Treatment Concept of the Földi Clinic for Edema Conditions
The Földi Clinic is recognized as a European center for lymphology and helps numerous patients from Germany and abroad each year to alleviate their edema symptoms and associated comorbidities.
The therapy specialization focuses on treating the following conditions:
- Secondary Lymphedema
- Primary Lymphedema
- Phlebological Edema
- Multicausal, Obesity-associated Edema
- Edema Conditions with Chronic Wounds
Focus Areas
The key to successful treatment is Complex Decongestive Therapy (CDT). Using physiotherapeutic edema therapy techniques, such as compression bandaging, it is possible to reduce edema.
The therapists at the Földi Clinic apply individually adapted and tailored compression bandages padded with foam. Through these globally leading bandaging techniques, edema fluid is displaced and hardened tissue is loosened.
In combination with movement, the venous and lymphatic muscle and joint pump is activated and lymphatic return flow is improved. With the help of Manual Lymphatic Drainage, particularly hardened, fibrotic lymphedema tissue can be loosened and edema fluid mobilized. Depending on the edema diagnosis and lymphedema stage, this massage technique is individually tailored to you. Gentle circular lymphatic drainage strokes can stimulate lymphatic vessel activity. Stronger, deeper strokes loosen hardened tissue.
Associated Conditions
Due to locally reduced immune defense, lymphedema patients often suffer from recurring infections. Erysipelas is a typical comorbidity of chronic lymphedema. In addition to good education about this issue, skin care and skin rehabilitation are important components of lymphedema therapy. Furthermore, learning treatment techniques and applying self-bandaging are parts of the therapeutic measures during your rehabilitation stay.
Therapy
The successful treatment of edema and associated conditions requires a holistic therapeutic approach. Orthopedic, internal medicine, psychological, or other diagnoses may require adjustments to the therapy emphasis. After medical examination and diagnosis, the therapeutic measures are adapted to your condition.
Components of therapy may include:
- Manual Lymphatic Drainage
- Skin Care
- Compression Therapy
- Sports and Exercise Therapy
- Physiotherapy
- Occupational Therapy
- Psychological Therapy
- Nutritional Medicine
- Pain Therapy
- Health Lectures and Training
- Social Counseling
Therapy for Lipedema Syndrome
Lipedema syndrome primarily affects women and is defined by two criteria:
- Disproportionate fatty tissue in the leg area (sometimes also the arms)
Plus
- Relevant pain/discomfort in this fatty tissue.
A large proportion of patients with lipedema syndrome also suffer from being overweight or obese, reduced physical fitness, psychological stress, or psychological disorders such as depression, post-traumatic symptoms, or eating disorders. Many affected individuals report problems with self-acceptance due to the prevalent slim beauty ideal.
Therefore, the therapy for lipedema syndrome is conducted interdisciplinarily and multimodally in a specially developed lipedema program at the Földi Clinic, which is based on the latest scientific findings. The foundation is the International Consensus on Lipedema Syndrome (2020) and the new S2k Guideline Lipedema (Jan. 2024).
Important to know:
Contrary to previous assumptions, lipedema syndrome is not an edema disease. The new S2k Guideline Lipedema explicitly states: "Lipedema is primarily neither an edema disease nor a condition with venous or lymphatic dysfunction." (S2k Guideline Lipedema, p. 38). Therefore, no decongestive therapy is needed for pure lipedema syndrome. The Földi Clinic is a European Center for Lymphology; diagnosis and therapy are always adapted to the latest scientific standards. For this reason, we no longer perform Manual Lymphatic Drainage on women with pure lipedema syndrome.
Modern Interdisciplinary Multimodal Therapy for Lipedema Syndrome
- Physical and Movement Therapy in Compression
- Psychosocial Therapy
- Weight Management
- Self-Management
- Liposuction only in well-selected cases
The Interdisciplinary Multimodal Lipedema Program at the Földi Clinic
- Bioimpedance measurement at admission and discharge to record changes in fatty tissue and muscle mass
- Fitness test at admission and discharge
- Individual training consultation for lipedema syndrome
- Compression therapy for lipedema syndrome
- Medical lecture on lipedema syndrome
- Psychologically guided lipedema group - an interactive workshop on psychological issues
- Nutrition group for lipedema syndrome
- Exercise group for lipedema syndrome
- Obesity counseling for women with lipedema syndrome and severe obesity (BMI 40 kg/m2)
The Long Journey to Proper Treatment
Many patients experience a long path of suffering before they receive the correct diagnosis and treatment at the Földi Clinic, where they finally receive effective therapy.
