SELF
LYMPHATIC DRAINAGE- LOWER EXTREMITY
If only one extremity is affected,
apply on the affected extremity.
1. Take 10 deep breaths.
2.
Massage in a half-circle motion on the outside of the LEFT hip 15 times.
3.
Massage the left groin along the underwear line in a scooping motion 15
times.
4. Begin self massage on the left thigh sweeping up toward the
groin and hip bone. Be sure to massage
inner/outer leg as
well.
5. Massage the knee lymph nodes 15 times (these are located in
the knee crease on the right and left
edges).
6. Gently
massage the lower leg (front and back) in an upward direction 15 times.
7.
Massage the top of the foot and around the ankle bones 15 times.
8.
Work the toes from tips toward the foot 5 times each.
9. Sweep the
fluid back up the leg toward the hip and groin lymph nodes 15 times.
10.
If both legs are affected, repeat steps 2 through 9 on the RIGHT
side.
SELF LYMPHATIC DRAINAGE TECHNIQUE--LEFT
UPPER EXTREMITY
1. Take 5 deep breaths.
2. Massage
(in half circles) just above both collarbones 45 seconds.
3. Massage
right armpit 45 seconds.
4. Sweep from sternum (breastbone) toward
right armpit 5 times; then from the right shoulder to the left
armpit 5 times.
5. Perform a scooping motion at the left
groin along the pantyline 5 times.
6. Sweep downward from left armpit
toward left groin 5 times.
7. Sweep in an upward motion toward the
shoulder cap working on the upper arm first (between
shoulder and
elbow) 5 times.
8. Sweep forearm from wrist to elbow making sure to
work both front and back sides 5 times.
9. Push fluid from mid palm
to outer edge of palm.
10. Turn hand over and sweep fluid along back
side of hand.
11. Work each finger individually in an upward motion
(toward the hand).
12. Move fluid back up the arm to the
shoulder.
13. Sweep fluid from the left shoulder cap to the left
groin 5 times. Sweep fluid from the left shoulder
cap to the right
armpit 5 times.
SELF LYMPHATIC DRAINAGE TECHNIQUE--RIGHT UPPER
EXTREMITY
1. Take 5 deep breaths.
2. Massage (in half
circles) just above both collarbones 45 seconds.
3. Massage left
armpit 45 seconds.
4. Sweep from sternum (breastbone) toward left
armpit 5 times; then from the right shoulder to the left
armpit 5
times.
5. Perform a scooping motion at the right groin along the
panty line 5 times.
6. Sweep downward from right armpit toward right
groin 5 times.
7. Sweep in an upward motion toward the shoulder cap
working on the upper arm first (between
shoulder and elbow) 5
times.
8. Sweep forearm from wrist to elbow making sure to work both
front and back sides 5 times.
9. Push fluid from mid palm to outer
edge of palm.
10. Turn hand over and sweep fluid along back side of
hand.
11. Work each finger individually in an upward motion (toward
the hand).
12. Move fluid back up the arm to the shoulder.
13.
Sweep fluid from the right shoulder cap to the right groin 5 times. Sweep
fluid from the right
shoulder cap to the left armpit 5 times.
Manual lymphatic leg drainage -
video
http://www.youtube.com/watch?v=XAM-Ne7BntU
shared
by Joe Zuther, founder of American Academy of Lymphatic
Studies.
Self Manual Lymph Drainage for Lymphedema Affecting the Arm
By Joachim Zuther, on January 8th, 2013
Complete decongestive therapy (CDT) is performed in two phases; in the first
phase, also known as the intensive or decongestive phase, treatments are
administered by trained lymphedema therapists on a daily basis until the
affected body part is decongested.
The duration of the intensive phase varies with the severity of the condition
and averages two-three weeks for patients with lymphedema affecting the arm.
However, in extreme cases the decongestive phase may last longer and may have
to be repeated several times.
The end of the first phase of CDT is determined by the results of
measurements taken by the therapist on the affected body part. Once
measurements approach a plateau, the end of phase one is reached and the
patient progresses seamlessly into phase two of CDT, which is also known as the
self-management phase.
