Updated: May 28, 2021
A) About the Lymphatic System, how it works and it's anatomical components
C) A Step-By-Step Self-Care Lymphatic Drainage Massage for Lower legs caused by Lymphedema, Pregnancy, Venous Insufficiency or Other Edema
A) About the Lymphatic System
The Lymphatic System is a circulatory system made up of lymph vessels, similar to blood vessels in our Circulatory system.
There is a key difference between the two systems. The Circulatory System, contains blood and has a built-in pump, the heart. The Lymphatic System contains lymph and has no pump, therefore needs to rely on other means for it to move; gravity, exercise, and massage.
The Lymphatic System drains extra fluid (called lymph) that has passed out of the blood and into tissues and returns it back to the blood. The lymphatic system also includes tissues and organs that make, store and release lymphocytes (a type of white blood cell). These tissues and organs (called lymphatic or lymphoid tissue) also monitor the lymph for germs, foreign substances and abnormal cells and remove waste products and bacteria from the lymph. The lymphatic system includes the tonsils, spleen, thymus, lymph nodes and lymph vessels and is an important part of the immune system that acts as the body's defense team, pushing back against disease. It also helps maintain blood pressure and transports some hormones, nutrients and waste products.
Lymph - Lymph is a clear fluid that contains:
lymphocytes, a type of white blood cell that fights germs, foreign substances and abnormal cells, like cancer cells
macrophages, another type of white blood cell that helps fight infection.
Lymph collects some waste products, bacteria and damaged cells from inside the body’s tissues so that they can be removed from the body or destroyed.
The lymph drains into lymph vessels that carry it to lymph nodes.
Lymph nodes clean the lymph and add more lymphocytes to it.
Lymphocytes - fight disease and micro-organisms that cause infections, like bacteria,
There are 3 types of lymphocytes:
B cells (B lymphocytes) make antibodies to fight an infection.
T cells (T lymphocytes) defend the body against disease and infection and control the immune response.
Natural killer cells attack cells infected with a virus and abnormal cells, like cancer cells.
Lymph vessels - are tubes that carry lymph through the body to lymph nodes and back to veins. The network of lymph vessels is similar to blood vessels (arteries and veins) that carry blood. Lymph vessels carry waste products, germs and damaged cells away from the body’s tissues.
Lymph nodes - are small, bean-shaped masses of lymphatic tissue along lymph vessels. They store lymphocytes and filter waste, bacteria and damaged cells (including cancer cells) from lymph. The lymphocytes inside the lymph nodes also attack bacteria and viruses that they find in the lymph. This is why lymph nodes often get swollen when we are sick or fighting off an illness like a cold or the flu. Lymph nodes are found in many parts of the body. The number of lymph nodes varies from one part of the body to another. Lymph nodes are located in groups, mainly in the following areas:
neck (called cervical lymph nodes)
chest (called thoracic and mediastinal lymph nodes)
armpit (called axillary nodes)
abdomen (called para-aortic, peri-aortic and mesenteric lymph nodes)
groin (called inguinal lymph nodes)
Tonsils - are small masses of tissue at the back of the mouth and nose and at the top of the throat. Tonsils have many lymphocytes. The adenoid (pharyngeal tonsil) is a single, small mass of lymphatic tissue in the back of the nose that contains lymphocytes. The adenoid is largest in children and starts to shrink just before puberty. Although it is often called “the adenoids,” there is only one adenoid. The tonsils and adenoid help the body fight infection and protect the opening to the digestive system and lungs from bacteria and viruses.
Spleen - is an organ in the abdomen, under the ribs on the left side of the body. It stores lymphocytes, filters the blood and destroys old blood cells. As blood passes through the spleen, lymphocytes attack any bacteria or virus or other types of harmful substances that can cause infection or illness.
Thymus - is a gland in the middle of the chest behind the sternum (breastbone) that sits in an area of the chest called the mediastinum. T cells (a type of lymphocyte) mature inside the thymus. But the T cells in the thymus don’t respond to infection until they are released into the blood and the lymphatic system. The thymus starts to shrink during late childhood and adolescence, becoming very small in adults.
