Lymphatic drainage massage: What it is, Benefits & How-to guide

Lymphatic drainage massage is often overlooked, but it’s a great way to help with weight loss and overall well-being.

The function of the lymphatic system is to guarantee the internal balance of liquids and promote the elimination of metabolic waste. 

The circulatory system returns the blood that has been drained of oxygen and nutrients to the heart. 

The functioning of these two systems can be altered by the habits of modern life, so therapeutic massage allows the elimination of fluids and stimulate blood circulation. And this is where a lymphatic drainage massage comes into play.

As a general rule, a lymphatic drainage massage helps remove excess fluid and metabolic waste accumulation. Through different massage techniques, toxins are removed from tissue which will give boost your body’s general well being and appearance.

Read on for all the details, benefits and learn how to perform certain massage techniques yourself.

Lymphatic drainage massage for circulation disorders

Emile Vodder is the brains behind the manual lymphatic drainage, which was then further developed by a lymphatic specialist by the name of Leduc who highlighted its therapeutic virtues.

This massage can be used in the face of serious pathologies directly affecting the lymphatic system, which inhibit its functions or causes and increase in fluid.

It is also used for individuals with benign circulation problems who want to take care of their skin tissue or as a preventive measure. 

In any case, the lymphatic system will function better, hence the many possible indications, not to mention the aesthetic effects it has on the skin tissue and fluid retention.

Finally, it is a relaxing massage with sedative and analgesic (pain-relieving) effects.

Tip: Did you know that massages also have healing effects? More on that in our other post Massage for healing: Why do massages heal the human body?

Anatomy of the lymphatic system

In addition to blood circulation, the body has a network of parallel vessels in which a liquid different from blood circulates: the lymph. 

The lymphatic network comprises channels of different sizes (vessels, capillaries and collecting trunks). 

Lymphatic circulation occurs in most body tissues, particularly within the most active organs where fluids are filtered through the lymphatic capillaries. 

Once in the lymphatic network, these fluids will travel slowly throughout the body and eventually enter the venous circulation where the internal jugular vein meets the subclavian. 

This point, called “Terminus”, is located at the base of the neck. 

Where its vessels widen, they are called ganglions. They are distributed throughout the body, but are mostly found in the neck, armpits, groin or popliteal fossae. 

It is very important to know their location to perform a lymphatic drainage massage correctly. The thymus, spleen and bone marrow are also part of the lymphatic system.

Lymph composition

Lymph is a yellowish-white liquid. The substances it carries (water, proteins, fats, immune cells, remains of dead cells) cannot be removed through the bloodstream.

Lymph functions

The lymphatic circulation has three basic functions:

• The hosting of cells that are very important for the defense and protection of the body as part of the immune system
• Transport of large metabolic substances
• Maintaining the internal balance of liquids

Principles of manual lymphatic drainage treatment

Keep quiet

It is recommended not to converse too much during the drainage to not interrupt the vegetative effects. 

Remember that this massage can affect the autonomic nervous system, even long after the session. 

The masseur doesn’t push the lymphatic fluid per se, but stimulates the autonomic or vegetative nervous system, which regulates the circulation in the lymphatic system.

Pressure

The pressure exerted by hand will be similar to a caress. Too much pressure can close the lymphatic vessels. 

If the skin turns red, then there is too much pressure.

Do not use lubricant

No lubricants are used in this type of massage, so that the skin of the hand and that of the person being massaged are perfectly synchronized.

Rhythm

The overall pace of the massage, regardless of the technique, will be much slower than that of a regular therapeutic massage. 

The masseur will adapt to the rhythm of the lymphatic flow of the superficial regions, with their vessels contracting between 9 and 15 times per minute.

Stimulation of the parasympathetic system

Lymphatic drainage facilitates the contraction of the smooth muscles of the lymphatic vessels and has an important soothing effect. 

For this reason, it is crucial to follow the principles of direction, rhythm and pressure of the massage precisely.

Direction 

The force of the massage should always be exerted from the extremities towards the center of the body. 

A massage will, however, always start by emptying the most central parts of the body to push the liquid accumulated in the most distant regions towards the center.