Phase two is an ongoing and individualized part of
CDT, in which the patient assumes responsibility for maintaining and improving
the treatment results achieved in the intensive phase (phase one).
During
the intensive phase patients are instructed by the therapist in the individual
components of self-management, which include self-manual lymph drainage (self
MLD, or simple MLD), a skin care regimen, home exercises, and the application
of compression garments (and bandages).
The self-manual lymph drainage techniques are relatively easy to perform and
therapists generally teach one or two MLD strokes that can be learned and
safely performed by the patient. It may help if the patient’s spouse, a
relative or a friend is present during the therapist’s demonstration of these
strokes to observe, take notes, or record the techniques with a camera.
The
strokes are based on the same principles as those performed by the therapist,
and it is very important that the patient clearly understands the hand
movements, specifically the principles of skin elasticity, the pressures used
during the working and resting phases of the strokes, and in which direction
the pressure should be applied.
To help understand the techniques of MLD it is advisable to read the
following articles published on this blog:
1. Manual lymph drainage and its role in the treatment of
lymphedema
2. The Science behind Manual Lymph Drainage in the Treatment of
Lymphedema
3. The Role of Complete Decongestive Therapy in Breast Cancer
Related Lymphedema
4. Skin and Nail Care in Lymphedema Management
The following techniques can be used for lymphedema affecting one arm; the
illustrations and techniques describe the sequence used for lymphedema
affecting the left arm. In this case the lymph nodes located in the opposite
axilla (right armpit, underarm) and those in the groin of the same side (left)
are unaffected and working properly.
This sequence should not be used in
lymphedema affecting both arms, or if the axillary lymph nodes on the
unaffected, or the inguinal (groin) lymph nodes on the affected side are
removed, or non-functioning due to other reasons.
The techniques described are performed in the sitting position; ideally, self
MLD should be applied at least once daily for 10-15 minutes, directly preceding
the exercise program, and should be followed by appropriate skin care and
compression therapy.
Each stroke should be repeated 5-7 times, and, if not
noted otherwise, the hand of the unaffected side (in this case the right hand)
should be used to perform the strokes.
The techniques and sequences below represent standard examples and may vary
from those demonstrated by the therapist. Therapists may have different
preferences, or the techniques may have to be adjusted to accommodate specific
requirements or physical limitations of the individual patient.
Neck
Affected Arm
Self Manual Lymph Drainage for Lymphedema Affecting the Leg
By Joachim Zuther, on January 22nd, 2013
Complete decongestive therapy
(CDT) is performed in two phases; in the first phase, also known as the
intensive or decongestive phase, treatments are administered by trained
lymphedema therapists on a daily basis until the affected body part is
decongested.
The duration of the intensive phase varies with the severity of the condition
and averages two-three weeks for patients with lymphedema affecting the lower
extremity. However, in extreme cases the decongestive phase may last longer and
may have to be repeated several times.
The end of the first phase of CDT is determined by the results of
measurements taken by the therapist on the affected body part. Once
measurements approach a plateau, the end of phase one is reached and the
patient progresses seamlessly into phase two of CDT, which is also known as the
self-management phase.
Phase two is an ongoing and individualized part of CDT, in which the patient
assumes responsibility for maintaining and improving the treatment results
achieved in the intensive phase (phase one).
During the intensive phase patients are instructed by the therapist in the
individual components of self-management, which include self-manual lymph
drainage (self MLD, or simple MLD), abdominal breathing techniques, a skin care
regimen, home exercises, and the application of compression garments (and
bandages).
The self-manual lymph drainage techniques are relatively easy to perform and
therapists generally teach one or two MLD strokes that can be learned and
safely performed by the patient. It may help if the patient’s spouse, a
relative or a friend is present during the therapist’s demonstration of these
strokes to observe, take notes, or record the techniques with a camera.
The strokes are based on the same principles as those performed by the
therapist, and it is very important that the patient clearly understands the
hand movements, specifically the principles of skin elasticity, the pressures
used during the working and resting phases of the strokes, and in which
direction the pressure should be applied.
