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Lymph Drainage Massage


Within us all there is a silent system working to keep us healthy- the lymph system. Without it our bodies would swell up like

balloons, swamping our cells with stagnant fluid. The lymph system's impact is so far reaching that many don't even realize

that minor aches and pains,low energy or susceptibility to colds and flu may be due to a sluggish lymph system and a

compromised immune system. In this article we’ll discus the anatomy of the lymph system, what happens during edema and

how lymph drainage massage can help as well as contraindications to lymphatic massage.

By performing lymphatic drainage massage correctly, we can stimulate the opening of the initial

lymphatic and increase the volume of lymph flow by as much as 20 times. But if we push too

hard, we collapse the initial lymphatic, diminishing the lymph flow. Excessive pressure can even

break the filaments that hold the initial lymphatic in place. This is one reason that deep styles

of massage are contraindicated in areas of edema. Luckily if deep pressure has broken any

filaments, they usually reform within 24 hours.
After the lymph has entered the initial

lymphatic, the
lymph moves into a larger vessel called the pre-collector, and then into even

larger vessels called.


Eventually, all lymph vessels lead to lymph nodes. Lymph nodes can be as small as the head of a pin, or as big as an olive.

There are 400-700 lymph nodes in the body, half of which are located in the abdomen, and many are in the neck.

The primary function of lymph nodes is to filter and purify the lymph. The lymph nodes produce various types of lymphocytes.

Lymphocytes destroy harmful substances within the body, and are a big part of the immune system. The lymph nodes

reabsorb about 40% of the liquid content of the lymph. This makes the lymph much thicker. Because of this thickening and

the filtering process, the lymph nodes offer the greatest resistance to the flow of lymph. In fact the lymph nodes offer about

15 times more resistance than the vessels themselves. Lymphatic drainage can help overcome this resistance and get the

lymph flowing.


Each cell is nourished by the nutrients, oxygen and proteins that flow across the walls of

capillaries into the interstitial fluid. There is a dynamic balance between the forces that help

those nutrients to first exit the capillaries, and then get reabsorbed back into the blood

stream. Proteins play a big part in this transfer because they have a tendency to draw

water to themselves. This means that the proper amounts of protein on both sides of the

capillary wall are vital to keep the tissues balanced. If there are too many proteins within the

interstitial spaces, fluid will start to accumulate, causing edema. The lymph system’s role of removing  proteins is vital to

keeping edema down. If the lymph system becomes sluggish, or is damaged by surgical removal of lymph nodes, edema

can develop. This type of edema is called lymphostatic edema- or a high protein edema. Lymphatic drainage can be helpful

in reducing this type of edema because the cause is a reduced functioning of the lymph system.Other causes of edema can

be a chemical imbalance in the body caused by liver disease, diabetes, or a variety of other ailments. This type of edema is

called lymphodynamic edema,and requires other forms of therapy due to the fact that it is a chemical imbalance.

(Kasseroller, R., Compendium of Dr.Vodder's Manual Lymph Drainage, Haug, Heidelberg, 1998)


Lymphatic drainage massage is a profound technique to help. increase lymph flow. With an increase of lymph flow immune

function is increased. Harmful substances are removed from the tissues and neutralized in the nodes. It has also been shown

that an increase in lymph flow stimulates an increased production of lymphocytes- enhancing immune function.

Patients that have extreme amounts of edema should work with a group of healthcare practitioner trained in lymph drainage,

bandaging and other modalities. However, with a proper understanding of contraindications and some basic training, massage

therapists can enhance the health of their clients and reduce minor cases of edema. Lymphatic drainage in this arena can be

applied to clients who are suffering from a lack of energy, or a sluggish immune system Lymphatic drainage massage is also

useful when working with clients who have sports injuries.After the initial inflammatory stage has passed, lymphatic work can

be applied after Sports or Neuromuscular massage has been completed. This will help to clear the tissue of debris, and

help to reduce the minor edema that sometimes occurs after deep massage. Continued applications of lymphatic drainage

while the client is healing can help to enhance the tissue regeneration process by keep the tissue as healthy as possible.

