The Role of Compression in Lymphedema Management: From Bandaging to Garments

Compression is one of the cornerstones of Complete Decongestive Therapy (CDT)—the gold standard for managing lymphedema. Whether applied through multi-layer short-stretch bandages or custom compression garments, the right compression helps maintain limb volume reduction, prevent fluid buildup, and support skin health.

However, not all compression is created equal. The type, pressure level, and technique must be tailored to each patient’s stage of lymphedema and overall health. This individualized approach requires the knowledge and skill of a Certified Lymphedema Therapist (CLT) trained in CDT principles—professionals who understand the delicate balance between therapeutic pressure and patient comfort.

In this blog, we’ll explore how compression works, the differences between bandaging and garments, and why proper education—like that provided by the Norton School of Lymphatic Therapy—is vital to safe and effective lymphedema care.

Lymphedema develops when the lymphatic system—responsible for draining protein-rich fluid from tissues—becomes impaired. This may occur due to congenital (primary) malformation or damage from surgery, radiation, trauma, or infection (secondary lymphedema). As fluid accumulates in the interstitial spaces, swelling, fibrosis, and inflammation follow.

Compression therapy counteracts this buildup through external pressure, which:

• Enhances lymphatic and venous return
• Prevents reaccumulation of fluid
• Improves skin and tissue integrity
• Reduces risk of infection and fibrosis

When applied properly, compression doesn’t just treat symptoms—it supports long-term tissue health and function.

Complete Decongestive Therapy is a comprehensive, evidence-based approach to lymphedema management that combines four key components:

• Manual Lymphatic Drainage (MLD) – Gentle, rhythmic massage that stimulates lymph flow.
• Compression Therapy – Bandaging and garments that prevent fluid return.
• Exercise – Movement that promotes lymph circulation through muscle pumping.
• Skin Care – Preventing infections and maintaining barrier integrity.

CDT is typically delivered in two phases:

• Phase 1: Intensive Reduction Phase: This phase focuses on reducing limb volume using multi-layer compression bandaging combined with daily MLD, exercise, and meticulous skincare.
• Phase 2: Maintenance Phase: Once swelling stabilizes, patients transition to custom compression garments or adjustable wraps to maintain results and prevent relapse.

Proper training ensures therapists know when and how to progress from bandaging to garments, how to measure accurately, and how to troubleshoot issues like pressure points or skin irritation.

During the intensive phase, short-stretch bandages—which provide high working pressure and low resting pressure—are applied in multiple layers to facilitate fluid movement without compromising circulation.

These bandages:

• Create a resisting force when muscles contract, enhancing lymphatic return.
• Support progressive decongestion by being reapplied daily as limb volume decreases.
• Help reshape and normalize tissue consistency in fibrotic limbs.

Bandaging is not one-size-fits-all. Therapists must consider limb shape, size, tissue condition, and patient tolerance. Proper padding, layering sequence, and tension are essential.

Untrained application can lead to serious complications such as:

• Impaired circulation
• Pain, numbness, or tingling
• Skin breakdown or infection

Certified Lymphedema Therapists (CLTs) trained through the Norton School understand the anatomy, pressure gradients, and materials required to safely and effectively bandage a limb.

Once swelling is stabilized, patients transition to compression garments—custom or ready-made sleeves, stockings, bras, or gloves designed to maintain limb volume and support everyday mobility.

• Flat-knit garments – Ideal for irregularly shaped limbs or advanced lymphedema.
• Circular-knit garments – Common for early-stage or mild cases.
• Custom garments – Tailored for unique limb shapes or sensitive areas like the chest or upper torso.
• Adjustable wraps – User-friendly alternatives for those with limited dexterity or fluctuating swelling.

Garments are designed to provide graduated compression, meaning the pressure is greatest at the distal (far) end of the limb and gradually decreases proximally. This promotes upward lymph flow, preventing stagnation.

The appropriate compression class (measured in mmHg) must be carefully chosen based on clinical assessment—too little pressure won’t control swelling, while too much can cause harm.

The shift from bandages to garments marks a major milestone in treatment. It signals that swelling has stabilized, and maintenance can begin.