Manual Lymphatic Drainage
Manual Lymphatic Drainage is a medical massage technique for treating lymphedema. Adapted to your skin and edema condition, gentle strokes stimulate the transport of lymphatic fluid in the lymph vessels and mobilize edema fluid in the tissue. Firm, hardened edema tissue is treated with firmer, kneading massage strokes, known as the fibrosis technique.
Manual Lymphatic Drainage is applied daily depending on the severity of the condition and is part of a complex treatment concept, Complex Decongestive Therapy (CDT).
Physiotherapy
Various physiotherapeutic techniques are used to specifically treat the mobility of the human body in cases of functional impairments. The goal of the therapies is to establish optimal mobility and freedom from pain and to improve activities in daily life. If restrictions are diagnosed, you will receive a physiotherapeutic examination and assessment.
Through an extensive targeted group program, which is supplemented by individual treatments when needed, physiotherapy supports successful rehabilitation.
Compression Bandaging
Bandaging represents an essential part of Complex Decongestive Therapy. Generally, the compression bandage is applied immediately after Manual Lymphatic Drainage treatment. You receive individually tailored foam padding combined with a compression dressing made of elastic compression bandages, which supports manual decongestion, loosens edema tissue, and enhances treatment success.
Compression Systems
Latest compression systems, such as the Medical Adaptive Compression (MAC) or intermittent pneumatic compression therapy, are used as supplementary treatments when needed. In addition to edema reduction, compression bandaging also has a positive effect on venous return and provides pain relief for tissue pain in lipedema syndrome.
Personal Responsibility as the Key to Treatment Success
The long-term success of therapy depends significantly on patients' own discipline and acceptance of responsibility, as they must learn to integrate the treatment into their daily lives.
Occupational Therapy
Occupational therapy is a versatile treatment approach aimed at helping people with physical, mental, or emotional limitations achieve greater independence in daily life. Through various therapy methods such as cognitive training, ADL (Activities of Daily Living) training, joint protection counseling, sensitivity training, and assistive device consultation, occupational therapists support their patients in improving their quality of life and better managing everyday tasks.
Our Occupational Therapy Services for You
- Cognitive Training
- ADL Training
- Joint Protection Counseling and Training
- Sensitivity Training
- Assistive Device Consultation
Sports and Exercise Therapy
It has been proven many times: sports and exercise have a positive effect on health. Physical activity reduces numerous health problems and promotes recovery.
Regular Exercise
Regular exercise protects against cardiovascular diseases and positively influences metabolism, while a strong muscular corset stabilizes the spine and joints. In relation to lymphedema, the muscle and joint pumps are activated, thereby stimulating decongestion. Exercise helps maintain weight, avoid obesity, and reduce pain issues in lipedema. Not least, sports have a positive effect on mental well-being.
Many arguments support maintaining an active and mobile lifestyle.
The Földi Clinic offers a diverse, differentiated sports and exercise program.
The focus of the group sports and exercise therapy program is improving general fitness. This increases performance capability and resilience for work and daily life at home while improving well-being.
The courses with varying intensities are prescribed by doctors according to your stress level. The range of movement therapies is broad and extends from gentle offerings like Tai Chi, Qi Gong, Feldenkrais, Yoga to aerobics, dance, step aerobics, walking, and playful forms of movement.
As a patient, you can get to know and try out a variety of methods to find the right type of movement for you, which can then be incorporated into your daily life.
