Lymphatic Facilitation
Who can benefit from this work?
Lymphatic facilitation can be helpful in reducing swelling and speeding up recovery from acute injury or surgery, such as:
. This work is best suited and most helpful to clients in the early stages of healing when there is:
This work can also be helpful shortly before a planned surgery to get the lymphatic system going and reduce initial swelling.
It is not a replacement for primary care or physical therapy, but can be a very helpful complimentary treatment.
- gender-affirming surgery
- orthopedic reconstructive surgery
- joint replacement
- sprains
- strains
- fractures
. This work is best suited and most helpful to clients in the early stages of healing when there is:
- bruising/discoloration
- swelling
- lingering local inflammation in the months after injury or surgery
This work can also be helpful shortly before a planned surgery to get the lymphatic system going and reduce initial swelling.
It is not a replacement for primary care or physical therapy, but can be a very helpful complimentary treatment.
when is this work not appropriate?
Lymphatic Facilitation is unfortunately not suited to chronic conditions such as those listed below. Practitioners trained in the much more in-depth modality of Manual Lymphatic Drainage may be able to help in such cases.
This work is also contraindicated for folks experiencing:
Treatment may be appropriate but may need to be modified for clients with any of the following. Please inform your provider if any of these applies to you:
- lymphedema resulting surgical removal or radiation treatment of lymph nodes (usually as part of cancer treatment)
- edema resulting from heart or circulatory conditions
- congenital lymphedema
- lymphedema caused by a virus, infection, or filarial parasite
This work is also contraindicated for folks experiencing:
- congestive heart failure
- kidney disease
- active cold or flu
- major infections anywhere
Treatment may be appropriate but may need to be modified for clients with any of the following. Please inform your provider if any of these applies to you:
- asthma
- hyperthyroidism
- current malignant disease
- pregnancy
- low blood pressure
- recent venomous stings or bites
What is it? How does it work?
When an injury or surgical site is swollen and/or bruised, the injury or surgery has allowed proteins that under normal circumstances stay in the capillaries to leave the circulatory system and leak into surrounding tissues. These proteins are too large to be easily reabsorbed into the bloodstream. They linger in and draw fluid to the affected area by osmosis. The body will eventually break down and reabsorb these proteins and the excess fluid they bring, but we can significantly speed up the process by engaging with the lymphatic system to move them into the circulatory system, so they can be filtered through the kidneys, and the excess fluid passed as urine.
Gentle, skin-level engagement at the neck (where lymph reenters the circulatory system) helps clear the way. Compressions within the client's comfort level help move fluid through major lymph vessels and lymph nodes. And again, gentle, skin-level engagement near the site of injury/surgery helps open lymph vessels so that they can absorb and remove excess fluids and proteins.
Gentle, skin-level engagement at the neck (where lymph reenters the circulatory system) helps clear the way. Compressions within the client's comfort level help move fluid through major lymph vessels and lymph nodes. And again, gentle, skin-level engagement near the site of injury/surgery helps open lymph vessels so that they can absorb and remove excess fluids and proteins.
What can I expect from a session?
After a brief intake and assessment, lymphatic facilitation treatment begins at the neck and just above the clavicles, with gentle skin-level engagement and gentle compressions to help clear the way for lymphatic fluid to reenter the bloodstream at the subclavian vein near each collarbone. Depending on the location of the swelling to be addressed, the practitioner may then use compressions – always checking in with the client to calibrate for comfort – to help move fluid through major vessels and lymph node beds between the area to be treated and the neck. Depending on the location of the swelling we are working to reduce, this may include a series of compressions at the abdomen, working with the client’s deep breaths, to help move fluid through major vessels deep in belly, and compressions at lymph node beds such as in the armpit, hip crease, or behind the knee. There will again be rhythmic, skin-level work around the edges of the swollen or bruised area.
This work is done with the client laying on a massage table, mostly face up. Based on the client’s preference, the client can be fully clothed in comfortable, loose-fitting clothes – think pajamas – as long as clothing allows direct access to the skin at the neck and collarbones, and at the swollen or bruised site. Loose pantlegs can be pulled up over the knee to treat the lower leg. Work around the hip is easier with baggy shorts. The work can also be done with the client undressed to the client’s level of comfort and under a sheet and blanket, similar to a massage session. In supporting recovery from gender-affirming surgery, we will not be working directly with any breast tissue, nipples, or genitals and these areas will remain covered. We will be working with the skin of the upper chest and side of the ribcage or upper thighs and lower abdomen as well as relevant lymph node beds in the armpits or hip creases.
Lymphatic facilitation is offered as part of a 60-or 90-minute session in combination with craniosacral therapy, or in certain cases as a stand-alone 30-minute follow-up treatment for return clients only.
This work is done with the client laying on a massage table, mostly face up. Based on the client’s preference, the client can be fully clothed in comfortable, loose-fitting clothes – think pajamas – as long as clothing allows direct access to the skin at the neck and collarbones, and at the swollen or bruised site. Loose pantlegs can be pulled up over the knee to treat the lower leg. Work around the hip is easier with baggy shorts. The work can also be done with the client undressed to the client’s level of comfort and under a sheet and blanket, similar to a massage session. In supporting recovery from gender-affirming surgery, we will not be working directly with any breast tissue, nipples, or genitals and these areas will remain covered. We will be working with the skin of the upper chest and side of the ribcage or upper thighs and lower abdomen as well as relevant lymph node beds in the armpits or hip creases.
Lymphatic facilitation is offered as part of a 60-or 90-minute session in combination with craniosacral therapy, or in certain cases as a stand-alone 30-minute follow-up treatment for return clients only.
marc maupoux, lmt, ccst
lic# MA60403982
lic# MA60403982