Lymphatic Drainage Learner Guide - Amazon S3...lymphatic system - and there are a number of specific techniques used by natural medicine to stimulate them. No eliminative system is

Lymphatic Drainage

Learner Guide

Massage Schools of Queensland

Lymphatic Drainage

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METHODS OF ASSESSMENT

Assessment of this unit will be conducted in two parts.

Written Assessments

Practical Assessment

Pass marks in this framework contribute to a ‘Competent’ in the following units:

HLTARO006, HLTMSG006, HLTMSG008

TOPICS TO COVER

Introduction of the Lymphatic system

Introduction to Lymphatic Drainage

Lymphatic Drainage Massage techniques, the four basic movements

Points to observe for maximum results

Major functions of the lymphatic system

Structures of the lymphatic system

Contraindications

Pathologies – Edema/Lymphedema Clinical procedures for Lymphatic Drainage

Recommended reading and references:

Textbook of Dr. Vodder’s Manual Lymph Drainage Volume 1. Author H and G Wittlinger. Publisher Karl

F. Haug Verlag 1998 Edition.

Compendium of Dr. Vodder’s Manual Lymph Drainage. Author Renato Kasseroller.

Publisher Karl F. Haug Verlag. 1998 Edition.

Textbook of Dr. Vodder’s Manual Lymph Drainage Volume 2. Author Ingrid Kurz.

Publisher Karl F. Haug Verlag. 1997 Edition.

Lymphedema Diagnosis and Therapy. Author Horst Weissleder and Christian Schuchhardt.

Publisher Koln: Viavital-Verl. 2001 Edition.

Healing Massage Techniques 2nd

Edition. Author Frances Tappan.

Publisher Prentice Hall.

Lymphoedema – A Guide for Therapists Prof. Michael Foldi M.D. and Ethel Foldi M.D.


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Introduction to the Lymphatic System

1. You can spend hundreds of hours and thousands of dollars on potions, pills, lotions and

treatments to improve your health. But none is likely to bring the benefits of simple natural

methods for periodic internal spring cleaning - especially if you enlist the help of your

body’s quite remarkable lymphatic system.

Beautiful skin, a firm and healthy body and clear mind are strongly dependent on your

system being able to efficiently and effectively rid your body of toxic materials and waste

products before they have the chance to damage cells, tissues, organs and systems.

2. Your body’s ability to detoxify itself is magnificent - provided you give it half a chance.

Living in this highly industrialised world, most of us have the tendency to eat the wrong

thing, eat too much and too often, PLUS with a sedentary lifestyle, your body’s natural

elimination channels can’t keep up with the task. That is when you need extra help.

One alternative is a two-week “cure” at a health farm, where a special diet, together with de-

stressing, massage, hydrotherapy and long walks, will trigger rapid detoxification. You

emerge a fortnight later looking and feeling 15 years younger. Why? Because each

encourages the rapid elimination of wastes and toxins which have built up over a long time.

When this elimination is stimulated and the tissues of your skin, muscles, organs and

systems are cleansed, then your bodies` own natural powers of regeneration, renewal and

healing move into top gear.

3. You have five main elimination channels in your body - the skin, lungs, kidneys, bowels and

lymphatic system - and there are a number of specific techniques used by natural medicine

to stimulate them. No eliminative system is less generally recognised or more important in

maintaining a high-level of well-being than your lymphatic system. Yet the state of its

health and functioning is still often ignored by many massage therapists and physicians, not

to mention the everyday person.

4. The lymphatic system is not only a major route for the absorption of nutrients from

digestion into the tissues, but is also your body’s metabolic waste-disposal system. It clears

away toxins by carrying unwanted proteins and large particles of waste matter which cannot

be removed by any other means from your cells and tissues. These are by-products of

metabolic wastes, stress, dead cells, fatty globules, pathogenic bacteria, heavy metals,

infectious viruses and other assorted debris which your cells cast off.

5. Doctors working with natural methods of healing insist that a primary cause of fatigue,

disease and cell degeneration is poor circulation of lymph to and from the cells and tissues

of the body.; The same tradition of natural medicine uses a number of effective techniques

designed to stimulate lymphatic functions as a means of healing even quite serious illnesses,

ranging from rheumatism or cardiovascular disease. These include exercise, skin brushing,

special breathing techniques, herbs and aromatherapy oils and lymphatic drainage.