To help understand the techniques of MLD it is advisable to read the
following articles published on this blog:
The following techniques can be used for lymphedema affecting one leg; the
illustrations and techniques describe the sequence used for lymphedema
affecting the left leg. In this case the lymph nodes located in the opposite
groin (right) and those in the axilla of the same side (left) are unaffected
and working properly.
This sequence should not be used in lymphedema affecting both legs, or if the
axillary lymph nodes on the affected, or the inguinal (groin) lymph nodes on
the unaffected side are removed, or non-functioning due to other reasons.
Ideally, self MLD should be applied at least once daily for 15-20 minutes,
directly preceding the exercise program, and should be followed by appropriate
skin care and compression therapy. Each stroke should be repeated 5-7
times.
The techniques and sequences below are standard examples and may vary from
those demonstrated by the therapist. Therapists may have different preferences,
or the techniques may have to be adjusted to accommodate specific requirements
or physical limitations of the individual patient.
Preparation and Abdominal Breathing:
Leg
LYMPHATIC DRAINAGE- LOWER EXTREMITY
If only one extremity is affected,
apply on the affected extremity.
1. Take 10 deep breaths.
2.
Massage in a half-circle motion on the outside of the LEFT hip 15 times.
3.
Massage the left groin along the underwear line in a scooping motion 15
times.
4. Begin self massage on the left thigh sweeping up toward the
groin and hip bone. Be sure to massage
inner/outer leg as
well.
5. Massage the knee lymph nodes 15 times (these are located in
the knee crease on the right and left
edges).
6. Gently
massage the lower leg (front and back) in an upward direction 15 times.
7.
Massage the top of the foot and around the ankle bones 15 times.
8.
Work the toes from tips toward the foot 5 times each.
9. Sweep the
fluid back up the leg toward the hip and groin lymph nodes 15 times.
10.
If both legs are affected, repeat steps 2 through 9 on the RIGHT
side.
SELF LYMPHATIC DRAINAGE TECHNIQUE--LEFT
UPPER EXTREMITY
1. Take 5 deep breaths.
2. Massage
(in half circles) just above both collarbones 45 seconds.
3. Massage
right armpit 45 seconds.
4. Sweep from sternum (breastbone) toward
right armpit 5 times; then from the right shoulder to the left
armpit 5 times.
5. Perform a scooping motion at the left
groin along the pantyline 5 times.
6. Sweep downward from left armpit
toward left groin 5 times.
7. Sweep in an upward motion toward the
shoulder cap working on the upper arm first (between
shoulder and
elbow) 5 times.
8. Sweep forearm from wrist to elbow making sure to
work both front and back sides 5 times.
9. Push fluid from mid palm
to outer edge of palm.
10. Turn hand over and sweep fluid along back
side of hand.
11. Work each finger individually in an upward motion
(toward the hand).
12. Move fluid back up the arm to the
shoulder.
13. Sweep fluid from the left shoulder cap to the left
groin 5 times. Sweep fluid from the left shoulder
cap to the right
armpit 5 times.
SELF LYMPHATIC DRAINAGE TECHNIQUE--RIGHT UPPER
EXTREMITY
1. Take 5 deep breaths.
2. Massage (in half
circles) just above both collarbones 45 seconds.
3. Massage left
armpit 45 seconds.
4. Sweep from sternum (breastbone) toward left
armpit 5 times; then from the right shoulder to the left
armpit 5
times.
5. Perform a scooping motion at the right groin along the
panty line 5 times.
6. Sweep downward from right armpit toward right
groin 5 times.
7. Sweep in an upward motion toward the shoulder cap
working on the upper arm first (between
shoulder and elbow) 5
times.
8. Sweep forearm from wrist to elbow making sure to work both
front and back sides 5 times.
9. Push fluid from mid palm to outer
edge of palm.
10. Turn hand over and sweep fluid along back side of
hand.
11. Work each finger individually in an upward motion (toward
the hand).
12. Move fluid back up the arm to the shoulder.
13.
Sweep fluid from the right shoulder cap to the right groin 5 times. Sweep
fluid from the right
shoulder cap to the left armpit 5 times.
