Self-Massage

INTRODUCTION

The primary purpose of self-massage, which is also known as lymphatic massage, is to improve the flow and drainage of lymph by stimulating the lymphatic vessels. Your lymphedema therapist will instruct you in a program of daily self-massage. This is an important part of managing your lymphedema and should be performed regularly as directed.

• If you have an infection, or any indication that you are developing an infection, you may need to modify (or skip)
  your self-massage until the infection is under control.
   Return to performing self-massage only after your physician has given the "all clear."
• Self-message is NOT RECOMMENDED for those with other medical conditions such as a malignant tumor. Get clearance from you physician and/or lymphedema therapist before you undertake this self-treatment.

Preparing for self-massage of the inguinal lymph nodes. © Lymph Notes.

UNDERSTANDING THE SELF-MASSAGE STROKES

To understand self-massage strokes, pay close attention to the instructions provided by your therapist. Those described here are the similar in sequence, and strokes, as used by in manual lymph drainage.

• Self-massage is a gentle technique taught to the patient by the therapist and the resulting massage should never hurt or make the skin red.
• Self-massage to encourage lymph drainage is not the same as conventional muscle massage. For this reason, it is important that you do not allow anyone, other than a qualified lymphedema therapist, to massage lymphedema affected tissues using deep strokes.
• Most self-massage strokes use very little pressure and the hands do not slide over the skin. Instead they move and stretch the skin to stimulate flow of lymph through the lymphatic capillaries that are located just under the skin.
• Oils and lotions that make the skin slippery are NOT ordinarily used during self-massage. If the skin is very dry, a lotion can be applied and allowed to absorb before you continue with  the massage.
• When massaging fibrotic tissues, use only the pressure and strokes recommended by your therapist to soften these hardened tissues.

RHYTHMIC PUMPING MOTION

A rhythmic pumping self-massage motion is used to stimulate areas such as the terminus and major lymph nodes. This motion is performed by very gently pressing with the fingers, moving the skin in a circle the size of a coin, and then releasing the pressure.

STRETCH-TWIST-RELEASE MOTION

• A stretch-twist-release motion is used to stimulate the flow of lymph through the tissues of the skin.
• This motion is performed by gently placing three fingers on the skin. The fingers gently stretch the skin for about an inch (2.5 cm) without sliding and then twist slightly to the right or left.
• This stroke is completed by lifting the fingers.

SWEEPING MOTION

• A sweeping motion, which is also known as effleurage, is used at the conclusion of a massage as a final stimulation of the lymph flow through the skin.
• This motion is performed as a gentle sweep of the fingers across the skin as if brushing bread crumbs from a table.

OVERVIEW OF SELF-MASSAGE 

• The information provided here will help you remember the sequence and strokes your therapist has instructed you to use.
• It is also a helpful guide for a caregiver or helper who is assisting you with self-massage.

THE RHYTHM OF FLOWING LYMPH

The subtle pumping motion of the lymphatic vessels moves the lymph upward toward the terminus in a rhythm of five-to-seven pulsations per minute.

• To match these pulsations, each self-massage movement should be repeated from five-to-seven times in the same position.
• By following this pattern, you enhance the effectiveness of your self-massage as you work with the natural pattern of the flow of lymph.

PREPARING FOR THE FLOW OF LYMPH

Lymph flows from the tips of the extremities toward the trunk. Within the trunk, lymph flows upward toward the terminus where it returns to the venous blood circulation via the subclavian veins.

• In contrast to this pattern of flow, self-massage begins with the terminus and moves down to clear the major groups of lymph nodes and the trunk.
• The final area to be massaged is the affected limb.The purpose of this massage sequence is to clear space within the lymphatic ducts to receive the lymph as it flows out of the affected limb or area.
• The axillary and inguinal lymph nodes give the greatest resistance to the flow of lymph and these nodes must be cleared before, during, and after massaging the limbs.
• If these nodes overfill after they have been cleared, they can feel hard and sore. If this happens, clear the terminus and then clear these lymph node groups again. This makes room for the lymph as it drains from the impaired area.

PREPARING FOR SELF-MASSAGE

Select a room for your self-massage that is quiet and at a comfortable temperature.

• Perform your massage in the positions that work best for you. Most commonly this is lying on your back in a comfortable and relaxed position. You may want to remove your glasses, jewelry, and any restrictive clothing.
• Each self-massage begins with a few quiet moments of deep breathing to help you relax and focus on the task at hand. This breathing pattern should be maintained throughout the massage session.
• Self-massage is best performed first thing in the morning, before bandaging or exercising, and at other times as specified by your therapist.
• Never stimulate the flow of lymph from a normal area into a lymphedema affected area.
• The length of time devoted to self-massage depends on your condition and the instructions provided by your therapist.
• Once practiced in self-massage, many individuals find that this massage takes only a few minutes.

REFERENCES

• Living Well with Lymphedema Ann Ehrlich, MA. Alma Harrewijn PT, CLT-LANA, and Elizabeth McMahon, Ph.D.
  Lymph Notes, 2005.
• Lymphedema Management: The comprehensive Guide for Practitioners 2-E, by J.E. Zuther. Thieme, 2010.
• Videos of these techniques can be found by searching on www.youtube.com

© LymphNotes 2014. This information does not replace the advice of a qualified health care professional.

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Category: How Lymphedema is Treated Updated: 2014-10-11