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6. A ceaseless interchange goes on between your body’s trillions of cells and their surrounding

interstitial fluids, so that food and oxygen are exchanged and waste products eliminated

from the cells - all through the medium of water.

Nutrients and oxygen are transported to the tissue and cells via the bloodstream. Arterial

pressure forces the blood through tiny capillaries and out into the cells “interstitial spaces”

to affect their exchange with wastes which the cells have produced. Here the water, or

interstitial fluid filled with toxic waste, is gathered by tiny lymphatic tubules and then sent

back through the lymph vessels to be de-toxified. The lymphatics are a highly organised

and elaborate system of ducts and channels which flow all over your body. In fact, almost

all the tissues of the body are equipped with lymph channels that drain excess fluid, and the

wastes which it contains, from the interstitial spaces.

The lymph from these minute channels carries the waste and toxic products into larger

lymphatic vessels, on through lymph nodes located in the groin, under the arm and the neck

primarily, where it undergoes a process of purification and eventually back to the blood.

The lymph nodes are also a place in which antibodies are made and fight infection. In this

way, the lymphatic system works ceaselessly to clear toxicity.

7. The microscopic network of these lymph channels resembles the vascular system except that

the blood system is powered by the action of the heart pump whereas the lymphatic system

has no pump. Instead, its nourishing, water balancing and eliminative functions are

dependant upon muscle contractions and body movements.

8. Living a sedentary lifestyle and having inappropriate dietary habits over a period of time,

amongst more specific things, can lead to a sluggish function of the lymphatic system. This

in turn can lead to a variety of health problems.

Lymphatic Drainage

1. Lymph drainage massage is a light manual technique designed to stimulate the

circulation of lymph fluid. It works with slow, rhythmical pumping movements in the

direction of lymphatic flow. It decongests the lymph nodes.

2 All five of the body’s most important lymph nodes centres can be reached when you

massage the neck, chest and abdomen. Concentration on these areas will speed up the

removal of wastes from all over the body.

3 It is a very powerful technique with body wide responses. Various styles are used for

lymphatic drainage. One style is manual lymph drainage, which was developed by Emil

Vodder. Another style, described by Eyal Lederman, an osteopathic physician, takes a

somewhat different approach to lymphatic drainage than Vodder. Manual lymphatic

drainage is a specific method, and specialised training is required to use it successfully.

4 All massage stimulates the circulation and lymph movement, but performing a massage to

focus specifically on the lymph system is a special therapeutic intervention. When an

individual body system is focused on, and the effects of the massage are concentrated to a

certain response, it is not uncommon for the client to feel the effects of the methods more


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than with general or local massage. The results are immediate and apparent, with loss of

fatigue and a feeling of well being.

5 This particular type of massage can also be named “The Fluid Release Technique”. It is

particularly useful to improve performance of athletes and dramatically reduces fatigue

levels after exertion. All the stagnant toxins that you move out of the lymph node will be

rapidly metabolised and eliminated. People will often feel the results of a thorough fluid

release massage for as long as a week.

6 Always begin at the terminus where the most important lymph node centres are located,

collecting lymph from the entire body. The active pressure gradient from high pressure to

low pressure is supported by creating low pressure areas in the vessels proximal to the area

to be drained.

7 The focus of the pressure is on the dermis, just below the surface of the skin and the layer of

tissue just beneath the skin and above the muscles. This is the superficial fascia layer. It

does not take must pressure to contact this area. If too much pressure is applied, the

capillaries are pressed closed. This nullifies any effect on the surface vessels.

8 This massage approach is appropriate for clients who are generally healthy. It is common to

develop a somewhat sluggish lymphatic flow. The usual culprits are inactivity,

consumption of inappropriate food and beverages and reduced water intake. All these

factors stress the lymphatic system. Recovery from colds, influenza and other common

bacterial and viral infections can temporarily overload the lymphatic system. Lymphatic

drainage coupled by corrective action by the client can reverse the problem.

Lymphatic Drainage Massage Techniques.

There are four basic movements. Note that the skin is moved rather than stroked (be in control).

The movements consist of a combination of round or oval, small or large, deep or shallow circular

movements. No vascular response (reddening). Slow rhythmic movements enhances the effects of

MLD.