Manual lymphatic leg drainage -
video
http://www.youtube.com/watch?v=XAM-Ne7BntU
shared
by Joe Zuther, founder of American Academy of Lymphatic
Studies.
Self Manual Lymph Drainage for Lymphedema Affecting the Arm
By Joachim Zuther, on January 8th, 2013
Complete decongestive therapy (CDT) is performed in two phases; in the first
phase, also known as the intensive or decongestive phase, treatments are
administered by trained lymphedema therapists on a daily basis until the
affected body part is decongested.
The duration of the intensive phase varies with the severity of the condition
and averages two-three weeks for patients with lymphedema affecting the arm.
However, in extreme cases the decongestive phase may last longer and may have
to be repeated several times.
The end of the first phase of CDT is determined by the results of
measurements taken by the therapist on the affected body part. Once
measurements approach a plateau, the end of phase one is reached and the
patient progresses seamlessly into phase two of CDT, which is also known as the
self-management phase.
Phase two is an ongoing and individualized part of
CDT, in which the patient assumes responsibility for maintaining and improving
the treatment results achieved in the intensive phase (phase one).
During
the intensive phase patients are instructed by the therapist in the individual
components of self-management, which include self-manual lymph drainage (self
MLD, or simple MLD), a skin care regimen, home exercises, and the application
of compression garments (and bandages).
The self-manual lymph drainage techniques are relatively easy to perform and
therapists generally teach one or two MLD strokes that can be learned and
safely performed by the patient. It may help if the patient’s spouse, a
relative or a friend is present during the therapist’s demonstration of these
strokes to observe, take notes, or record the techniques with a camera.
The
strokes are based on the same principles as those performed by the therapist,
and it is very important that the patient clearly understands the hand
movements, specifically the principles of skin elasticity, the pressures used
during the working and resting phases of the strokes, and in which direction
the pressure should be applied.
To help understand the techniques of MLD it is advisable to read the
following articles published on this blog:
1. Manual lymph drainage and its role in the treatment of
lymphedema
2. The Science behind Manual Lymph Drainage in the Treatment of
Lymphedema
3. The Role of Complete Decongestive Therapy in Breast Cancer
Related Lymphedema
4. Skin and Nail Care in Lymphedema Management
The following techniques can be used for lymphedema affecting one arm; the
illustrations and techniques describe the sequence used for lymphedema
affecting the left arm. In this case the lymph nodes located in the opposite
axilla (right armpit, underarm) and those in the groin of the same side (left)
are unaffected and working properly.
This sequence should not be used in
lymphedema affecting both arms, or if the axillary lymph nodes on the
unaffected, or the inguinal (groin) lymph nodes on the affected side are
removed, or non-functioning due to other reasons.
The techniques described are performed in the sitting position; ideally, self
MLD should be applied at least once daily for 10-15 minutes, directly preceding
the exercise program, and should be followed by appropriate skin care and
compression therapy.
Each stroke should be repeated 5-7 times, and, if not
noted otherwise, the hand of the unaffected side (in this case the right hand)
should be used to perform the strokes.
The techniques and sequences below represent standard examples and may vary
from those demonstrated by the therapist. Therapists may have different
preferences, or the techniques may have to be adjusted to accommodate specific
requirements or physical limitations of the individual patient.
Neck
- Stationary circles with flat fingers above the collarbone on both sides. The
fingers of the right hand manipulate the skin above the collarbone on the left
and the fingers of the left hand manipulate the skin above the collarbone on
the right. The pressure is applied with the flat phalanges of the fingers
(generally the index, middle and ring fingers) and the pressure is directed
toward the neck. This technique can be applied simultaneously on both sides or
on each side individually.
Step 1
- Stationary circles with the flat hand in the center of the opposite axilla
(armpit, underarm). The pressure is directed downward (deep) into the axilla
and applied with the flat fingers and palm of the affected arm.
Step 2
- Soft effleurage over the skin from the affected axilla to the axilla of the
opposite side.
Step 3
- Stationary circles with the flat hand in several placements from the axilla
on the affected side to the axilla on the opposite side. The pressure is
directed toward the axilla on the opposite side.
