COVID-19 Announcement: For more information about our current policies and procedures. Please click here. Get the latest information from CDC: https:/www.coronavirus.gov. Get the latest research from NIH: https://www.nih.gov/coronavirus

Lymph Drainage & Massage

Many think of manual lymph drainage as a type of massage; however, it is different from traditional massage therapy. When performing self manual lymph drainage, there are several things to keep in mind.

Another important facet of this procedure is the “resting” phase. After performing the stretch and movement, you should then allow the skin to move back to its original position to allow the lymph vessels to absorb the fluids.

How to Perform Manual Lymph Drainage on Yourself

Manual lymph drainage is just one component of complete decongestive therapy (CDC). In addition to MLD, complete decongestive therapy includes compression, exercise, and skincare. These therapeutic components, when performed together, can ultimately relieve the symptoms of lipedema, which can often be painful.

When you stimulate the lymphatic system, you will be effect several benefits:

  • Increase the capacity of the lymphatic system, which will then let it process more fluid than normal.
  • Increase the flow through the lymph nodes, which will, in turn, allow the system to filter out waste, dead cells, excess proteins, and toxins.
  • The production of lymphocytes will increase to heighten the body’s ability to fight infections.

Other benefits include reduction of pain and swelling and an increase of venous return and circulation.

The Pump Technique

Another technique of self manual lymph drainage is the pump technique. During this technique, the hand is placed at an angle to the skin. The fingers then stretch the skin, with the thumb on one side of the limb, and the fingers on the other. The wrist then lowers to move the skin in a pumping motion. 

Deep Tissue Massage

There are many types of deep tissue massage. The most well known are Hot Stone Massage, Tui Na an ancient Chinese massage technique which means grab and push, Gua Sha another ancient Chinese massage technique which uses a scraping instrument, and Instrument Assisted Soft Tissue Mobilization, IASTM. The research on these different techniques is relatively sparse and I can find no head to head comparison trials of the different deep tissue techniques. Most of the research on the deep tissue focuses on the use of deep tissue techniques for sports injury and recovery, treatment of chronic low back pain, neck, and other acute and chronic muscular-skeletal conditions. 

Proposed Mechanism of Deep Tissue Massage

The mechanism behind the therapeutic effects of deep tissue is not completely known but based on some animal studies and our understanding of injury repair the mechanism is thought to involve the deep pressure or even minor trauma to stimulate healing. Microvascular and capillary hemorrhage, along with localized inflammation, occurs and which restarts the healing process. It is thought that deep tissue The soft tissue healing process that is restarted involves increased secretion of fibronectin and increased attraction and proliferation of fibroblasts. When a stimulus is applied to the injured soft tissue using a forceful thumb or an instrument, the activity and the amount of fibroblasts are increased and the amount of fibronectin is increased. It is thought that deep tissue massage improves venous vasculature as well as the subcutaneous fat tissue. These changes facilitate the synthesis and realignment of collagen is one of the proteins that make up the extracellular matrix (Davidson et al., 1997);

Early Results of Deep Tissue Massage and Lipedema

Dr. Karen Herbst published the result of a small study using a type of deep tissue massage called Quadrivas Therapy. The paper titled “Pilot study: whole-body manual subcutaneous adipose tissue (SAT) therapy improved pain and SAT structure in women with lipedema” was published online. The study found Limb fat over total body fat mass (p = 0.08)[ not quite statically significantly decreased] and trunk fat over total body mass trended down from baseline (p = 0.08)[ not quite statically significantly decreased] measure by Dual X-ray absorptiometry (DXA) scans. Leg volume and caliper assessments in eight of nine areas (p < 0.007), LEFS (p = 0.002) and average pain (p = 0.007) significantly decreased from baseline. Fibrosis significantly decreased in the nodules, hips and groin. Ultrasound showed improved SAT structure in some subjects. Side effects included pain, bruising, itching, swelling, and gastroesophageal reflux disease. All women said they would recommend SAT therapy to other women with lipedema. The conclusion of this pilot study is subcutaneous massage therapy in 4 weeks of improved tissue structure, perceived leg function, and volume in women with lipedema.


How Deep Tissue Massage Might Work in Lipedema and Dercum’s Disease

Instrument Assisted Soft Tissue Mobilization, IASTM massage and Quadrivas Therapeutic Massage hold the most promise as they can cause inflammation and or induce tissue remodeling. Instrument Assisted Soft Tissue Mobilization is actually not new. The ancient Greeks used an instrument called a strigil and the ancient Chinese used a deep tissue technique with a scraping instrument called a Gua Sha. 