1 Stationary circles

a. Using “flats” of fingers of one hand or two

b. Movement comes from the arm, not the fingers

c. Using one hand on top of the other.

d. Thumbs or fingertips

e. Moving smoothly into the tissue, creating a stretch of the skin then smoothly

circling around to release out of the tissue.

f. Used mainly on neck, face and lymph nodes.

2. Pumps

a. Palms down, don’t use fingertips.

b. Stretch skin forward, then release, creating a pumping action

c. Use mainly on limbs.


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3. Scoops

a. Palms up

b. Stretch skin across, pivot wrist and release.

c. Mainly used for limbs.

4. Rotary

a. Palms down.

b. Wrist comes up, fingers move forward with no pressure.

c. Thumb moves out, wrist comes down with no pressure.

d. Twist the palm, emphasising the thumb, with enough pressure to stretch the

skin then release.

5. Points to observe for maximum results

1 All massage techniques have one thing in common; by connecting the skin, they stimulate

specific receptors resulting in a specific reaction. Which type of receptors are stimulated,

with the corresponding effect, depends on how the skin is touched. By performing this

technique correctly, we can stimulate the volume of lymphatic flow by up to twenty times.

In order to acquire these skills for an effective lymphatic drainage.

2 It is of upmost importance that these points are remembered.

a. Proximal to distal. All areas are commenced by treating proximal areas first, and

then move distally. This ensures making room for fluid flowing in from distal areas and

creating a suction effect. We work within one watershed area at a time.

b. Pressure, less than 60g per cm square. Deep enough that you do not slide over the

skin, but light enough that you don’t feel anything below the skin. No reddening of the skin

should appear.

c. A pressure / zero stroke is used. Each circular movement has a variance in pressure,

that changes smoothly, so that a gentle pumping action is produced into the tissue.

d. The direction of pressure depends on the direction of lymph flow in that particular

area, i.e. toward the correct nodes.

e. Rhythm; usually 3 - 5 repetitions are used on each movement, and then each portion

of sequence repeated three times.

f. The pressure phase of movement last longer than the zero phase.

g. Always start with the neck first in all treatments.


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3 It is very common for massage therapists to apply too much pressure in the learning phase.

It is hard to believe that something so light could be so effective. Always remember - you

are working on skin. How much pressure does it take to skim over the skin only? Almost

nothing. If you push too hard you will collapse the initial lymphatics. This about moving

water. Visualise the initial lymphatics just under the skin, stretching, opening them up, then

release and wait for the lymph angions to pump the lymph down the vessel - 2 second

interval action.

4. Within 20 minutes of a technically perfect execution of MLD, there will be systemic effects

throughout the entire body.


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Major functions of the lymphatic system

a. Maintains the connective tissue to an optimal state; clean, healthy and working well.

b. Carries debris and toxins out of the interstitial spaces.

c. Immune reaction - helps transport lymphocytes and hormones etc throughout the body.

d. Recovers substances that have escaped into the tissues i.e. Proteins, and returns them to the

blood circulation.

e. Lymph nodes filter lymph of bacterial infection and harmful substances.

f. Lymph nodes produce fresh lymphocytes for circulation.

g. Transports long chain fatty acids and fat soluble vitamins absorbed from the small intestines

to the blood circulations.

h. Maintains balance of fluids in the tissues.

i. Helps to maintain blood volume.

Structure of the lymphatic system

1 The tissues of the body are permeated by a vast network of capillaries containing blood.

The walls of the capillaries consist of a single layer of cells and, except for the white cells

which at certain times are able to make their way through these walls, the blood does not

actually come into direct contact with the tissues. The tissues are, however, bathed in tissue

fluid to interchange nourishment and waste products. Movement of fluids between

capillaries and body cells depends on hydrostatic and osmotic pressures.

(filtration/resorption)

2 The lymphatic system is a subsidiary or second circulatory system which consists of a

network of successively larger lymphatic vessels, the lymph nodes, other lymphoid organs,

such as the tonsils, thymus and spleen. It is responsible for carrying up to 10% of the

body’s fluid from the interstitial spaces back to the heart, ensuring fluid balance of the

circulatory system, blood purification and immunity for our bodily system.

