Lymphatic drainage exercises 

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[Text on screen: Karen Hock, MS, PT
Physical Therapist
James Cancer Hospital and Solove Research Institute]

Karen Hock, MS, PT: Lymphatic drainage is a way to work with some of our deep lymphatic structures and our superficial lymphatic structures to help facilitate that whole filtering process to really help that lymphatic fluid move a little bit, maybe better. So there are some simple techniques that can help with a normal lymphatic system to move that fluid. We're always going to start with the central deep lymphatic structures, and we always start with the biggest drains that are up here near your collarbone or clavicle. 

[Text on screen: Shoulder raises & rolls]

One of the easiest ways to facilitate the fluid moving here is simply by elevating and depressing your collarbone. So you can easily do that by moving your shoulders up to your ears and back down. So frequently we'll tell our patients to do some nice shoulder rolls that move your shoulders back, or posteriorly, and you pull those shoulder blades together, and that's going to facilitate this duct taking in more fluid.

[Text on screen: Collar bone push & tuck]

If you have a healthy lymphatic system and you have no other medical issues, then it might be okay to actually use your fingers in this area, and I will tell my patients to cross their hands and gently just kind of push down and tuck like you're tucking underneath your collarbone. So you can do that on both sides. And repetition is good, so always think about maybe five to 10 times when you do that. The next thing we'll talk about is deep diaphragmatic breathing, because another big lymphatic drain is right in our lower abdomen. If we want to facilitate that duct, we're going to do some nice deep breathing, but we want that air to fill our lower abdomen. We don't want to be an upper chest breather. The way we facilitate the lymphatic duct with deep breathing is by changing pressure. So as we change the pressure in our abdomen, we're facilitating that duct pulling more fluid in.

[Text on screen: Diaphragmatic breathing]

So if you lightly place your hands on your lower abdomen, when you take in a breath, you want to feel your hands kind of move out or your belly expand. You don't want to see a lot of movement up here from your breathing. So we'll breathe in, we'll fill up here, and you can blow out like you're blowing out your birthday candles. So you breathe in. What we don't want is... We want the air to come down into the belly. So that's a great way to facilitate that duct bringing in more fluid. And sometimes that takes a little bit of practice. When we do that, and if you get good at it, you can actually apply a little bit of resistance, which will change the pressure even more in your tummy and facilitate that duct doing more work. So when you do that, just as you breathe in, don't push so hard that your stomach can expand, but you can give it just a little resistance, so you have to push just a little bit harder, and then you'll breathe out and blow out the birthday candles.

So those are two great ways, and you can do that sitting at your desk. No one will even know you're doing it. Now, we talked about changing pressure, and you can do that in your limbs as well. 

[Text on screen: Muscle pumping & contracting]

So a great way to help facilitate venous return and lymphatic function is with muscle pumping. So you can do ankle pumps to help with that return from your legs. You can do isometric contractions, which means just tightening up your muscles and relaxing. That causes a pumping action, and you can do the same thing in your hands and your arms. So an isometric contraction over and over or an actual pumping motion with hands or feet can help facilitate that movement.

And we'll talk about two other techniques. There's two other big groupings of lymph nodes that we typically will work with when we do lymphatic drainage. Those are under your arm, in your groin or the crease of your leg. If you want to facilitate those lymph nodes, you're just going to apply a little bit of pressure and kind of a pumping action. 

[Text on screen: Armpit pumping]

So you can place your hand right in the curve of your armpit, right in that pit, and you're going to gently pump and release. So you'll be gently pushing and then letting go, and you can do that a couple times, five to 10 times, and you can do them both together. So this won't take you very long. 

[Text on screen: Leg crease pumping]

Then the other place you can do a pumping action is right in the crease of your leg. I always talk about, we'll go from in to out. This will be our exit door on the side, and you can take your fingers and just gently press along the crease of your leg. Those lymph nodes sit right where your leg bends, and again, you're going to do that for five to 10 trips across the crease of your leg. Those are just some easy techniques to facilitate some deeper lymphatic ducts and some of our bigger groupings of lymph nodes. It can be helpful after exercise, but you always do want to check with your healthcare professional to make sure it's appropriate for you.

[Text on screen: The James
The Ohio State University Comprehensive Cancer Center
For more information, visit cancer.osu.edu]

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