Sports and Exercise Program
Functional Full Body Training
A mix of cardio training and workout
Back and Posture Training for Workplace and Daily Life
With many tips for everyday life, because good posture helps prevent back problems
Relaxing with Breath
Deep breathing not only promotes lymph flow, it also helps detoxify, relax and better cope with everyday life
Mobilization While Seated
Movement is possible even while sitting to become stronger and more mobile.
Balance, Equilibrium Training and Fall Prevention in Small and Large Groups
Avoiding falls is an important goal to prevent serious injuries and long phases of immobility.
Group Fascia Training
Stretching, loosening, releasing adhesions. Fascia training promotes both mobility and stability.
Fascia Self-Treatment in Small Groups
In small groups, individuals can work on softening their tissue.
Pelvic Floor Exercises
The pelvic floor is supporting for our posture. The focus is on improved awareness of the pelvic floor
Tai Chi, Qi Gong
These Far Eastern movement methods help relax, improve posture and promote mobility
Yoga
The meditation method with versatile stretching and strengthening poses helps you relax better and improves flexibility and stability of the entire body.
Zumba, Dance, Step
Movement is better with music! In addition to the cardiovascular system, coordination is also trained
Arm Group
The arm group is specially tailored for patients with arm lymphedema after breast cancer.
Less Pain Through Gentle Movement
Gentle movement is a key to better managing pain.
Walking with Qi Gong
Walking adapted to your physical performance level with or without walking poles in beautiful Black Forest scenery. Walking with different intensity levels
Equipment Therapy Area
In addition to our diverse sports therapy group programs, you will find optimal opportunities to improve your mobility and fitness in the large equipment therapy area. A Milon strength and endurance circuit, cable machines, treadmills, bicycle ergometers, NuStep devices, and MOTOmed ergometers are available to you. You will receive individual instruction for health-oriented training on the equipment.
Obesity Therapy
For morbidly obese patients (BMI > 40 kg/m²) with lymphedema or lipedema syndrome, a multimodal therapy concept has been developed where lymphological decongestion and substantial weight reduction go hand in hand. The therapy program is conducted and evaluated under internal medicine supervision by a qualified and interdisciplinary team of therapists.
Therapy Team
- Internists, Diabetologists, Nutritional Medicine Physicians, General Practitioners
- Psychological Psychotherapist and Clinical Psychologist
- Physiotherapists and Lymph Therapists with Additional Qualification in Obesity Sports
- Sports Educators with Additional Qualification in Obesity Sports
- Dietitian/Diabetes Assistant DDG Physiotherapists and Lymph Therapists with Additional Qualification in Obesity Sports
- Dietetically Trained Chef
- Nursing Team Experienced in Treating Obese Patients
- Cooperation with a Certified Center for Obesity Surgical Procedures
- Cooperation with a University Center for Plastic Surgery Procedures.
Therapy Goals
- Reduction of Obesity-Associated Lymphedema or Lipedema Syndrome
- Weight Reduction
- Improvement of Psychological and Physical Health Status, Particularly the Cardiovascular Risk Profile
- Development of Concrete Action Planning for Post-Hospital Period
- Improvement of Quality of Life
- Work Capability or Reintegration into Professional Life.
Treatment of Chronic Wounds
Lymphedema is often associated with chronic wounds and wound healing disorders due to various underlying conditions. A therapeutic focus of the Földi Clinic is modern phase-appropriate wound management with certified and annually trained wound managers according to the criteria and standards of national and international professional societies (DGfW:
German Society for Wound Healing, ICW
Initiative for Chronic Wounds, EWMA
Interdisciplinary Concept
The treatment of chronic wounds is only successful when, in addition to local wound treatment, diagnosis and therapy of the underlying condition are considered in an interdisciplinary concept. Another therapeutic pillar consists of optimal decongestive therapy as well as the possibility of surgical wound cleansing and final defect closure through skin grafting, which can be performed by our cooperation partner, the University Hospital Freiburg.