3 The lymphatic system consists of:

1. Lymphatic capillaries

2. Lymphatic vessels: pre collectors/collectors

3. Lymphatic trunks and ducts.

4. Watersheds

5. Lymphoid organs

6. Lymph nodes


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Lymphatic capillaries, or initial lymph vessels

Interstitial fluid enters the lymphatic system by passing through the single-layered endothelial cells

of the lymphatic capillaries. Since the lymphatics are a one-way system, - only returning fluids to

the blood stream, these capillaries are dead-end vessels. After fluid enters the capillary, the flat

cells of the capillary wall close, working as a flap valve, trapping fluid inside this initial lymph

vessel. The fluid is now called lymph.

The tiny vessels form a very tight, web-like network everywhere under the dermo-epidermic

junction. The lymph collected in the capillaries gathers in the pre collectors.

Lymph vessels

Pre-collectors - the cells overlap forming valves in the walls of the vessels to allow the one-way

movement of fluid lymph only moves away from the tissues into the collector vessels.

Collectors - These are larger vessels that transports lymph to the nodes. They also have valves and

smooth muscle spirals around them. The superficial collectors, above the fascia, drain

approximately 70% of the lymph of the body.

Trunks and Ducts

Lymphatic trunks receive lymph from the larger areas of the body via the collectors and they are

named for the areas that they serve. The “lumbar trunk” drains lymph from the legs, lower

abdominal wall and the pelvic organs. The “intestinal trunk” drains organs of the abdominal cavity.

The “intercostal” and “bronchomediastinal trunk” receive lymph from portions of the thorax. The

“subclavian trunk” drains the arm, and the “jugular trunk” drains parts of the neck and head. These

trunks then join one of two collecting ducts, the thoracic duct or the right lymphatic duct. After

leaving theses collecting ducts, lymph enters the veins to become part of the plasma, just before the

blood returns to the right atrium of the heart.

Thoracic Duct

Vessels from the entire left side of the body and from the right side of the body below the chest

converge into the thoracic duct, which in turn empties into the left subclavian vein (situated below

the left clavicle).

Right Lymphatic Duct

Collects lymph from the vessels from the right side of the head, neck, upper chest and right arm. It

empties into the subclavian vein (beneath the right clavicle).


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Watersheds

A watershed is a line that divides lymph territories (watershed areas).

A zone is a group of overlapping dermal areas whose capillaries drain into one collector lymph

vessel. Zones cover the whole surface of the body (about 3cm) Zones overlap to form a lymph

territory, a group of overlapping zones that drain to collectors that lead to a cluster of regional

lymph nodes. eg. Right axilla.

Territories don’t overlap each other. The dividing line between two different territories is the

watershed. These two territories drain in different directions, to different node areas. The

superficial and deep initial plexuses overlap across these watersheds.

Lymphoid System

The lymphoid organs include the thymus, the spleen and mucosa-associated lymphoid tissue.

The thymus lies in the upper part of the thorax between the heart and the sternum. Most of the

lymphocytes in the thymus are T cells, which recognise foreign body antigens.( B lymphocytes

recognise only the body’s own cells and antigens.) The thymus secretes hormones that regulate T

cell production and function.

The spleen removes particles and aged red blood cells from the circulation. The spleen plays an

important role in building the immune response.

Musoca-associated lymphoid tissues are found in the respiratory system, urogenital tract and

digestive tract. These tissues contain B and T lymphocytes and serve as a proactive function in the

cavities of the body exposed to external environment.

T cells attack antigens or antigen-bearing agents directly, providing cell mediated immunity. B

cells produce antibodies that act against specific antigens, allowing for antibody mediated

immunity.

Lymph Nodes are part of the lymphoid system, along with the various organs that are part of the

immune system. The size of nodes may vary from a pin head to an almond. Inflamed nodes can

become significantly larger, however. They vary in shape; round, oval and oblong, but are more

often like a kidney bean.

There are 600 to 1000 nodes in the human body. Many are located in the abdomen and over 150 in

the neck region. The other main groups of nodes can be found in the major articulation folds of the

body.

Lymph nodes are connected to the vascular system; blood vessels enter and exit at the hilus.

Lymph enters the node through a number of afferent vessels, circulates through the sinuses within

the node, and then exits the node through efferent vessels at the hilus. Each node has fewer

efferent vessels than afferent. The lymph flow stays within the node, allowing time for the

generation of an immune response, for macrophages to remove debris and concentrating the lymph,

before it flows out again. Lymph passes through several nodes on its way through the lymphatic

pathway.


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Lymph node functions

a. Filter station -Lymph is purified, so only purified lymph is reintroduced to the

bloodstream

-Leaves debris to be macrophaged

b. Immunological function

-Bacteria, cell debris and cancer cells removed and stored.

