Lymphatic Drainage Therapy - the What and the Why

For the entirety of my 23 years as a massage therapist, I have been an avid learner of the lymphatic system and lymphatic drainage. It is a remarkable, but little understood part of our circulatory system both within the massage therapy profession and mainstream medicine (including surgeons). I specifically mention surgeons because knowing whether your lymph flow is moving well or not is a crucial aspect of our overall health and healing, especially following an injury or surgery. 

Excess Swelling? Use Lymphatic Drainage. If you have excess swelling in the body NOT due to an inefficient heart, poor veins, or the side effect of a medication, look to the lymphatic system for potential relief. If your swelling is post-surgery, from an injury or fall, look to the lymphatic system to reduce, and redistribute excess fluid in the tissue back into the larger circulatory system and the heart. 

It’s Not Just Swelling, It’s Protein in the Tissue. It’s not just the excess fluid that we want to move out of the tissue post-surgery or after an injury, but large protein molecules as well. We have large protein molecules in our blood all the time. Many of these molecules find their way into the tissue daily. It is the lymphatic system’s job in part, to keep these proteins out of the tissue. When tissue is damaged, protein molecules in the blood leak into the damaged tissue. Many of these protein molecules in the tissue play the role of attracting water. The lymphatic system keeps moving these molecules out of our tissue, so we don’t gain excess fluid. It’s a balancing act, the molecules are too large to fit through our veins but can readily travel through the larger lymphatic vessels. 

To Flow You Must Drain. Part of good post-surgical care is increasing the lymph flow to move the swelling from built up fluids and the large proteins out of the tissue. This is not accomplished through traditional massage, but through lymphatic drainage massage. This is part of the reason why getting skilled lymphatic care is helpful post-surgery. It not only moves out the excess fluid, but also the protein molecules that contribute to the swelling. In the case of liposuction surgery, you have invested in new contouring of various parts of your body; ensuring good lymphatic flow supports the movement of excess swelling and protein molecules, supporting more defined contouring.  

What is Lymphatic Drainage Massage? Not all lymphatic massages are the same. There are variations, but all involve a lightweight touch. Originating in Europe with Emil Vodder in the 1930s, he discovered that by using specific, light, repetitive techniques, he could stimulate the flow of the lymphatic system. This, in turn helped move swelling out of the body’s tissue. Because 60% of the lymphatic system is directly under the skin, if you press too hard or too deeply into the tissue, you don’t help the lymph move, rather you can injure the tissue more. Lymphatic massage is very light technique to stimulate lymph flow under the skin. In my experience, when clients practice home techniques they are generally going too deep in the tissue. 

How Effective is Lymphatic Drainage Really? Consider this: according to the medical physiology book by Guyton & Hall, the lymphatic system during an aerobic workout will increase the lymphatic flow 10-30x its resting rate. This is a substantial increase in flow rate. While there is no aerobic activity during a lymphatic drainage session, you can still substantially increase the flow of the lymph with manual techniques. The more lymph you get moving, the faster it moves through the body, essentially working like a siphon. By the end of a 90-minute session, it’s impressive how much fluid can be moving under your hands  with bruising patterns changing over a session as fluid moves out. The lymphatic system can be very effective at moving swelling out of the tissue! Where does this extra fluid go? The excess fluid travels to the end of the lymphatic system and into your veins (behind our clavicles), it gets filtered by your liver before going to the kidneys which manage what fluid to recycle and what fluid to remove.  

How Well Does Your Lymph Flow? Lymphatic Mapping is a technique for identifying how well your lymph is moving through your body, locally and regionally. Learning the baseline of your own body and systems so you understand how well they work pre- and post-surgery can be very helpful. Find a lymphatic drainage therapist who can do this. https://chiklyinstitute.com/index.php/find-a-therapist.

What Slows Lymph Flow? 

Perhaps the first answer is damage to your lymphatic system or lymph node removal. The next way our lymph slows is when structures compress aspects of your lymph capillaries, like if the liver-stomach-diaphragm is tight. Thirdly, it may be your nervous system slowing your lymph flow.

In my practice, the most common events resulting in a slower lymphatic flow are a history of impacts and injuries, such as from contact sports, car accidents, or slips, and falls. Often these events will stimulate the fight, flight or freeze response, and if left untreated, this unresolved physiologic response can slow your lymphatic flow systemically.  See blog ‘My Practice’ for how I address this defensive physiology to help restore strong lymphatic flow. 

If there is not a fight or flight response, there are other ways the body contracts and tightens following impacts to the body. These too can slow lymphatic flow. 

When someone comes in for lymphatic drainage, sometimes lymphatic drainage is exactly what they need to get speedy lymph flow. Depending on your history, you many need areas of your body addressed to increase the lymph flow. One example of this is a fall to your tailbone or a history of hitting your head. Releasing tension at either of these areas may be the key to restoring your lymph flow and getting that post surgical swelling out of your tissue. Increase ease to your nervous system, your lymphatic system respond immediately, increasing it’s function.

The take away here is, if you have an upcoming surgery or suspect you want to schedule a lymphatic drainage session as part of your recovery, get a session well before the surgery. Lymphatic mapping will tell you how well your lymphatic system is working, and this pre-surgical assessment-treatment can help you better strategize for an optimal outcome and speedy post surgical recovery.