However, this transition requires:

• Precise limb measurements, ideally by a trained CLT.
• Custom garment fitting, especially in nonstandard limb shapes.
• Patient education on donning, doffing, and garment care.

The Norton School of Lymphatic Therapy emphasizes this skill in its CDT certification training, ensuring graduates can assess fit, measure accurately, and teach patients how to manage compression safely.

For patients who struggle with traditional garments or need flexibility, adjustable compression wraps like ReadyWrap® or Juzo® compression wraps offer an excellent alternative. These Velcro-based systems are easy to adjust, promote independence, and can accommodate daily volume fluctuations.

• Easier self-application for those with limited mobility
• Allows quick pressure adjustments
• Encourages consistent use and adherence

Products such as Juzo compression wraps, Norton Compression Solutions bandages, and ReadyWrap systems available through LymphedemaProducts.com are designed to complement professional care plans prescribed by CDT-trained therapists.

Even well-intentioned patients can make mistakes that reduce the effectiveness—or even cause harm—when compression isn’t properly managed. Common pitfalls include:

• Improper garment sizing (too tight or too loose)
• Using elastic bandages instead of short-stretch materials
• Neglecting garment replacement (most last 4–6 months)
• Ignoring signs of infection or skin irritation
• Skipping maintenance phase compression

These issues underscore the importance of professional guidance and ongoing follow-up from a certified lymphedema therapist.

Proper compression therapy is both an art and a science. It requires deep understanding of anatomy, physiology, and the pathophysiology of lymphedema.

That’s why professional education—like the CDT Certification Course offered by the Norton School of Lymphatic Therapy—is so essential.

• Hands-on instruction in MLD and compression bandaging
• Limb measurement and garment fitting
• Advanced compression techniques for trunk, chest, and genital edema
• Understanding of contraindications and precautions
• Patient education and self-care strategies

Therapists who complete Norton School training become skilled in providing safe, evidence-based care that enhances patient outcomes and promotes self-management.

Compression therapy is most effective when patients understand why they’re using it and how to do it correctly. Educated patients are more likely to adhere to daily compression routines and recognize early signs of complications.

Certified therapists play a crucial role in:

• Teaching proper garment application
• Emphasizing daily use and replacement schedules
• Encouraging exercise while wearing compression
• Advising on skin care and infection prevention

Empowered patients are more confident and consistent—key ingredients for successful long-term lymphedema management.

While compression may initially feel restrictive, patients often report significant improvements once they experience the benefits:

• Reduced swelling and heaviness
• Improved mobility and function
• Less pain and fatigue
• Enhanced appearance and confidence

With proper guidance and training, compression therapy becomes not just a treatment—but a lifelong tool for wellness.

Every patient’s lymphedema journey is unique. A Certified Lymphedema Therapist bridges the gap between medical treatment and daily self-care by designing individualized programs that combine MLD, compression, exercise, and education.

Through Norton School’s CDT training, therapists learn how to:

• Evaluate the stage and type of lymphedema
• Design effective compression plans
• Fit custom garments
• Adapt treatment for special populations (e.g., breast cancer survivors, pediatric patients)

Their expertise ensures that compression is safe, comfortable, and sustainable.

From the first bandage wrap to the final custom garment, compression therapy is at the heart of effective lymphedema management. But it’s not a one-size-fits-all solution—it requires precision, skill, and clinical insight.

Proper compression supports lymphatic flow, protects tissue, and empowers patients to live fuller, healthier lives. Yet without the guidance of trained professionals, even the best materials can fall short.

That’s why the Norton School of Lymphatic Therapy continues to lead the way in CDT education, preparing healthcare professionals to deliver expert, compassionate care. When it comes to compression in lymphedema management, training isn’t optional—it’s essential.

Ready to Start Your CDT Journey?

If you’re a healthcare professional looking to expand your expertise in lymphedema management, consider earning your CDT Certification through the Norton School of Lymphatic Therapy. Our comprehensive training programs teach you the hands-on skills and clinical judgment needed to provide exceptional patient care.

👉 Learn more or register for an upcoming course at www.nortonschool.com.