Description of specific massage techniques

All techniques have three phases. 

First there is contact with the skin, then gentle pressure and finally relaxation of the tissues and their return to their original position. 

The pressure is applied in a circular motion with each procedure is adapted to the particular area of the body being treated.

Sliding pressure

The hands are placed on their radial edge between the thumb and forefinger, on each side of the limb to be drained to embrace it almost completely. 

Then pressure is increased while sliding with the palms, via a rotation of the wrists, until we the masseur makes contact with the hands’ ulnar edge (corresponding to the little finger). 

As soon as maximum elasticity is reached, the tension on the skin is released so that the tissues return to their initial position. 

Unlike other techniques that exert a push, the purpose of the sliding pressure is to create a vacuum beforehand so that the lymph can pass through. 

So the movement will be from the point closest to the Terminus to the point furthest away.

Rotational movement

The patient’s hand is turned towards the masseur, whose own hand is placed in a cross with the limb to be treated. 

As soon as the skin makes contact, they rotate their wrist to place their hand parallel to the drained arm. 

The movement will naturally be limited by the resistance of the tissue.

Pumping

This time, the hand makes contact with the skin between the spread thumb and forefinger.

Pressure is applied perpendicular to the skin, then a gentle rub with a rocking motion.

And finally, the tissue is stretched with their palm moving in the drainage direction.

Step

The masseur presses the tips of his or her extended fingers, then progressively lowers their palm and wrist until they press their whole hand and stretch the tissues in the direction of the lymphatic circulation. 

While doing so,  the movement is made in the direction of the Terminus point by leaning on their thumb during the release phase.

Circles with thumbs

The thumbs are placed on the lymphatic vessel, then one of them is straightened perpendicular to the skin and the lymphatic vessel and returned to its initial position via a circular movement. 

When the skin tissue begins to resist, then the same is done with the other thumb.

Fixed circles

The two hands are placed next to each other, pressing the entire surface of the four fingers (no thumbs) and palms against the skin. 

Then pressure is applied in a circular motion in the direction of the lymphatic flow to gently drain the lymph.

Manual lymphatic drainage session

To apply lymphatic drainage, the person receiving the massage must be lying on his or her back and feel comfortable and relaxed. The position of the masseur will vary depending on the area of the body that he will treat.

It is important to know the layout of the lymphatic network and the location of the different groups of lymph nodes to help transport the lymph in the right direction.

There are no fixed rules for how many times the motions should be repeated, but a guideline would be 6 to 8 times.

Effleurage

Effleurage is a basic technique of manual lymphatic drainage. It’s both a starting and finishing point, whichever sort of massage is done.

This consists of gently caressing the skin with the tips of the fingers spread out. This gesture provokes a very particular sensation. The entire area to be massaged will be covered to prepare it and to make first contact with the body of the person being massaged.

Drainage of the Terminus point and the neck

The drainage of the neck area and the Terminus point is fundamental.

It should be performed just before any drainage session, regardless of the area of the body concerned. 

There is a large concentration of lymph nodes in the neck. 

The person receiving the massage should lie on their back with their neck relaxed and slightly extended.

Fixed circles on the deltoid

The deltoid covers the head of the humerus in the shoulder joint. 

This is the region furthest from the ganglion chain, and therefore the last point of intervention which will happen with both hands simultaneously to facilitate the circulation of the lymph.

Circling with fingers above and below the ears

The hands press on both sides of the head, thumbs apart, with the index fingers placed just above the earlobes, while the other three fingers remain below.

Without moving hands, circles are drawn with the fingers in the direction of the Terminus.

Fixed circles on the Terminus point

The Terminus point is located at the junction of the internal jugular vein and the subclavian. Place your hands just above the collarbone in the area closest to the neck to palpate this area. 

The massage should be done on both sides of the body simultaneously. However, it is important to know that most of the lymphatic load comes from the left to the Terminus point. 

One then draws circles without moving from the point found with extended and relaxed fingers. 

Drainage of this area can be interspersed with drainage of other areas, as this is where the general drainage occurs.