Lymphatic tissue - also includes areas of the body that have high numbers of lymphocytes. These areas are called lymphatic tissue. They include the appendix and areas of the small intestine called Peyer’s patches. There are also areas of lymphatic tissue scattered in other parts of the digestive system and respiratory system. Like lymph nodes, lymphatic tissue helps remove waste, bacteria and damaged cells from lymph.
Bone marrow - is where lymphocytes and other blood cells are made. The bone marrow is the soft, spongy area inside of most bones. Many of the blood cells in the bone marrow are immature and are called stem cells. Stem cells change and grow into different types of cells, including blood cells. Most blood cells grow and mature in the bone marrow. Most blood cells leave the bone marrow and move into the blood and other areas of the body once they are mature.
What is Lymphedema?
Lymphedema occurs when the lymphatic system fails to drain lymph fluid collected in the interstitial tissues due to various reasons. One of the various reasons for the improper functioning of the lymphatic system is after cancer surgery. This is due to the fact that the lymph nodes, which are an essential part of lymphatic system, are removed during cancer surgery. The removal of lymph nodes leads to disruption of the lymph drainage leading to accumulation of fluid in the interstitial tissues causing swelling and lymphedema. Lymphedema can occur months or years after surgery.
The most common symptom of lymphedema after cancer surgery is the swelling of the extremity on the side of the lymph node removal. However, it is not uncommon to see swelling on the side with intact lymph nodes. The amount of swelling varies according to the severity of the condition and patient care and in some cases the swelling on the non-affected side may be more severe than the affected side.
Other symptoms include feeling of tightness, fullness and heaviness, aching pain or discomfort, inability to move a joint (fingers, wrist, elbow, shoulders, foot, knee, thigh, ankle and legs), swelling in the upper or lower extremity, weakness or paresthesia (prickly feeling of a foot falling asleep, for example), of the arm or legs, dry or thickened skin of the affected part, delayed wound healing (minor cut of insect bite) and greater chances of infection in the affected area. The symptoms need to be managed without delay to prevent lymphedema from getting severe.
The treatment of lymphedema after surgery depends on the severity of the condition and it aims at preventing the progression of swelling and managing the symptoms. To reduce swelling, a decompression therapy program, which includes massage, skin care, exercise and compression garments (compression bandages, compression sleeve or stocking), is adopted. Tight clothing and activities that restrict the flow of lymph movement are avoided and wearing of compression stockings/sleeve is encouraged to minimize the swelling. Lifestyle modification with diet and exercise is also adopted for weight management.
Indian Head Massage 1-Hour Treatment with Lymphatic Drainage Massage
An Indian Head Massage includes the areas on the face, head, neck, shoulders, scapula, collar bones, back, arms, hands. If your therapist is skilled in massaging the lymphatics, and if the client is experiencing swelling in these areas, your Indian Head Massage will include the delicate sweeping and circling technique.
B) Self-Care Massage Routine to Reduce Swelling in Head and Neck Region
One of the most effective ways to manage lymphedema, after surgery, is a self-care massage routine that you can do daily, specifically in the morning, when you rise. This is because you have been lying flat during the past 7 or 8 hours and the fluid has backed up into the neck and head region. Doing a manual self-care massage will encourage the lymph fluid to move away from face, ears, neck and clavicles toward the healthy axillary nodes (armpit).
Rules about Self-Care Manual Lymphatic Massage
Whenever possible, use the flat surface of your hand at the targeted site.
If you need to use finger tips, only do so in small, hard to reach locations around your neck area.
The lymph system runs just beneath the derma layer (skin). The pressure you would use in massaging the lymph system is far less than what is needed in massage therapy, where the therapist needs to find the deeper muscle locations. The pressure is gentle, sweeping, circling.
It's best to do your Self-Care Manual Lymphatic Drainage Massage while you are in a sitting position, giving the fluid the best chance to move down and away from the neck and the head region.