Step 4
- Stationary circles with the flat hand (use hand of affected side) in the
area of the groin lymph nodes (inguinal lymph nodes) on the same side. The hand
is placed just below the inguinal ligament (in the green area depicted on the
illustration on the very bottom of the page) and the pressure is directed
toward the belly.
Step 5
- Stationary circles with the flat hand in several placements from the axilla
on the affected side to the inguinal lymph nodes on the same side covering the
entire surface of the lateral trunk (flank). The pressure is directed toward
the inguinal lymph nodes (same side).
Affected Arm
- Soft effleurage over the skin of the arm from the
hand to the top of the shoulder.
- Stationary circles with the flat hand and fingers
in several placements on the upper portion of the lateral upper arm, from the
shoulder muscle (deltoid muscle area) of the affected arm to the top of the
shoulder. The pressure is directed toward the neck.
Step 8
- Stationary circles with the flat hand and fingers
in several placements from the medial (inside) portion to the lateral (outside)
portion of the upper arm. With the pressure directed toward the lateral aspect
of the arm, the entire upper arm from the top (just below the axilla) down to
the elbow should be covered.
Step 9
- Stationary circles with the flat hand and fingers
in several placements on the lateral upper arm. The entire lateral surface of
the upper arm, from the elbow to the shoulder should be covered, with the
pressure directed toward the shoulder muscle.
Step 10
- Stationary circles with the flat hand and fingers
in several placements covering the entire frontal (anterior) aspect of the
lower arm, from the elbow crease to the hand. In order to reach all aspects of
the forearm, the arm should be held in supination with the palm of the hand
pointing to the front. The pressure is directed toward the upper arm.
Step 11
- Repeat step number 10.
- Stationary circles with the flat hand and fingers
in several placements on the posterior aspect of the lower arm, from the elbow
to the back of the hand. In order to reach all aspects of the forearm, the arm
should be held in pronation with the palm of the hand resting on the thigh. The
pressure is directed toward the upper arm.
Step 13
- Repeat steps 1, 2, and 5. Other steps may be
repeated as well.
Self Manual Lymph Drainage for Lymphedema Affecting the Leg
By Joachim Zuther, on January 22nd, 2013
Complete decongestive therapy
(CDT) is performed in two phases; in the first phase, also known as the
intensive or decongestive phase, treatments are administered by trained
lymphedema therapists on a daily basis until the affected body part is
decongested.
The duration of the intensive phase varies with the severity of the condition
and averages two-three weeks for patients with lymphedema affecting the lower
extremity. However, in extreme cases the decongestive phase may last longer and
may have to be repeated several times.
The end of the first phase of CDT is determined by the results of
measurements taken by the therapist on the affected body part. Once
measurements approach a plateau, the end of phase one is reached and the
patient progresses seamlessly into phase two of CDT, which is also known as the
self-management phase.
Phase two is an ongoing and individualized part of CDT, in which the patient
assumes responsibility for maintaining and improving the treatment results
achieved in the intensive phase (phase one).
During the intensive phase patients are instructed by the therapist in the
individual components of self-management, which include self-manual lymph
drainage (self MLD, or simple MLD), abdominal breathing techniques, a skin care
regimen, home exercises, and the application of compression garments (and
bandages).
The self-manual lymph drainage techniques are relatively easy to perform and
therapists generally teach one or two MLD strokes that can be learned and
safely performed by the patient. It may help if the patient’s spouse, a
relative or a friend is present during the therapist’s demonstration of these
strokes to observe, take notes, or record the techniques with a camera.
The strokes are based on the same principles as those performed by the
therapist, and it is very important that the patient clearly understands the
hand movements, specifically the principles of skin elasticity, the pressures
used during the working and resting phases of the strokes, and in which
direction the pressure should be applied.