-Foreign substances removed (dust, glass, soot, mineral & dyes

stored)

-B lymphocytes are formed, matured and stored.

-T cell antigen reaction - antigens are immobilised neutralised and

destroyed

c. Concentration of lymph

- approximately 40% of water load leaves to the blood supply

nodes rebuild after damage

- to original size - if blood and nerve supply are intact.


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The principle groups of lymph nodes are:

OCCIPITAL NODES: which drain the back of the scalp.

RETRO-AURICULAR NODES: which drain the area around the ear.

SUB-MENTAL and SUB-

MANDIBULAR NODES: which drain the face and floor of the mouth.

SUPERFICIAL CERVICAL NODES: which drain the external ear and neck.

DEEP CERVICAL NODES: which drain the tongue, lower pharynx, larynx &

thyroid.

AXILLARY NODES: which drains the upper limbs and breasts.

SUPRA- or EPITROCHLEAR or

CUBITAL NODES: which drain the hands and forearms.

STERNAL NODES: which drain the front chest and abdominal wall.

INTERCOSTAL NODES: which drain the chest wall.

MEDIASTINAL NODES: which drain the heart, pericardium and thymus.

BRONCHIAL NODES: which drain the lungs.

COELIAC NODES: which drain the stomach, spleen, pancreas and liver.

MESENTERIC NODES: which drain the intestines.

LUMBAR NODES: which drain the kidneys, adrenals, ovaries and testes.

INTERNAL ILIAC NODES: which drain the pelvic viscera.

EXTERNAL ILIAC NODES: which drain the groins.

SUPERFICIAL INGUINAL NODES: which drain the buttocks, anus, perineum, the external

genitals, and nearly all the superficial lymph of the

lower limbs.

DEEP INGUINAL NODES: which drain the deep tissues of the lower limbs.

POPLITEAL NODES: which drain the legs.


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Contraindications for Lymphatic drainage massage

ABSOLUTE

a. Malignant disease - whether undiagnosed, reoccurring or present.

b. Acute inflammation with infection i.e. - viral, bacterial, open wounds, acute bronchitis

c. Acute Venous disease - i.e. thrombosis, embolism

d. Cardiac edema - heart valve insufficiency

RELATIVE / CAUTIONARY

a. Edemas - are medical disorders - refer for assessment, maybe ok.

b. Thyroid problems - don’t work the front of neck.

c. Low BP - do a slower, shorter treatment

d. chronic inflammation - check that it is not sub-acute

e. Pregnancy - check with physician. Can be great for legs and stretchmarks

f. Menstruation - first day or two - can cause a ‘flooding’ effect.

g. Gynaecological infections, uterus - retroverse or prolapsed, fibroma cysts; avoid deep

abdominal work.

h. Major kidney problems, major renal insufficiency, hemodialysis; check with physician first.

i. Nevis, moles etc, check not changing.

j. removed spleen - try short sessions first

k. Thrombosis, treated - check with physician first.

l. Diabetes - not over pancreas.

m. Crohns- light over abdomen, and good technique

n. Treated cancer - get doctors permission in writing

o. Bronchial asthma - not acute stage - short treatment - avoid sternum

p. TB - encapsulated - avoid affected area.

q. Lupus - get medical certification.

GOLDEN RULE - IF IN DOUBT - DON’T - REFER FIRST!


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Indications and applications for lymphatic drainage massage

Because the Lymphatic drainage massage we are learning is of a basic nature, it is important that

diseases first be diagnosed by a physician. It is only suitable for people with intact lymphatic

systems.

This massage is indicated for:

a. Detoxification

b. Chronic fatigue/fibromyalgia

c. overweight

d. post surgical conditions - face lift, caesarean delivery, and skin grafts.

e. rheumatism/arthritis

f. neurological disorders

g. scars - i.e. after burns, tatoo removal

h. post traumatic conditions / sports injuries - work proximal to site, use in conjunction with

RICE.

i. haematomas

j. stress

k. pain, toothache

l. inflammation

m. constipation

n. cellulite

o. Congestive conditions i.e. acne, rosacea etc

p. allergy - eczema, asthma, sinusitis with out infection

q. thick, heavy, fatigued legs.

r. pregnancy - great for swollen ankles

s. stretchmarks

t. general health and well being - regeneration

u. dermal disorders

v. Sudeck syndrome (sympathetic reflux dystrophy) usually affects older people after fracture -

causes inflamed circulatory problem locally and proximal to fracture. Work more

proximally.

