Should moderate or deep pressure be used for manual lymphatic drainage?

In this blog I want to talk about pressure used during manual lymphatic drainage, it is a question I am often asked by clients. Should moderate or deep pressure be used?

The simple answer to this question is no!

Lymphatic drainage is a therapeutic massage technique designed to stimulate the lymphatic system which is essential for good immune function and fluid balance throughout the body. It is beneficial for people with lymphedema, post-surgery, sport strains, stress and general detoxification. It focuses on the superficial lymph vessels just beneath the skin surface and encourages lymph fluid to move toward the lymph nodes. Hallmarks of manual lymphatic drainage are light pressure, rhythmic, circular and gentle stroking techniques.

Traditional massage generally uses deeper pressure, targeting muscles. Deep tissue techniques incorporate strokes towards the heart, lymphatic strokes work away from the heart, thereby reducing swelling.

In order to reduce swelling within the body manual lymphatic drainage can be used to encourage extra interstitial fluid found in the tissues and collected by the lymph nodes for filtration and purification. The lymphatic capillaries that collect interstitial fluid are very small. In principle if too much pressure is applied these vessels can collapse and not function properly and collect fluid, until they rejuvenate themselves. This fluid will then travel through larger and larger vessels moving toward the heart and cardiovascular system.

Theoretically people may mistake deep tissue massage for lymphatic drainage because there can be some tissue changes leading to some fluid drainage following deep tissue. Common issues such as stress, overuse can result in muscle tightness. This muscle tightness can lead to excessive pressure being placed on circulatory vessels, obstructing general circulation. When a deep tissue massage is carried out, these tight muscles relax and allow adequate “drainage” of the tissues via unobstructed vessels. This is NOT lymphatic drainage. Better fluid exchange within the tissues promotes more efficient circulation resulting from a good massage. Deep/moderate pressure massage should not be confused with the techniques used by manual lymphatic drainage which encourage the uptake of interstitial fluid into lymphatic capillaries.

It is worth mentioning that deep tissue techniques may result in more swelling and tissue damage. This is because when pressure is applied to swollen tissues it can further stretch or tear the affected area. People who try to force fluid out of a swollen area with deep tissue techniques causes more damage, scar tissue and possible infection. This could also be extremely painful for the client!

To reiterate, deep tissue/moderate pressure techniques should never be used for manual lymphatic drainage.

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