What exactly is the lymphatic drainage system and why do massage therapists need to know about it?

The lymphatic system is the body’s waste disposal.  It’s job, in part, is to remove bacteria, cellular debris, excess water, proteins and wastes from the connective tissue to stop the tissues from puffing up, thereby keeping a balance of fluid in the body.

Hey massage therapists: Have you ever had a client who had puffiness in their feet? What about a client who has had lymph nodes removed?  Hmmmmm….You better keep reading.

The lymphatic system is part of the body’s circulatory system and is a vital part of the body’s immune system.  It is said that if your body’s lymphatic system shuts down, you will be dead within 24-48 hours. It plays that important of a function in the body!

So, in a nutshell, here is how it works:

Interstitial Fluid

The heart pumps blood through arteries into the smaller capillaries. This is where an exchange of nutrients and gases takes place. About 90% of the blood gets returned to the heart through the veins, but there is a small amount of leakage that takes place at the capillary level. It is the job of the lymphatic system to gather up this interstitial fluid (made up of water, large proteins molecules, fats and cellular waste products) and pull it into the finger-like cell walls of the lymph vessels. If fluid is allowed to accumulate at this level, Lymphedema (or swelling) will develop.

Lymph Vessels

The lymph vessels are a road map of one directional valves directing lymph from the body up-path toward the neck to get back into the bloodstream.  This is mostly through a system of one-way valves creating a pump. The valves do not allow for a reverse flow therefore prevent fluid from backing up. Vessels are comprised of smooth muscle that can contract which causes forward motion of the lymph and through skeletal muscle (i.e. exercise, regular daily movement) which will squeeze parts of the body and cause the fluid to move. Manual Lymphatic Drainage will also cause the lymph to move forward.

Lymph Nodes

Via muscular contraction or manual therapy, the lymph is pumped through lymph vessels to lymph nodes where it is filtered and enhanced.  The lymph nodes add white blood cells to the lymph and if antigens are detected, the nodes react with an inflammatory response to attack the foreign invader.

There are multiple lymph nodes located throughout the body including the elbow, knee, chest, groin, abdomen, armpit and neck.

Lymph Organs

Several organs are central to the lymphatic drainage system as well. The tonsils act as a local defense at an area where we are exposed to outside antigens. The thymus gland stores lymphocytes where they mature to become T-cells before migrating to infected areas of the body. The spleen acts as a filter to help remove cells coated with antibodies and antigens from the blood and lymph before it is returned to the venous system.

Venus Return

The filtered lymphatic fluid empties into our veins at the end of the venus circulation system at the subclavian veins (which in MLD is called “the terminous” or anatomically, the supraclavicular fossa) and rejuvenates the blood with fresh plasma and white cells. The blood then re-enters the heart near the superior vena cava and the cycle repeats.

 

What is Manual Lymphatic Drainage and why must massage therapists know about it?

Unlike what we typically expect from a massage therapy session, in Manual Lymphatic Drainage (MLD), we are not using a strong pressure because we are not addressing fascia and muscle. A deep pressure in effect squishes the vessels so the lymph cannot flow through.

Manual lymphatic drainage is a very light technique that stretches and twists the skin in a very precise manner and direction in order to allow the lymphatic system to draw more fluid out of the tissue and into the lymphatic system. There are normal pathways that the lymph takes to move through the body. There are also alternate pathways that the body will automatically use if lymph nodes have been removed. A trained MLD therapist should be aware of alternate pathways when performing a treatment.

Following the path of the lymphatic system, the gentle, rhythmic pulling of the skin allows interstitial fluids to enter the lymph vessels and push existing fluid on to the next segment, thereby keeping a balance of fluid. This work helps the vessels to contract more frequently than they would on their own. In utilizing MLD techniques, it is believed that by getting pathogens such as viruses and bacteria to the antibodies that are produced in the lymph nodes at a faster pace than if on their own, that we are actually building up the immune system.

Contraindications/Indications

In most instances, this work is very well received. Contraindications do exist whenever an increased lymph flow would be detrimental such as in a case of acute inflammation caused by infection, major cardiac or circulatory problems and edemas caused by cardiac insufficiency, thrombosis and malignant tumors.

Lymphedema is definitely an indication for MLD. This work is beneficial for pre-op and post-op patients to detoxify the body and speed the healing process.  MLD has such a calming, relaxing effect on the sympathetic nervous system that often patients will fall asleep when receiving this work. The therapists receive a relaxation effect too. MLD has been shown to decrease chronic pain, headaches and muscle spasms and has applications with athletes. It can be used to reduce the appearance of cellulite, reduce scars, to help alleviate symptoms of arthritis, acne, insomnia and so much more!

Learning Manual Lymphatic Drainage techniques is like being given a magic wand! This is a skill that every massage professional needs to have.