Wound Spectrum
- Ulcus cruris in phlebolymphedema (CVI - chronic venous insufficiency, PTS - post-thrombotic syndrome, PAD - peripheral arterial disease)
- Diabetes mellitus/Diabetic foot syndrome
- Pressure ulcer care and prevention
- Burn wounds
Wound Healing Disorders
- Chronic and iatrogenic wound healing disorders after surgical treatment or radiation therapy for cancer (possibly with secondary lymphedema)
- Wound healing disorders due to maceration, mycosis, erysipelas, abscess, necrotizing fasciitis in chronic lymphedema stage III
- Post-traumatic wound healing disorders
Palliative wound situation
Admission is through rehabilitation or post-hospital rehabilitation application.
The following must be submitted to patient administration before inpatient admission:
- Current bacteriological findings including MRSA and MRGN
- Relevant findings and medical reports, wound documentation, photographic documentation, wound dimensions
- Information about underlying conditions - multimorbidity, mobility, care requirements, necessity of a hospital bed
- Review of findings by specialist physician
- Depending on treatment and care requirements, special compensation must be requested from healthcare providers
Treatment of Internal Medicine Comorbidities
After the initial medical examination, known comorbidities that may have a deteriorating effect on lymphedema are closely monitored and treated.
Particularly patients with multicausal lymphedema require specialist internal medicine therapy that also treats edema-aggravating conditions. Of course, we administer all forms of medication.
Furthermore, additional examinations are performed if there are indications of such conditions. In cooperation with oncological centers, we also continue ongoing chemotherapy treatments.
Interdisciplinary Diagnostics and Treatment of Comorbidities
- Lymphology (ICG fluorescence lymphography)
- Vascular diagnostics (LRR, Doppler, CCDS)
- Diabetology
- Internal Medicine
- Bariatrics (consultation for obesity surgery)
- Gynecology, Endocrinology
- Nutritional Counseling
- Psychotherapy
Nursing Pain Management
"Don't let your pain turn you into someone you don't want to be"
In nursing pain therapy, you will experience and learn which applications can provide pain relief or help counteract pain.
Non-medicinal applications are used, e.g., rhythmic massages according to Wegman & Hauschka, heat-cold applications, aromatherapy, use of dolography cards. Equally important is the counseling for better management of your analgesics.
The goal is to strengthen/support you in your entirety, to achieve better management of your pain situation. In our interdisciplinary pain team, your personal pain situation is reviewed in regular internal meetings, and an individual pain therapy tailored entirely to your needs is developed.
Nursing Mission Statement of the Földi Clinic
We strive to support our patients in planning and organizing their daily routine, take on advisory functions, and maintain constant contact with all departments.
Our nursing concept forms the professional foundation of our nursing activities, adapting in a practice-oriented way to our clinic's mission statement and nursing mission statement.
For us, nursing is a holistic, activating form of care that encompasses the patient in their entirety and provides supportive accompaniment in their recovery process.
The highest goal of our care is to maintain, restore, or improve the quality of life of our patients.
We strive to integrate each patient's individual needs into their care and place these at the center of our actions. We always try to address and respect cultural and religious needs.
We strive to enhance the physical and emotional well-being of our patients and promote their resources.
Psychology
Our three experienced psychologists support you with psychological questions or problems - beyond your primary condition of lymphedema or lipedema syndrome - through specialized group and individual offerings.
We Provide Therapeutic Support
- Individually tailored to you
- Based on the latest psychotherapy research
- Resource- and solution-oriented
Our Group Programs for You
Psychological Training
- Stress Management
- Lipedema Group - Interactive Workshop
- Mindfulness and Mindful Eating
- Mindful Breakfast Practice Group
- Lecture on Chronic Pain
- Autogenic Training
As part of Medical-Vocational Oriented Rehabilitation (MBOR):
- MBOR-Stress Management in Working Life
- MBOR-Communication and Conflicts in the Workplace
Individual Psychological Consultations - Our Methods
- Systemic Therapy - resource- and solution-oriented
- Behavioral Therapy
- Hypnotherapy
- Psycho-oncology
- Trauma Therapy EMDR
- Process and Embodiment-focused Psychology PEP®
according to Dr. M. Bohne - Mindfulness-based Methods
We are here for you with individual psychological consultations for:
- Problems with coping with illness
- Depression
- Anxiety or panic disorders
- Post-traumatic symptoms
- Eating disorders such as Binge Eating
- Chronic pain syndromes
- Crisis situations
- Problems or conflicts in work life
- Grief
- Preparation for bariatric surgery as part of the obesity program
- Psychological stress that you are suffering from
If needed, we are happy to support you through individual psychological consultations, family member consultations, couple or family therapy sessions. The prescription takes place during the initial medical consultation or through your attending ward physician.