Fixed circles on the trapezius

The ganglion chain continues towards the shoulders. 

First, the top of the trapezius muscle area is massaged, always in the direction of the Terminus point, simultaneously with one hand on each shoulder.

Fixed circles on each side of the neck

You apply your hands very gently on each side of the neck, covering as much surface as possible. Then circles are traced towards the back and the top.

Fixed circles under the chin

The massage is carried out with finger movements in the direction of the throat, without and hand movement, all on the lower jaw.

The masseur will stand on one side of the massage table, at the height of the arms of the person being treated, or at the head of the table. 

The movement must be performed on both sides of the body simultaneously with both hands.

Drainage of the upper limbs

The person receiving the massage will be asked to lie on their back to drain the upper limbs. 

If necessary, the masseur will take your arm in his/her hands or simply leave it in a resting position on the massage table.

Step on the front of the arm

The arm is rested on the massage table and the fingertips are pressed down perpendicular to the skin. 

Then the hand is lowered until the entire palm rests on the biceps.

In doing so, the skin is moved in the direction of the shoulder within the limits of its elasticity of course. 

Hand pumping

The hand of the person to be massaged will be covered with two hands placed on each side of it. 

Light, even pressure is applied, as if to crush it. And then released. 

This action should be repeated for 11 times.

Pumping of the anterior part of the forearm

For pumping, the forearm should be placed on the table to prevent it from moving or having to hold it with one hand. 

The other hand, placed perpendicularly, will take the limb between its index finger and its thumb spread out, then lower itself to press the entire palm on the forearm. 

The skin’s elasticity here is much more reduced than on the arm.

Rotation on the posterior part of the forearm

To drain the back of the forearm, the masseur will hold you hand and lift it away from the massage table. 

The maneuvers are similar to those applied to the arm with a perpendicular position to stretch the skin by rotating the wrist.

Circling with thumbs, fingers and the palm

The same maneuver as before is repeated along the three imaginary lines, but this time on the palm of the hand.

Circles with thumbs, fingers and the back of the hand

Three imaginary lines in the direction of its length of the hand: 

• a power plant
• another along the axis of the index, and 
• a last one following that of the ring finger

 Circular pressure is made along these lines, by the thumb and up to the wrist that will tighten the skin towards the Terminus point, 3 or 4 times.

Rotational movement on the arm

The arm is raised to the level of the forearm. Then the masseur places their other hand perpendicularly on your arm. 

The wrist is then rotated and light pressure is applied to the skin within the limits of its elasticity.

Movement is stopped when the hand rests lengthwise on the arm, and then resumed it several times in a row from the initial position and this by advancing little by little on the arm.

Drainage of the lower limbs

While you lay on your back, the masseur will move your legs – it is important not to interrupt the body’s vegetative activity stimulated by the massage.

Circles with thumbs on the foot and the ankle

Imaginary three lines are drawn between the toes, and the masseur slides their thumbs on it alternately. 

As with the hands, each line will be covered three times. The foot to be massaged beyond the massage table or slightly elevated.

Step above the knee

This is one of the areas of the body where the sliding pressure technique is most useful. The leg must be bent, so that the foot can rest on the table.

It will start at the bottom of the thigh, with the masseur pressing their index fingers on the skin.

Then they will rotate the wrist with pressure applied by their little finger. 

The masseur proceeds to go down little by little towards the knee while repeating the maneuver.

Rotational movement on the leg

To have free access to the twin muscles, the leg can be supported with one hand or held flexed on the foot. 

The hand is placed perpendicularly, then the wrist is rotated to tighten the skin, and done from the ankle up to the posterior region of the knee.

The lower part of the patella to the thigh middle

The only precaution to be taken here is not to press too hard on the patella with the radial edge of the hand. 

For convenience, the leg to be massaged should be fully extended on the support surface. 

The function of this maneuver is to channel the lymphatic flow into the joint.

Sliding pressure on the ankle

The aim is to drain the most distant joint, and first the ankle is emptied and then treating the rest of the foot. 

