Lymphatic Massage

Your lymphatic system helps eliminate your body’s waste. A healthy, active lymphatic system uses the natural movements of smooth muscle tissue to do this. However, surgery or other damage can cause fluids to build up in your lymph system and your lymph nodes, a condition known as lymphedema.

If you’ve ever had a surgery on or involving your lymph nodes, your doctor may have suggested lymphatic drainage massage.

Lymphadema

Procedures that affect or remove your lymph nodes can cause lymphedema as a side effect. Lymphedema will only occur in the area of your body near the surgical site. For example, if you have lymph nodes removed as a part of cancer surgery to your left breast, only your left arm, not your right, might be affected with lymphedema.

Lymphatic massage is a gentle pressure technique used to move the waste fluids from the damaged area. Raakhee Patel, PT, DPT, CLT is a physical therapist and certified lymphedema specialist who trains patients to perform their own lymphatic massage after surgery. Lymphatic massage is one technique used to reduce lymphedema.

“We don’t talk enough about lymphedema,” says Patel. Not only is fluid buildup uncomfortable, causing pain and heaviness in the affected area, but according to Patel, “Stage 3 lymphedema can be devastating,” causing significant depression and lack of mobility that could further complicate healing.

Clearing and Reabsorption

Patel teaches two stages of lymphatic massage: clearing and reabsorption. The purpose of clearing is to create a vacuum with gentle pressure so the area is prepared to bring in more fluid, creating a flushing effect.

Clearing involves:

  • the supraclavicular lymph area: located directly under the collarbone
  • the axillary lymph area: located under the arms
  • the inside of the elbows

Clearing motions can be repeated as many as ten times a day. Patel advises, “Always massage both sides of your body, not just the side with the lymphedema.”

A Guide to Clearing

There are three stages to clearing. Be sure to clear the supraclavicular area, the axillary area, and the inner-elbow area, in order.

To clear the supraclavicular area:

  1. Begin by lying on a comfortable, flat surface.
  2. Cross your arms on your chest, with your hands resting just below the collarbones.
  3. Then simply lift your elbows slowly. The muscle action is as much pressure as is required to prepare the area to flush lymphatic fluid.

Next, clear the axillary area:

  1. Lay your hand above your head.
  2. Use your other hand to gently scoop the underarm area from top to bottom. The only pressure required is that which is gentle enough to move the surface of the skin.

Finally, clear the area inside the elbows:

  1. Lay your arm straight at your side.
  2. Use the fingers of your opposite hand to gently pull the skin inside the elbow an inch at a time.

Only very gentle pressure is required. “In lymphatic massage, you’re only working the superficial skin structure,” says Patel. That’s where the fluid is trapped.

A Guide to Reabsorption

The second part of lymphatic massage is reabsorption. To perform this stage of massage:

  1. Begin at the affected part of the body farthest from the core of the body. Begin at the tips of the fingers if you have lymphedema in your hand, arm, and shoulder.
  2. Using a gentle, sweeping motion with just enough pressure to shift the surface of the skin. Massage from fingertip to hand, from hand to elbow, and from elbow to shoulder.

“Patient compliance is the hardest part of self-care, especially for women, who are so used to taking care of others,” says Patel. She advises patients to set aside at least 20 minutes a day for lymphatic drainage massage. “If you only have a brief amount of time, perform the clearing stage of massage.”

Measuring Effectiveness

How do you know if lymphatic drainage massage is effective? “This is a maintenance technique,” says Patel. “Your lymphedema should not get worse if you regularly practice lymphatic massage.”

Managing your lymphedema can also include using a compression sleeve to prevent fluid buildup. You can see a qualified therapist for in-office drainage massage.

When choosing a therapist, learn as much about their education as possible. “Massage is very good for you, but deep tissue massage can be too heavy for someone with lymphedema, so don’t assume you can just go to a massage therapist.”

Look for someone who is a certified lymphedema therapist, CLT, and preferably a physical or occupational therapist with oncology and pathology training.