This type of self-care manual lymph massaging is contraindicated if you still have scars and are in the process of healing from your surgery. Also, you should not do this if you are feeling unwell, fevered, headache, body-aches or nausea.
Always start from the lowest point and work up toward the swelling and then return to that position. The movement is up and then down. That allows for the lower areas to be cleared to accept drainage from above.
Full Self-Care Manual Lymph Drainage - to address head and neck lymphedema.
Your lymphatic system can help move fluid out of the area and reduce toxins. It also plays a role in our immune function. If you've had cancer surgery and you've had lymph nodes removed in your head and neck region or if you've had radiation therapy, this can cause damage and a backed up system that will cause lymphedema in the neck and head region. Unfortunately, when you have swelling in this area, it can be difficult to swallow or to speak.
10 - Be-Kind-To-Yourself Steps
Start with 4 deep belly breaths. there are many lymph nodes located deep in your belly region. We want to make sure we are stimulating and activating these belly lymph nodes to assist with the swelling in the neck and head. Put your hands over your abdomen and apply a little pressure, as you breathe in, through your nose and out your mouth. Resist the belly pushing against your hands. Adjust the location of the placement of your hands so that you cover all quadrants of your abdomen for these deep breaths.
Take your full hand and place it under the armpits and massage gently down and away. The movement is literally pushing the skin down and away, so gently. Do this 8-10 times - whatever you feel you need. Use your whole hand up into the arm pit. Then repeat on the other side.
3) Collar Bone to Neck
Moving now, up around your collar bone. You have a number of lymph nodes in this area, at the base of the neck. Using your flat hand, massage gently in circles above the left collar bone first. If you need to use your finger tips here to navigate the crevices, you can do so. Move up onto the shoulder area, next to neck and massage in large circles, directionally, down and away. The movement here is you are stretching the skin downward, then releasing any pressure to return above, then repeat. The stretching is gentle and easy. do about 8-10 circles on that left side and then repeat on the right side. Stretching and letting go.
4) Side of Neck to Ears
Work our way up from the neck area. A number of our lymph nodes are up along the side of the neck and around both sides of the ears. Again, working directionally in a down and back motion, split your fingers into two groups of two fingers (think Spock from Star Trek) and place them on either side of your left ear. Gently massage around the ear, down and away, circle, from that area. Do 8 to 10 circles on that left side and then repeat on the right side. It's a wiping action, gently working down and away. 8-10 times.
5) Under Jaw and Chin
Under Jaw and Chin - Using your hand, just start to massage, circular motion, thinking directionally, down and out. Massages are moving toward the neck area. Be very gentle in this area. Repeat this on the other side, down and out.
6) Front of Neck
Continue with Under Jaw/Under Chin, but more on the front of the neck. Same gently sweeping action. You can use both hands and do this at the same time, but you need to cross your hands over. Either way is fine.
7) Under Chin
Tighten up your focus, using your finger tips and work right under the chin, massaging down and away, both sides.
8) Back of Neck
Take both hands to the back of the head, just at the hair line, to that natural indentation where the occipital bone meets the spine. Starting at the hair line, sweep your fingers down your neck area toward your shoulders, thinking about down and away movement, down to shoulders and back up.
Facial Swelling - think about a line dissecting the face from the forehead through the nose and through the chin. Using that imaginary line as a guide, you will massage from the center, out toward the side of the face and down.
Do this on the chin, over the mouth, nose, under and around the eyes, and forehead. This is a gentle wiping movement on the face. When you go over the eyelids, use a delicate touch. Remember to wipe out and down the sides of the face, next to the ears as there are many lymph nodes in this area.
10) Reverse the Order and Repeat all Areas
Returning to the armpits, now you are going to make your way, around the ears again, down the chin, under the chin, down the neck at the front, sides and back, down to the areas just above the collar bone, and ending at the armpit.
If you do this daily, first thing in the morning, even better, you will start to feel a difference and see the changes. Swelling should minimize!