Obviously the degree of severity of a condition must be taken into account before treating.


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Pathologies - edema/Lymphedema

1 No matter what massage modality you decide to specialise in, it is important to be aware

that as lymphedema increases at an alarming rate, you may be exposed to a potential

lymphedema client, without suspicion from you or the client! It is therefore highly

important to become more aware of lymphedema, its causes, symptoms, pre stages, risks

and cautions, i.e. if someone has had just one lymph node removed anywhere in the body,

deep tissue massage could encourage the occurrence of lymphedema.

2 As a lymphatic drainage therapist, you may attract clients with lymphedema or potential

lymphedema, as it is contraindicated to regular massage. You will need to develop an

understanding, knowing how to approach this client.

a. When is it not appropriate to treat someone with deeper massage?

b. When is it appropriate to treat with your level of training in MLD?

c. Who would need specialist treatment from a remedial lymphatic therapist?

d. when would you refer to a practitioner?

Massage therapists are not legally able to diagnose lymphedema however, with an awareness of this

condition, we can refer appropriately in the pre or early stages. As lymphedema is incurable once

contracted, and ten percent develop into cancer, the best treatment is preventions and awareness.

Early detection and prompt, appropriate treatment is most beneficial.

There are two types of lymphedema. Primary Lymphedema

Congenital, present at birth, known as Milroy’s’ disease, aplasia, lymph system absent

Adolescent, primarily in females, lymphedemas praecox

Lymphedema tarda - same as praecox, but after 35 almost always in the legs.

Pathological lymphedema, inadequate lymph drainage, too few lymphatics, system absent, too

few nodes, or lymphatics that are generally dilated.

Secondary Lymphedema

Results from loss or obstruction from previously normal lymphatics

removal of one or more nodes

irradiation of nodes

Interruption of lymph pathways as a result of injury or trauma to a body part due to accident or

surgery.

blockage by parasites, filariasis, globally most common cause

deep vein thrombosis

Chronic venous diseases/veins run beside large lymph vessels.

artificial lymphedemas


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Clinical procedure of lymphatic drainage massage

Codes of Practice

a. Nationally endorsed industry, ethical standards

b. Consent prior to treatment

c. Parent or guardian present when treating minors

d. Privacy, confidentiality and discretion considered at all times

e. Legal and regulatory requirements regarding massage practice and discrimination

f. Risk minimalisation strategies

g. Duty of care.

Preparation of client - cleansing

a. 1-4 days prior - Drink plenty of water and natural fruit juice

b. 1-2 days prior - Eat plenty of fruit, vegetables, salads, soup

- Light meals

- Avoid additives, artificial colourings and preservatives

- (not pre-packed food, cooked fresh)

- Avoid processed foods, fatty, oily or overcooked

- See suggested diet, next page.

c. On the day - As above. Drink plenty of water

- Ask them to wear little or no skin products

- Check contraindications and fluid intake

Recommended diet for day prior to treatment, on the day, even the day after.

BREAKFAST – Lemon juice, fresh squeezed, in water. Drink upon rising.

- Cereal, with skim or soy milk.

- Fresh fruit, i.e. paw paw or rockmelon.

SNACK - Watermelon juice

LUNCH - Tossed salad of lettuce, tomato, cucumber, bean shoots, lemon juice, radishes,

garlic, ginger. No cheese or dressing.

SNACK - Fresh fruit.

DINNER - Vegetable soup (see below) or salad as above.

Eat lightly

Herb teas may be taken between meals

2 litres of water must be taken daily

VEGETABLE SOUP RECIPE

Carrots Leeks Celery

Onions Garlic Broccoli

Zucchini Ginger Parsley

Potato Celery leaves Parsnip


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Chop all vegetables, except celery leaves and parsley. Add to large pot with 12 cups of boiling

water. (You can make substitute 2-4 cups of water with Campbell’s All Natural Real Vegetable or

Chicken Stock). Simmer for 2 hours. Finely chop celery and parsley leaves and add near end of

cooking time (you may puree soup first).