To help understand the techniques of MLD it is advisable to read the
following articles published on this blog:
- Manual lymph drainage and its role in the treatment of
lymphedema
- The Science behind Manual Lymph Drainage in the Treatment of
Lymphedema
- Skin and Nail Care in Lymphedema Management
- Primary Lymphedema
- Secondary Lymphedema
The following techniques can be used for lymphedema affecting one leg; the
illustrations and techniques describe the sequence used for lymphedema
affecting the left leg. In this case the lymph nodes located in the opposite
groin (right) and those in the axilla of the same side (left) are unaffected
and working properly.
This sequence should not be used in lymphedema affecting both legs, or if the
axillary lymph nodes on the affected, or the inguinal (groin) lymph nodes on
the unaffected side are removed, or non-functioning due to other reasons.
Ideally, self MLD should be applied at least once daily for 15-20 minutes,
directly preceding the exercise program, and should be followed by appropriate
skin care and compression therapy. Each stroke should be repeated 5-7
times.
The techniques and sequences below are standard examples and may vary from
those demonstrated by the therapist. Therapists may have different preferences,
or the techniques may have to be adjusted to accommodate specific requirements
or physical limitations of the individual patient.
Preparation and Abdominal Breathing:
- Stationary circles with flat fingers above the collarbone on both sides. The
fingers of the right hand manipulate the skin above the collarbone on the left
and the fingers of the left hand manipulate the skin above the collarbone on
the right. The pressure is applied with the flat phalanges of the fingers
(generally the index, middle and ring fingers) and the pressure is directed
toward the neck. This technique can be applied simultaneously on both sides or
on each side individually.
Step 1
- Stationary circles with the flat hand in the center of the axilla (armpit,
underarm) on the same (affected) side. The pressure is directed downward (deep)
into the axilla and applied with the flat fingers and palm.
Step 2
- Stationary circles with the flat hand in several placements from the waist
on the affected side to the axillary lymph nodes on the same side covering the
entire surface of the lateral trunk (flank). The pressure is directed toward
the axillary lymph nodes (same side).
Step 3
- Stationary circles with the flat hand in the area of the groin lymph nodes
(inguinal lymph nodes) on the opposite side. The hand is placed just below the
inguinal ligament (in the green area depicted on the illustration on the very
bottom of this page) and the pressure is directed toward the belly.
Step 4
- Stationary circles with the flat hand in several placements from the groin
(inguinal) area on the affected side to the groin (inguinal) area on the
opposite side. The pressure is directed toward the groin (inguinal) area on the
opposite side.
Step 5
- Diaphragmatic (abdominal) breathing:
It is important to discuss
any possible contraindications for this technique with the
therapist!
Abdominal breathing is done by contracting the
diaphragm, a muscle located horizontally between the chest cavity and stomach
cavity. As air enters the lungs this deep breathing is marked by expansion of
the abdomen rather than the chest when inhaling. During the inhalation both
hands that are placed flat on the belly provide resistance to the expanding
abdomen.
Step 6 – Inhalation
During the exhalation the hands follow the belly and at the end of the
exhalation, the hands press gently downward and upward toward the chest.
Step 6 – Exhalation
This technique should be repeated five times.
Leg
- Soft effleurage over the skin of the entire leg from the ankles (or knees)
to the waist.
Step 7
- Stationary circles with the flat hand and fingers in several placements on
the lateral (outside) thigh and hip. The pressure is directed toward the waist.
Step 8
- Stationary circles with the flat hand and fingers in several placements from
the medial (inside) portion to the lateral portion of the thigh. With the
pressure directed toward the lateral aspect of the thigh, the entire thigh from
the top (just below the groin) down to the knee should be covered.
Step 9
- Stationary circles with the flat fingers of both hands behind the knee. The
pressure is directed upward toward the thigh.
Step 10
- Stationary circles with the flat fingers of both hands on the medial
(inside) lower leg. With the pressure directed toward the thigh, the entire
area between the knee and the medial ankle bone should be covered.
Step 11
- Stationary circles with the flat hand and fingers of both hands on the inner
and outer surface of the lower leg. With the pressure directed toward the
thigh, the entire area between the area below the knee and the ankle bones
should be covered.
Step 12
- Repeat as many of the steps on the leg as you wish.
- Repeat steps 2, 4, and 6
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