C) Full Self-Care Manual Lymphatic Drainage and Acupressure Massage Exercise- to address Lower Leg Swelling
The following Step-by-Step instructions will show you how to massage your swollen legs using lymphatic drainage techniques and acupressure points.
Swelling located in the lower extremities is the most difficult to relieve simply due to being the furthest away from the heart and gravity is not their best friend. It's common for them to be the first to swell up and the last to shrink with lymphedema, pregnancy or other vein related swelling, such as venous insufficiency.
CAUTION! If you have a blood clot, also known as Deep Vein Thrombosis (DVT), or severe swelling, do not use these instructions, but seek professional medical help first. It's always recommended to seek the advice of your family physician, or physical therapist for assistance with severe edema, pitting edema, lymphedema and DVT.
7 - Be-Kind-To-Yourself Self-Care Massage Exercise Steps
1) It is recommended to a warm bath or use a foot bath and soak your feet before beginning this treatment and set of massage exercises
2) There are clusters of lymph nodes located in the groin areas and the backs of the knees. Lie on your back with your knees bent and lightly caress the inguinal nodes in the groin area. Using your palms and finger tips, move gently along the bikini lines in a downward direction.
3) Reach behind your knees, with your hands in an upward cupping motion, and lightly caress the popliteal nodes of the knee on both sides.
4) With your palms, lightly caress your leg from the ankle all the way to the groin, several times, using your palms and fingers, one leg at a time, sweep from the ankle to the groin.
5) Put your hands on the calf, holding the top and the bottom so that your thumbs are positioned on the inside of leg. Gently caress the leg upward, toward the groin, several times.
6) Cup the calf muscles from underneath, starting at the ankle and use a hand-over-hand motion up the back of the leg, caressing up to the back of the knee several times.
7) Then effleurage up the thigh muscles from the knee to the groin. If you want to reduce the swelling faster, try raising your leg, knee toward your face and let the gravity assist.
3 Be-Kind-to-Yourself Key Acupressure Points that, when pressed, will help with tired swollen legs
1) The first point is called Kidney 1 (also known as "Bubbling Springs") and it is located on the plantar (bottom) side of the foot, just below the ball of the foot and very close to the middle of the upper third section. If pressed with over-lapped thumbs, at a 90 degree angle from the point, this point will help to revive energy. Begin to deepen the pressure into this point and hold for 2.5 to 3 minutes, then gently pull back out of the point.
2) The second point, not part of the major meridians, is called "Lost Sleep" and is very helpful, when pressed, with insomnia. It is also effective in controlling water retention and elimination. It is location in the middle of the heel, both feet. If you were to draw a straight line from the second toe down to the heel, it would intersect this point with the ankles. It can be pressed and hooked.
But since the heel is hard and tough, it's much easier, to step onto a golf ball and roll it around this point to maximize the effect.
3) The third key acupressure point, is called Urinary Bladder 57, and the points are located on the backs of both legs, where the calf muscle turns into the Achilles tendon. Press this point with overlapped thumbs from underneath or from the inside of the leg. Hook your other fingers over the top of your leg onto the shin bone and press the pad of your overlapped thumb. Once you've identified the location, rest it on your knee. This point is on the bladder meridian and it helps with water elimination and is quite detoxifying. Repeat on the other side.
If you book a 1-hour Indian Head Massage Appointment with me, and if you are suffering from swelling or lymphatic fluid pooling or backing up in your head, face, or neck, I will include lymphatic massage in your treatment.
If you book a 1-hour Foot Reflexology Appointment, I will be massaging all the points for the body, through the feet or hands: points in zones for the body's systems, the glands, tissues and organs, and additionally, if there is swelling in your lower limbs, legs, calves, ankles or feet, I will be including and focusing on Kidney 1, Lost Sleep and Urinary Bladder 57 points as well.
Lori M. Read, Certified Holistic Therapist, Reflexology and Indian Head Massage
Book with me at: Compass Rose Wellness
29 Kilworth Park Drive, Komoka, Ontario
PHONE - (519) 471-3773
EMAIL - email@example.com