I quickly learned that self drainage is essential if you want to make sure your lymphedema does not worsen dramatically.
Below you can read more about the reasoning behind doing self drainage and more importantly how to do it.
As always, I can only describe my own experiences with the this, and I would always advise you to listen to your own physiotherapists and doctors if they tell you to do this some other way.
- What is self drainage and why should it be performed
- When to do it
- How to do it
- Tissue already gone hard
What is self drainage and why should it be performed?
The problem with lymphedema is that the flow of the lymphatic system is not working properly. The lymphatic system in our bodies consists of a network of lymph vessels and the purpose of these vessels is to carry lymph fluid to the lymph nodes from where it will at some point be returned to the bloodstream.
When our lymph vessels does not work properly, they cannot transport the lymph fluid away from the tissue and that results in limbs swelling up.
The point of selv drainage is to help your body increasing the flow in your lymphatic system and thereby prevent more swelling.
With that being said my experience has taught me that self drainage is not a miracle worker. In my case it can – by itself – only help to a certain extent. But if I combine it with the other elements described under “My way to a great life with lymphedema” I can actually get the swelling of the lymphedema down to a minimum where it is not even that visible and uncomfortable.
When to do it
My physiotherapists advised me to do self drainage once or twice a day. But since I combine my self drainage with a lot of other things I normally only do it once a day, but I would advise you to explore you own lymphedema and figure out what works best for you.
I was told to do the drainage in the evening before I go to bed as a minimum. I did this for some time, but then I tried experimenting a bit. I discovered that it has a much better effect on my legs if I do my drainage in the mornings, just after the shower and just before putting on my stockings. It feels like the self draining “kickstarts” my lymphatic system and then by putting on my stockings right after, the stockings help the system to keep on working (to some extent) for the rest of the day.
I spend between 8-15 minutes on the routine every morning, depending on how busy I am getting out the door. With that being said, I do not get any effect of the draining if I stress while doing it. I try to be in a place of mental calmness, cause otherwise the self drainage seems to be in vain and I might as well not do it.
But what should be mentioned in connection to this is that I also lie in my compression pump several days a week which means that I get “drained” manually in the mornings and then in the pump later in the afternoon. So I actually do the self drainage twice a day on the days where I go into the pump.
How to do it
As far as I know there are a lot of different variations to the basic form of self drainage. I learned it one specific way when I first got treatment for lymphedema and since it works quite well on my legs, I have used that way of doing it ever since.
I have described my way of doing it below. I learned self drainage by being supervised when doing it the first few times and I would advise other lymphedema patients to get the necessary guidance from health personel before conducting any self drainage on themselves.
IMPORTANT: You always do self drainage with yours hand lying flat on your skin while massaging your skin in circles from the same outgoing place of hand position. The rhythm of the massaging is very slow and gentle.
Self drainage – Step 1: Neck and collarbone
I start by massaging (gently!) in circles on the top of my collarbone. I do the circles in the direction of my heart.
Then I massage my neck, holding my hands on each side of the spine just beneath the level of my ears, in circles. Again, I do the circles in the direction of my heart, never in the direction in the top of my spine.
I do 5-10 repetitions on each place and then switch to the other place. I do this combined repetition a couple of times.
Self drainage – Step 2: Armpits
I then move on to the armpits. I massage both armpits at the same time, but you can also just do one at a time.
The massaging once again consists of my hands moving in circles towards the heart. The massage is done with a light pressure in the armpits.
When I first learned how to self drainage I did an exact amount of circles (like 15). But now I just do it for a minute or two because I works better for me.
Self drainage – Step 3: Deep breathing
Next I put my hands on my stomach and take deep breaths all the way down in my stomach, so the stomach is blown up like a balloon.
I prefer breathing both in and out through my nose, but you can also breathe in through your nose and out through your mouth.
I would advise no less than 8-10 deep breaths. I some times do much more while having my eyes closed – that way it has some kind of meditating effect on me which is a nice way to start the day.
Self drainage – Step 4: The legs
Important: Only work on one leg at a time. So do the complete massage on one leg before moving on to the next leg.
I always start with my left leg (don’t know why, probably just a matter of habit).
I start my massaging from the knee and down towards the hip. I do this all around the thigh, not just on the front. I also massage on the side of my knee where fluid has a tendency to clog up.
I then move on to the lower leg where I massage from my ankle towards my knee. After doing this massage on the entire lower leg, I focus on my ankle which often needs extra attention because of all the fluid clogging there.
Lastly I massage my foot in the direction of my toes to my ankles.
After doing my left leg I repeat the entire process on my right leg.
Tissue already gone hard
As I told up under “My story” my lymphedema started in my right leg, in my right ankle to be exact. Because the doctor thought it was just a strain, we did not do anything about it. The swelling then continued up through my right leg all the way up to the top of my thigh and then it suddenly “jumped over” to my left ankle with the result of me thinking: “Yep, this is probably not just a strain.”
Because I walked around for several months with the swelling without knowing that it was lymphedema and without getting the proper treatment, the tissue in my right ankle – where the swelling started – got hard. And when the tissue gets hard because of lymphedema, the enlarged part of your limb with the hard tissue is permanently damaged. This means that my right ankle always will be bigger than my left ankle, because I cannot make it any smaller or less swelled.
Because I have had so many erysipelas infections in my left leg now, I have also had some permanent damage in my right thigh in the shape of a small ball of hard tissue.
My physiotherapist back in 2012 told me that it would be a good idea to massage a bit less gentle on the areas where the tissue has gotten hard. This because it does not have much of an effect with the self drainage to massage gently on the places where the tissue is hard.
I have good experience with massaging quite hard on the areas where I have hard tissue. When I do my self drainage, I therefore shift a bit between the pressure depending on whether I massage on soft or hard tissue. But this is only my personal experience, so talk to your own physiotherapist or doctor before trying it out.