Not only is lymphatic drainage useful for sports injuries, but it can also help scars.(Godart, S., "Lymphatic regeneration after

second degree burn," Progress in Lymphology, 1975/ Hutzshenreuter, P.O. and Brummer, H., "Manual Lymph Drainage used

for Scar Healing," University of Ulm). Lymph work has been shown to help the scarring process by enhancing circulation and

immunity. As the lymph flow around the scar is increased, lymph vessels that have been damaged are stimulated to heal, and

the increased lymph flow also draws away toxins, improving the health of the tissues.

When attempting to assist healthy scar formation, it is important not to push the lymph into the scar, which can cause the

formation of keloids (a buildup of collagen fibers). All scar workshould be done without deforming a newly forming scar- so as

to not rip the tissue. One way is to workabove the scar (closer to the node that drains the area). For example, a lymph

therapist could work in the axilla and upper arm to help increase the lymph flow around a scar in the forearm. Beyond its

application for injuries, Estheticians have been using lymph drainage massage for years to enhance the quality of the skin,

especially on the face. When the lymph is flowing,the cells are being bathed in fresh fluid, causing the skin to look fresh and

alive. We have all experienced having minor edema in our faces- that puffy feeling and baggy eyes when we first wake in the

morning after a long night. Usually after a few minutes of being vertical the lymphsystem starts to drain the face. A great way

to see the power of lymph drainage is to apply a few strokes on one of those mornings, and watch in just a few minutes the

tissues drain right before your eyes- leaving you looking vibrant and healthy.Another common use for lymph drainage massage

is with women who have had breast cancer and had some axillary lymph nodes removed. Sometimes these people develop

edema in their arm. If there is a great deal of swelling, then this is out of the scope of practice for a most massage therapists

due to the need for bandaging. If the swelling is minor however, then a massage therapist with a good knowledge of

contraindication and a few techniques can do a great amount of good.


For the most part lymphatic drainage massage is safe. With such a light touch, the danger of causing damage to the tissue

is slim. However, there are a few conditions that are contraindicated, and these happen when an increase of lymph flow would

be detrimental.It is a good idea to get clearance from their doctor if you ever feel uncertain about working on someone. Acute

inflammation, Malignant tumors, Thrombosis and major heart problems are all contraindications to lymphatic drainage

massage. Lets look at these one at a time.Acute inflammation caused by bacteria, viruses, poisons or allergens is


You can tell if this is the case because the tissues will be , , and painful, with congestion accompanied by fever. Lymphatic

drainage massage will push these substances into the lymph channels before the body has a chance to eliminate them

through phagocytosis in the interstitialspaces. If you perform lymphatic drainage you can spread the toxic substances

throughout the body. Wait a few days until the condition is not acute, and the body has had a chance to clean up the

area.Malignant tumors are a contraindication for lymphatic drainage massage because of the fear of spreading the cancer.

Wait until after the malignancy is treated to perform lymphatic drainage massage.Thrombosis and phlebitis are two conditions

that can lead to free floating blood clots. Usually people with these conditions will be in a hospital on blood thinners. If you are

working in a hospital setting, do not work on these patients. In your practice, one indication of a possible femoral thrombosis

is when the client has pain in one leg and a sudden swelling and bluish discoloration of the skin. People who are bedridden

have a greater likelihood of developing thrombosis in the legs.Major heart problems. If the heart is not fully functioning the \

edema can be lymphodynamic, due to lack of venous return. Putting more fluid into the heart would only stress it more,

worsening the condition.After reading the contraindications for a modality, many therapists experience fear of working on

anyone. The most appropriate response to this list is to add it to your client intake questionnaire. It should also make you

take pause to reflect on the power of this type of work- to do harm as well as good.Lymphatic drainage massage is a great

ally in any massage therapist's tool kit. By being able to address the lymph system directly, client's immune system function

can be significantly increased. When we have a strong immune system, we are happy, balanced and whole. Lymphatic

drainage massage can go where Deep Tissue and Swedish cannot- into swollen areas. The paradox is that such a superficial

technique has such a deep impact.

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