It is possible to use a towel roll to separate this area of the body from the massage table and to work on its entire surface

Fixed circles in the popliteal fossa

The popliteal fossa is an area that should be approached with caution, so the drainage of the lymph nodes will be done on the side. 

The leg to be massaged should be flexed so that the foot rests completely on the massage table. 

The masseur will then place their fingers on each side of the knee to perform a circular movement upwards, as always respecting the limits of elasticity of the tissues.

Pumping of the inner thigh

It is now time to drain the inner side of the thigh, from the knee to the groin. 

Your legs should be slightly bent and separated, feet together, sole to sole.

The massage will start at the furthest point in the direction of the Terminus, pulling the skin within the limits of its elasticity.

The index finger and thumb spread, the hand placed perpendicularly, the masseur will proceed to follow the body’s contours.

Sliding pressure below the knee

The leg remains bent. This maneuver is applied to the upper part of the leg, without reaching either the popliteal fossa or the patella. 

Both hands encircle the leg, adapting the radial and ulnar edges to its cylindrical shape.

Fixed circles on the groin

This maneuver consists of placing the fingers and palms on the inner thigh and making an almost oscillatory upward movement. 

The leg being massaged can be stretched or flexed. The important thing is that it is slightly separated from the other leg. 

The groin is home to many lymph nodes, so this is where draining the lower limbs start.

Circles around the patella by alternating thumbs

The leg remains stretched and supported on the table because the muscles must not stretch the patella. 

Joining two thumbs just below the joint and then, using the circular movements already described, the masseur will separate them to cover the entire perimeter. 

How to stimulate venous return?

Do abdominal massages

Abdominal massage can facilitate blood return via activation of abdominal pumping.

Practice massages for improved venous circulation

The most important principles of venous massage are:

• The massage techniques must be more energetic than for lymphatic drainage, as the veins are located deeper in the body.
• Follow the right direction, always towards the heart. Start by emptying the areas closest to the heart, the thigh, then stimulate blood circulation in the areas furthest from the heart (leg and foot).

Walk for better circulation

If you have to stand for a long time, take short walks to activate the plantar pump of your feet.

Wear compression stockings

This type of stocking, which must be recommended by a doctor, increasingly compresses the body in its outermost regions. The result is a massaging effect of pressure and drainage.

Practice hydrotherapy techniques

This is to change abruptly from cold to warm and provoke the contraction and relaxation of the arteriovenous system in the body, and, consequently, a pumping effect. Finish your showers with a blast of cooler water.

Blood pumping exercises

We can stimulate venous return via the appropriate muscle contractions with a few simple exercises.

Raise the feet of the bed

Sleeping at night allows us to adopt a position that favors venous return for a long period. 

Simply elevate the foot of your bed with wedges about 2.4 inches high to stimulate your venous circulation.

Sit with feet raised

Sit on a chair so that its back is slightly tilted back.

Then raise your legs to the level of your heart on another chair or by helping ourselves with cushions. 

Be careful not to stay too long in this position.

Active preventive exercises to improve venous return

Remember that muscle contraction is one of the main factors that will allow the propulsion of blood to the heart. 

Here are some simple and practical exercises to improve blood circulation:

• Do breathing exercises
• Make circles with the feet in one direction and then in the other
• Stand on the tip of one foot and then the other to stimulate the plantar pump and the contraction of the sural triceps at the same time.
• Flex and extend your wrists
• Bend and extend the knee while sitting
• Kick your legs in the water
• Raise your arms in a cross and join your palms above your head, elbows stretched out to the sides
• Move your feet pointing down and then up. This exercise can be done standing, sitting or lying down.
• Squeeze and spread your fingers

Lymphatic drainage massage: Conclusion

If you have circulatory problems, a lymphatic drainage massage is not a luxury but a necessity. There is a direct correlation between water and toxin retention and physical well-being, how you present yourself and your appearance.

A lymphatic drainage massage will definitely go a long way to healing your body from any impurities and the havoc they may have wreaked.

In addition, massages have benefits for the overweight and obese among us, read our other post for more info: Massage for overweight and obese people: Advantages & best tips