving is going to be really helpful.
Lauren Hodge
What is rebounding?
Sarah Paxford
Jumping on a trampoline.
Kendra Till
That’s playful.
Lauren Hodge
I do that with my nieces!
Sarah Paxford
You can get those at home round ones, we prescribe a lot for people to have, and it just sits in the laundry room, and they do some rebounding. It’s really fun, too. It’s pretty good, obviously, it’s not for everyone. But as long as the choices are pretty good, and you can handle it. It’s really good for the lymphatic. Then we’ve got things like dry brushing, guasha, self massage, like all of those sort of tactile things where you’re physically touching and moving the skin to stimulate the system is going to be really beneficial. Staying hydrated is really important. Some people when they’re feeling fluid, they don’t want to drink more fluid, it feels a little bit, kind of backwards, but it’s actually the opposite. So if you’re dehydrated, obviously, the body’s going to try and hang on to more fluid too. So as long as you’re hydrated and flushing the system properly, that’s going to be really beneficial.
There is one thing I kind of want to touch on, because a lot of people suggest a sauna for the lymphatics, which is really good. If you’ve got an intact system, saunas are great. And the idea behind that is basically when we’re in heat, so hot weather or sauna, or spa or whatever, the body will actually produce more fluid. But the idea is then that we sweat that out. As long as you sweat, saunas are great, because you’re going to be flushing out more of that fluid. The problem is people who don’t have an intact system, so if they’ve had lymph nodes removed, it’s really not advisable to jump in a sauna, or a spa or anything super hot, because the body will still produce more fluid, but then they won’t be draining it quickly enough.
So we’ve actually seen cases of people being in spas and saunas, where that’s actually onset lymphedema for them. That’s like the severe sort of more serious cases, like that’s really like the end of the spectrum. But I think it’s worth mentioning, because there’s not a lot of support for those people and not a lot of information to access. So they sometimes will go off just kind of the general recommendations and saunas usually on there, but it’s not necessarily the best one if you’ve had damage to the lymphatic system.
Lauren Hodge
So a sauna might be good for prevention or for supporting a healthy life, but not good for intervention.
Sarah Paxford
The general population, as long as you’ve got an intact system, and as long as you sweat.
Lauren Hodge
But then if you don’t, then it’s not advisable.
Sarah Paxford
Yeah, so it can be a bit risky.
Lauren Hodge
It sounds like exercise, breathing, rebounding, and hydration. All of those strategies are kind of the recommended strategies, dry brushing and those types of things are recommended to support the lymphatic system. Do you do dry brushing? Have you ever tried that Kendra?
Kendra Till
I actually do. I admit though when we moved, the dry brush did not come with me because I actually told myself, “I’m just gonna get a new one when I get to the US” and I have not purchased it yet. So I needed to get one.
Lauren Hodge
I’ve never actually done it before, I’ll have to try that out.
Sarah Paxford
Then you leave it out because it looks nice in the bathroom.
Kendra Till
There is a quick quick question actually with that, because I’ve had that, obviously, you dry brush to the heart, but in fact, it’s actually the main lymph that’s on that left near the collarbone. Is that correct?
Sarah Paxford
Yeah, both sides, but you’ll do more on the left. So that’s where your main thoracic ducts come up, and they’ll empty back into the subclavian vein. That’s what your main points are. So it’s really nice, dry body brushings, or similar. I recommend it to a lot of people. If you want to even power that up and enhance that a little more, you can massage your lymph nodes before you do it.
There would be two areas that I would suggest, if you push your shoulders forward, collarbones kind of pop out, and then you can find where you can stick your fingers in above there to massage. So that’s the two main points, and you could do under the arms and in the groin, those main areas of the lymph nodes, then you could do your dry body brushing just to kind of try and really enhance that response in the lymph pathway.
Kendra Till
Excellent. And I also just really liked that you emphasize with the posture and how important that is as well, I think that’s a big one that’s probably very underestimated. I see a lot of individuals, as you know, as we do in pilates that come in with not so great postures, and it’s nice to be a part of educating them on the importance of their posture. So that’s definitely something I’m going to throw in there.
Sarah Paxford
If you think about the diaphragm, it just makes such a difference. Like I’m a little bit slouched. But as soon as you sit up straight, it’s like, “oh, wow, like I have so much more room for my diaphragm now.” Like, if you actually pay attention to that, you can see how having more of a slouched posture really impacts the movement of the diaphragm.
Lauren Hodge
I easily slouch and I have a hypermobility, so I have to constantly remind myself. Thankfully, having Kendra as a friend is definitely really useful.
Kendra Till
I give them the eye.
Lauren Hodge
You know, shoulders back.
Kendra Till
My poor husband, I put my hand on his back, and he just automatically knows.
Lauren Hodge
So we have a rapid fire question that we do at the end of each podcast episode, and the question is: what is your go to strategy to maintain your physical and mental health whenever you’re experiencing a whole bunch of stress or a big life transition or change in your life? Which you’re moving, so that’s a big life transition, so what’s your go to strategy to help you stay sane during all of that?
Sarah Paxford
That’s a very good question for me at the moment, because it’s quite overwhelming and stressful. And I’m probably gonna get a bit of a boring answer, but for me, it’s just walking. So normally, I love pilates. I love crossfit, I love running. I love quite intense activities, and I like my life to be that way too. Like I move very quickly, I take on a lot of projects, like I can get wrapped up quite into that sort of really sympathetic drive that fight or flight is really productive. But it’s really not good for my health, and I know that long term, and it’s not some sort of state that I can sustain, and I’ll know I’ll start feeling a bit rundown or start feeling really tired in the mornings. And I noticed my breath change, and so that’s when I just I just slow down.
I might not be able to take all those things off my plate, but I can just go for a walk in the afternoon or the morning and I can just take it really slow. I can focus on my breathing, and even if it’s only like 20 minutes, like I’ll try and go for an hour, but if I can only squeeze in 10 or 20 minutes, I’ll just get outside walk amongst the trees, and for me that’s like, it’s not just the walking, it’s not just the exercise, but it’s the slow down. It’s just trying to create some space when everything can feel a little overwhelming because those other forms of exercise are just contributing to that more simple exotic drive. So for me, it’s just yeah, really trying to slow down and we live in a beautiful area. So I can walk amongst the trees. And we’re so lucky in that way. So really try and maximize that.