Both Lipedema and Dercum’s disease have tenderness and swelling consistent with inflammation and over time develop fibrosis and tissue thickening. The fibrosis in the skin is responsible for the nodules in lipedema and the lipomas in Dercum’s Disease. In many ways, Lipedema and Dercum’s disease behave like a disease of chronic inflammation with impaired healing. We know that impaired healing leads to fibrosis. So it is possible that IASTM massage could restart the healing process and allow for more complete healing and less fibrosis in both lipedema and Dercum’s Disease.

Lymphatic Massage is an important part of the treatment of lipedema. Lymphatic Massage is a type of massage using a technique developed by Vodder and others. The technique gently stretches the skin, activating the lymphatic capillaries and stimulating lymphangions in concentric motions either toward lymph nodes or towards lymph nodes. Lymphatic massage is proven to help lymphedema and lipedema with secondary lymphedema. There are many different deep tissue massage techniques, but they rely on greater pressure focused on tissues below the superficial lymphatics.

Complete Decongestive Therapy

For people who suffer from lymphedema and lipedema disorders which have impaired lymphatic systems that prevent proper drainage of lymph fluids, the symptoms can be annoying and difficult to alleviate. Oftentimes, lymphedema, and lipedema occur in the legs, where the buildup of lymph fluid causes unnatural swelling and pain. Less severe lipedema and lymphedema symptoms may be treated with medical-grade compression garments, but for advanced lymphedema symptoms, the best treatment option is Complete Decongestive Therapy or CDT. 

How CDT Works

Complete Decongestive Therapy works through a multistep approach using massage techniques, exercise, compression, and sometimes additional skincare techniques. The main component of CDT has focused massage techniques termed manual lymph drainage massage. This technique uses a scooping motion with the hand, applying pressure to manually guide trapped lymph fluid out of the affected limb or limbs.

Manual lymph drainage is combined with exercise and stretching to increase the mobility of the affected patient. Additionally, compression garments are used to help the body keep the lymph fluid from building up further, or from reversing the effects of the manual lymph drainage massage. Medical grade compression garments are tightest at the ankle, with a graduated lessening of pressure as they move up the leg. 

Effectiveness of CDT Treatments

For patients who suffer from extreme lymphedema, CDT can be very effective in alleviating symptoms. For example, one woman experienced a loss of 110 lbs. after just a month of treatment, including around 67 liters of fluid that accounted for a nearly 40% volume reduction in her legs. This amazing transformation is indicative of the healing power of the CDT treatment plan.

Complete Decongestive Therapy can also have benefits for people with generalized edema and lipo-lymphedema. Lipo-lymphedema, also known as secondary lymphedema, occurs when a patient with advanced lipedema symptoms develops lymphedema as a result. These two conditions create a vicious cycle, with the symptoms of each disease feeding the other. CDT is often used as a treatment method for these patients, helping reduce swelling and pain, and even increasing the strength of capillaries, helping to avoid hematoma formation in lipedema patients. However, people who have lipedema, but aren’t experiencing much swelling, may not benefit from CDT.

Consultations Available

If you have lymphedema or lipedema or are experiencing symptoms associated with these disorders, you may benefit from Complete Decongestive Therapy. This non-invasive medical technique has helped countless patients manage and reverse their symptoms. Call today to schedule your consultation, and see how you can benefit from this effective therapy option.

→Up Next: Compression Therapy

Rat tendon morphologic and functional changes resulting from soft tissue mobilization. Davidson CJ, Ganion LR, Gehlsen GM, Verhoestra B, Roepke JE, Sevier TL

Med Sci Sports Exerc. 1997 Mar; 29(3):313-9. [PubMed]

Fibroblast responses to variation in soft tissue mobilization pressure. Gehlsen GM, Ganion LR, Helfst R Med Sci Sports Exerc. 1999 Apr; 31(4):531-5. [PubMed]

Pilot study: Whole body manual subcutaneous adipose tissue (SAT) therapy improved pain and SAT structure in women with lipedema https://www.degruyter.com/view/j/hmbci.ahead-of-print/hmbci-2017-0035/www.degruyter.com/view/j/hmbci.ahead-of-print/hmbci-2017-0035/hmbci-2017-0035.xml

To learn more, watch Dr Hebst discuss her study: https://www.youtube.com/watch?v=j8IzweESelo

Got A Question?

Ask Nancy

Meet Dr. Wright

Dr. Wright

Meet Dr. Thomas Wright, medical director of Laser Lipo and Vein Center. Dr. Wright is a board certified Phlebologist and cosmetic surgery specialist, with over 15 years of practicing experience. A graduate of the University of Missouri Columbia medical program, Dr. Wright was one of the first two hundred surgeons to become a diplomate in Phlebology.

read more

* Results May Vary From Person to Person