Nutritional Therapy
Through nutrition, we provide our body with energy (carbohydrates, protein, fats) and important nutrients, vitamins, minerals, and secondary plant compounds. With healthy nutrition, we set the course to prevent nutrition-dependent diseases or treat existing conditions.
The nutritional concept in our clinic consists of a holistic approach:
The focus is on healthy balanced nutrition, consisting of a varied, diverse, colorful, fiber-rich food selection. According to current research, this should be based on the Mediterranean diet and be predominantly plant-based. The food selection should, as far as possible, consist of regional and seasonal foods in terms of sustainability.
- Mindful, enjoyable eating
- Exercise
Our Consultation Services:
Individual Consultation:
Individually based on the nutrition protocol completed at home, e.g., for obesity, hypercholesterolemia, food intolerances, diabetes mellitus, etc.
Group Training:
- Seminar on healthy nutrition
- Interactive workshop on inflammatory diseases
- Teaching kitchen events
- Shopping training
Social Counseling
Our social counseling service provides comprehensive and holistic information and advice to patients and their relatives regarding social, personal, professional, financial, and social law issues - with competence and empathy.
Self-Help Potential and Personal Resources
The goal of counseling is to reduce or alleviate the psychosocial burdens caused by lymphatic system disease by activating self-help potential and developing personal resources and those of the social environment.
The willingness to empathize with the situation of patients and their close contacts is the foundation for good counseling. Specifically, this involves developing coping strategies and problem solutions together with the patients.
Organization & Coordination
In implementation, the focus is on organizing continued health and social care as well as coordinating care services. During the hospital stay, appropriate follow-up care is initiated and coordinated in cooperation with the patient, their social environment, and post-hospital services and facilities.
Range of Social Counseling Services
- Lecture "The Social Network"
- MBOR: Rehabilitation patients with occupational integration prognosis
- Monthly additional self-help offering FR "Lymphedema & Lipedema Syndrome"
- Information events
- Degree of disability
- Rehabilitation sports
- Individual counseling
MBOR
MBOR stands for Medical-Vocational Oriented Rehabilitation.
Patients who participate in this program have a special occupational problem situation, which is determined through a screening questionnaire.
It manifests in:
- problematic socio-medical histories, such as long or frequent periods of work incapacity or unemployment due to health limitations
- negative occupational prognosis (including concerns about not being able to meet workplace requirements)
- occupational changes that are necessary from a socio-medical perspective
- high occupational stress, possibly including health limitations due to occupational activity
Individual Consultations and Group Work
Through interdisciplinary work in the fields of medicine, psychology, physiotherapy, occupational therapy, nutrition, and social counseling, affected patients with special occupational problem situations are holistically supported and accompanied through individual consultations and group work by:
- occupation-related diagnostics (comparison of abilities, individual therapy goals)
- psychosocial work
- occupation-related setting
- and workplace training.
This means that during the rehabilitation stay with us, both health and the occupational situation or career perspectives are in focus.
Personal Responsibility and Independence
The goal and simultaneous mandate of the pension insurance provider is to maintain, improve, or restore employment capability and enable participation in social life while considering personal responsibility and independence. The transfer of gained experiences to everyday life after rehabilitation is particularly important to us.
The rehabilitation measure, in the context of occupational problems, therefore primarily serves as a turning point for future health and career development!
Help for Self-Help
The chronic condition of "lymphedema" represents a major psychological challenge for patients. Encouragement and support, especially from the social environment, are of great importance. Education and training are essential, as patients must cope with their chronic condition 365 days a year.
In medical lectures and compression bandaging courses, you will learn self-treatment and learn everything important regarding daily life with lymphedema. Parents of affected children can learn how to treat their child through individual training from our therapists.