Massage.
TechniquelymphaticBeyond Cert IVDraft

Lymphatic drainage (introduction)

An introduction to very light, slow, rhythmic skin-stretching strokes directed towards the nearest lymph nodes, starting near the nodes and working outwards.

Purpose
  • Awareness of how lymphatic techniques differ from ordinary massage strokes
  • Gently stretch the skin in the direction of the nearest lymph nodes
  • Give a slow, rhythmic, very light experience that many clients find calming
Pressure
1–1 / 10 · pressure scale
RhythmSlow and repetitive, roughly 2 seconds per stretch followed by a full release, several repetitions in each spot.
HandsFlat, relaxed palms and fingers in full contact; little or no oil so the hand moves the skin rather than sliding
Cautions
  • Clinical lymphoedema work needs specialist training; in Australia this means an ALA-accredited lymphoedema course. Refer any client with lymphoedema or unexplained swelling to an accredited practitioner.
  • Pressure should be only enough to stretch the skin. If the skin reddens or blanches, you are pressing too hard.
  • Always direct strokes towards the nearest group of lymph nodes, never away from them.
  • Do not work over broken, infected, hot or painful skin.

Step by step

1 / 6
  1. 01 / 06

    Set up

    Warm your hands and use little or no oil. Position the client comfortably, for example supine with the arm supported.

  2. 02 / 06
    Work starts close to the armpit lymph nodes with a flat, feather-light hand

    Start near the nodes

    Begin close to the lymph nodes the area drains towards, for the arm the armpit. Work there first before moving further out.

  3. 03 / 06
    The palm gently stretches the skin towards the nodes, then releases so the skin springs back

    Stretch the skin

    Rest a flat palm on the skin and gently stretch the skin towards the nodes, about 2 seconds per stretch. You are moving skin, not muscle.

  4. 04 / 06

    Release fully

    Let the pressure go completely so the skin springs back before the next stretch. Repeat several times in the same spot.

  5. 05 / 06
    Section by section further down the arm, every stroke still directed towards the nodes

    Work outwards

    Move a hand-width further from the nodes and repeat, section by section, always stretching towards the nodes.

  6. 06 / 06

    Finish near the nodes

    End with a few more slow strokes close to the nodes, then let the client rest.

Common mistakes

  • Pressing as you would for effleurage. The pressure should be feather-light.
  • Gliding over the skin with oil instead of stretching it.
  • Stroking away from the nodes or starting at the far end of the limb.
  • Rushing. The strokes should be slow and rhythmical.

How it should feel

  • Giver: the skin moves under your hand like a loose sleeve; you feel almost no muscle.
  • Receiver: very light, slow and rhythmic; many describe it as soothing rather than massage-like.

Self-check

Drills

This technique is beyond Cert IV scope and should be practised only after appropriate training. This note is an introduction for awareness only.

Manual lymphatic drainage was developed by Emil and Estrid Vodder in the 1930s. It is very different from Effleurage: the pressure is so light that it moves only the skin, and the strokes always travel towards the nearest group of lymph nodes (the neck, armpit or groin). Treatment starts close to the nodes and gradually works further away.

Lymphoedema (long-term swelling from a damaged lymphatic system) needs assessment and treatment by an accredited lymphoedema practitioner. The Australasian Lymphology Association sets the training standards. Research on lymphatic drainage for lymphoedema is mixed, so make no claims about reducing swelling. In a relaxation massage, the most you should say is that many clients find these slow, light strokes calming.

More videos

Sources

  1. Wikipedia: Manual lymphatic drainage (Very light pressure and rhythmic movements; developed by Emil and Estrid Vodder in the 1930s; mixed evidence.)
  2. MD Anderson Cancer Center: Living with lymphedema – arm manual lymphatic drainage (video transcript) (A skin technique, just enough pressure to stretch the skin; proximal to distal order; fluid directed towards working nodes; about 2 seconds per stroke.)
  3. Australasian Lymphology Association: Accredited lymphoedema training (ALA-accredited training and competency standards for lymphoedema practitioners, including remedial massage therapists.)