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Self- Lymphatic Massage for Arm, Breast or Trunk Lymphedema
The lymphatic system is part of our circulatory system. It helps
balance the fluids of our body and plays an important role in our
immune function. Every day our lymphatic system absorbs fluid,
protein molecules and
waste. Waste products are filtered and destroyed in the lymph
nodes and eliminated by the body. The remaining lymph fluid and
protein molecules
are filtered and cleansed in the lymph nodes and are returned to
the heart
to join the blood.
We have lymph nodes all over our body, but we have large
clusters or chains of lymph nodes in our neck, under our arms and
in our groin. Lymph fluid normally flows in certain pathways. For
example, lymph fluid from your arm, trunk and breast would normally
be filtered and drained by the lymph nodes under your arm. If you
have had some lymph nodes removed or radiated under your arm, you
may be at risk of developing swelling or lymphedema
in your arm, trunk, breast, or back.
Manual Lymph Drainage, or MLD, is a specialized type of gentle m
ge that is designed to aid lymphatic circulation. It helps move
excesfluid from an area that is swollen (or is at risk of becoming
swo
as your arm, trunk or breast, into an area where the lymph
nodesat their full capacity, for example, to the neck, unaffected
underagroin nodes.s lyllen arerm assa
mph
), such working or
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SylviaTypewritten TextThis handout does not replace manual lymph
drainage performed by a trained Combined Decongestive Therapist in
the community. It is meant to be used as a guide to help lymphedema
patients and/or their family members do self-lymphatic massage
after they have been taught these skills by a Combined Decongestive
Therapist. A single copy of these materials may be reprinted for
non commercial personal use only. Please visit the UHN Patient
Education website for more health information:
www.uhnpatienteducation.ca 2009 University Health Network. All
rights reserved
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The pressure of your hands on your skin should be just enough to
stretch the skin. It should be very light. Hands should be flat
allowing more contact with the skin. This is how you stimulate the
lymph vessels. If you can feel your muscles underneath your
fingers, then you are too deep.When doing self massage remember:
Support your affected arm on a table or with pillows, allowing your
shoulders to relax. Never strain your shoulders, neck, arm or hand
when doing self- massage Keep your hands soft and relaxed, use the
flats of hands and fingers instead of finger tips Use a light
pressure Gently stretch the skin as far as it goes naturally and
then release. Massage towards the unaffected or alternate lymph
nodes Self-massage should always be pain free. Self-massage may be
done while seated or lying down. Do not do self-massage if you have
an infection.
Do not stroke across your chest if you currently have a
portacath or if you have had treatment for breast cancer on both
breasts.
The following massage is based on Manual Lymphatic
Drainage(MLD)
1. Deep BreathingA very important part of your self-care is deep
breathing. There are lymph vessels deep in the abdomen that get
stimulated by the contraction of the diaphragm when we breathe
deeply. You can also practice deep breathing anytime! Place the
palms/flats of your hands on your stomach Slowly, breathe deeply
through your nose, allowing the stomach to expand Breathe out
slowly through pursed lips, allowing the stomach to flatten Repeat
5 times with a short rest between each breath to avoid
dizziness
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2. Start at your neck Place the flats your fingers on either
side of your neck
just above your collarbone. Some people find it more comfortable
to cross their hands when they do this stroke.
Place your nd and rd fingers just above your collarbone on
either side of your neck and
stretch the skin just as far as it naturally goes. Stroke down
towards your collarbone and inward. This stroke would look like two
J strokes facing one another. This motion helps lymph fluid drain
back to the heart.
Repeat 15 times.
3. Side of neck Place your flat hands on either side of your
neck
just under your ears and gently stretch the skin down towards
your
collarbone and release Try to stroke your neck in a slow, gentle
and
rhythmical manner. Repeat this stroke 10 to 15 times. Remember
to keep your pressure light
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4. Back of neck Place your flat hands on the back of your neck
just below your hairline
on either side of your spine. Stretch the skin towards the spine
and then down toward base of neck and release. Repeat 10-15
times
Place your affected arm in a comfortable position slightly
elevated and supported so that you can do the chest and arm massage
comfortably. Try placing it on an arm rest or table for comfort
5. Chest PreparationIn preparation to redirect fluid in the
chest area you gently pump your unaffected underarm by placing your
palm against your underarm that has not had surgery gently rolling
your palm up towards your head and into your body. Pump or knead
your unaffected underarm about 10 to 15 times.
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5.
7. Chest Gently massage your chest - in a sweeping motion
remembering to gently stretch the
skin as far as it naturally goes and release. Place your hand by
your affected underarm, above
any scar and lightly sweep your hand across your chest over to
your unaffected underarm.
Repeat this motion 10 to 15 times. Try to find the most
comfortable position for your
hand without straining your wrist too much.
You may need to use both your hands. Also, try to do the massage
when you are
comfortably warm. Our muscles are more flexible when our body is
warm.
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8A. Upper Arm to groin We also want to direct the fluid from
your upper
arm and the side of your chest down the side of your body toward
your groin.
Pump, as you did with your underarm in #5, at your groin (on the
same side as your affected arm)
Place the flats of your hands over the crease at the top of your
leg and pump gently.
Repeat 15 times
8B. Continue with the arm comfortably supported and slightly
elevated.
If you have difficulty raising your arm, try bringing your arm
forward.
From the inner part of the upper arm, stroke around the outside
of your underarm (remember you want to re-direct fluid around the
underarm where lymph nodes have been removed and/or radiated)
and
continue the stroke from the side of the chest downward toward
the groin.
Remember to stretch the skin gently as far as it will go.
Repeat 15 times.
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8C. Chest to groin Massage from your affected under arm,
below
anyscar, down the side of your body to your groin area.
Remember to stretch the skin and release. Repeat 10 to 15
times.
9. Upper Arm Starting with your shoulder, gently massage towards
your neck and if it is not too much
of a strain on your wrist, stroke across the back of your
shoulder to your neck. Try to gently stretch the skin, towards your
neck and release. Repeat 15 times. Lymphatic fluid in the upper arm
normally flows into the underarm. We want to
redirect this fluid to the back of your upper arm so we can move
it into your neck and opposite underarm.
Massage your whole upper arm from the inside of your arm to the
top of your upper arm. Repeat 15 times Now massage from the back of
your arm to the top of your upper arm. Stretch the skin and
release. Repeat 15 times
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10. Arm Gently massage your entire arm towards your head. Start
with your shoulder, and then move to your upper arm elbow and
forearm. Try to gently stretch the skin, push the fluid upwards and
release.
11. Hand and Fingers
If your hand is swollen massage the back and palm of your hand.
Gently stretch the skin, towards the forearm and release.
If your fingers are swollen place your index finger and thumb of
your unaffected hand
on the base of your finger and gently stretch the skin towards
your hand. Massage the entire finger
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Self massage does not have to be a chore! Make self-massage a
part of your daily routine. Set aside some quiet time without
interruptions so you can focus on practicing!
Additional Notes
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