The flow of lymph belongs to the circulatory apparatus wherein one direction allows for the blood to leave the heart (the arterial system) and two others allow for it to return( the venous and lymphatic system). Therefore the lymphatic system runs parallel to the “red” blood system.

Lymph is a fluid that is formed by part of the constituents of blood filtering out of the blood capillaries into the spaces between each cell (the interstitium). In order to return to the heart, the flow of lymph from the interstitial spaces are reabsorbed  into the feather-fine lymphagions into the lymphatic capillaries into the pre-collectors to the collectors, nodes, ducts and trunks. The cysterna chili (at T12) and thoracic duct (crosses the midline at T4-T6) represent the terminal  lymphatic pathways that eventually join the major venous circulation just before reaching the heart. As in any active “waterway”, the flow of lymph is directed by pumps and valves to prevent a backflow. This is mediated by contracting muscle fibers in the lymphangions at the pulse rate of 5-8/minute at rest. This rate increases during excercise. These lymphangions consist of 2-3 layers of spiral muscle and  one way valves. They producing peristaltic waves of contraction mediated by the autonomic nervous system. Stimuating these lymphangions can increase the flow of lymph back to heart through the lymphatic system by some twenty to thirty times. This forms the basis of lymphatic drainage wherein a mechanical compressive force is applied to increase the amount of lymph entering the lymphangions which are then subjected to a stretch and continued external compression to increase the volume of flow of lymph into the lymphatic system.

The lymphatic circulation is a low presure system moving with a slow rhythm and low velocity. Lymphatics are present everywhere in the body except in tissues without blood vascularization viz.: the epithelium ,cartilage and the lens and cornea of the eye. And certain tissues possessing vascularization viz.: the placenta, the labyrinth of the inner ear and central nervous system. Exceptions to these are the dura and pia mater, the pituitary capsule, the orbit of the eye, the nasal mucosa and the middle ear.

Lymph drainage is a very useful adjunct to manual therapy in order to:

1.      Reroute the flow of lymph in primary and secondary edemas in the skin, mucosa,muscles,viscera, joints, cranial sutures, periosteum, chambers of the eyes, cochlea, etc. increase of the rate of the flow of lymph because increasing lymphatic flow improves the filtering and removal of fluid, inflammatory mediators, and waste products from interstitial space.

2.      Drain toxins inorder to enhance tissue regeneration e.g. scars, stretch marks, wrinkles, fractures or surgery.

3.      Stimulation of the immune system

4.      Stimulation of the parasympathetic system

5.      Enhance/correct the functioning of the nervous system, the digestive system, the urogenital system, the respiratory system and in dental and metabolic disorders, gynecology, dermatology,ophthalmology, ENT and orthopedic and osteopathic conditions

6.      Reduce pain and muscle spasm.

There are several contraindications as well, mainly including the following:

1.      Acute infectious  and inflammatory illnesses

2.      Serious circulatory problems e.g. phlebitis, venous obstruction

3.      Cardiac issues e.g. angina, CCF

4.      Hemorrhage except in the case of a hematoma

5.      Absence of urination

6.      Active cancer or an undiagnosed “lump”

For maximum results the following points are to be observed:

1.      Hand pressure should be optimal to prevent lymphangion collapse. This averages approximately 8oz./sq.inch

2.      Frequency and rhythm of hand motion. This is typically one full maneuver every one to four seconds and can be repeated 8-16 times per area for maximum effectiveness till you feel you have efficiently moved the fluid.

3.      Direction of the flow of lymph is towards the heart

In general, once thixotropy ( liquefaction of the jelly-like constituents of the connective tissue) occurs at the beginning of a session, wait for the lymph to move your hand at the right time with the right frquency and in the right direction of the flow of lymph.


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