Preparation of the environment

a. Treatments may be in - Hospitals, hospices, or aged care facilities

- Massage clinics

- In-home and other mobile care situations

- stimulated clinic environments

b. The environment - Quiet and welcoming

- Warm

- Low lighting / eye pillow

- Music does not help with this modality

- Make sure phones won’t ring

- Avoid the likelihood of any disturbances

- Try to give the client as much ‘silent time’ as possible

Informed consent and etiquette

a. The chest/breast area is subject to specific treatment and is an important part of the

therapy

- This needs to be clearly explained to client

- Requires extra time explaining procedure. I.e. routine and draping technique

- Requires diligent attention to draping technique

b. The groin area will need to be worked on, however the procedures do not require contact

with the genital area.

c. If the client does not fully understand the procedure, the areas to be treated, and agree

to the procedure, the treatment must NOT take place.

At the end of the session:-

allow client some calm and rest time before getting up

if possible, wait for client to speak first before you do

advise client how to get up to avoid vertigo

ask them if they are sure that are stable enough to drive

suggest they take a stroll before driving

they may require emotional/psychological support during / after the session


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Possible reactions following lymphatic Drainage massage.

Your recipient may experience some detoxification reaction, (healing reaction) in up to six days

following sessions, depending on the amount of toxins present in the body. You may or may not

want to inform them in advance. It may be appropriate to start some programmes with shorter

session times on the first treatments.

a. Some common reactions may be:

Sluggishness, nausea, muscle aches, pain, tiredness, headaches.

Urinary reactions - more frequent, more volume, more concentrated, strong in odour. Some

woman can even have a mini-urine infection that lasts for two days then stops by itself.

Sleep - some may feel a pleasant tiredness and want to sleep more, others may be

completely the opposite, so full of energy they don’t want to sleep!

Some bones can spontaneously ‘crack’ (tension release)

Emotions - even during treatment too, they may yawn, cry or sigh a lot, releasing the

emotions.

Acute signs or fever can specifically be signs of detoxification reactions; should not stay for

more than two days, can be a chronic condition becoming acute. Remember you don’t treat

if acute signs are present and may need to refer to physician.

Clients may experience better memory, taste, smell, visual perception.

b. The ‘nothing’ reaction

check to find out if recipient really pays attention to changes in his / her body / life.

ask if they still suffer from, feel uncomfortable with, or complains of certain feelings /

conditions

help him / her realise possible changes, check patient record.

As with any technique, sometimes drainage is not as effective as hoped.

can occur in 6% of cases

may indicate that they have another problem that must be addressed first i.e.: bone

misalignment, lack of vitamins or nutrients, tooth problems, repressed psychological

trauma etc.

In general, if a lot of your recipients don’t feel better after your sessions, you might want

to have a review of your technique done.

‘Self-Help’ techniques for your client

As part of a lymphatic drainage program, these techniques and hints are a great way for the client to

become more involved with healing him / herself. Self help follow up between sessions (and

ongoing, for general health) is a great way to

reduce likelihood of a healing reaction

reduce symptoms of a healing reaction

increase the effect of the treatment/program


Lymphatic Drainage

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Ask/show your client to:

a. drink water in order to flush out the system.

b. eat light and healthily

c. relax or sleep directly after sessions to maintain the benefit of relaxation

d. follow an exercise program that can suit them.

e. diaphragmatic breathing exercises can be practiced daily

f. avoid diuretics, especially if any edemas are present.

g. self massage of some techniques i.e. clavicle and abdominals. (Headaches)

*you may need to demonstrate using yourself and make a note for them.

You may conclude the session with the application of a specific cream or lotion, essential oil blend,

seaweed pack, baths etc. The increase in lymph drainage may facilitate up to six times the

absorption of active substances.

How to improve your skills

a. practice, practice, practice. Experience and refine your abilities for the technique.

b. hand exercises, stretches and self massage.

c. have a lymphatic drainage session yourself every now and them, (its tax deductible;

continuing education or market research)

d. form a study group / partner from your class and make appointments to work together.

e. frequently review your notes and other review material and take a review session

f. trust your natural instincts and feelings. Stay open to new sensations

g. use a bit of talc in your hands or if their body is clammy

h. have warm hands, short nails

i. short treatment times are ineffective, min 1 hour

j. encourage deep breathing at intervals during sessions.

Lymphatic Drainage Learner Guide - Amazon S3...lymphatic system - and there are a number of specific techniques used by natural medicine to stimulate them. No eliminative system is

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