Lymphatic drainage
Gentle, rhythmic hand techniques that get congested tissue fluid moving – for swelling after surgery, lymphoedema and lipoedema.
Areas of application
When lymphatic drainage is prescribed
After surgery, after an injury, or with a permanently weakened lymphatic system, fluid builds up in the tissue. Manual lymphatic drainage channels it away via healthy pathways – it is prescribed among other things for lymphoedema and lipoedema, for swelling after joint and breast surgery, and after sports injuries.
After surgeries
After knee, hip and shoulder surgeries as well as breast procedures, the tissue swells. Decongestion creates space, allowing you to move your arm or leg more freely again.
Lymphoedema and lipoedema
For chronic oedema, lymphatic drainage is part of a longer-term therapy – often combined with compression and exercise, repeated over several prescriptions.
After injuries
Bruises, sprains and fractures leave behind swelling that slows down the healing process. Early decongestion supports mobility as you continue to build strength.
How a session works
Light pressure, many repetitions
Lymphatic drainage works with very light pressure. Using circular, pumping and scooping hand movements, our hands follow the course of the lymphatic vessels, always opening from the torso towards the periphery and then back again. We begin at the neck and torso to clear the drainage pathways, and only then move to the swollen region.
Many patients find the treatment calming; it should not be painful. Where it makes sense, we add compression, breathing and movement exercises that keep the fluid moving between appointments.
- Brief assessment: circumference, skin condition, mobility
- Decongestion of the lymph nodes at neck and torso
- Rhythmic hand movements along the affected pathways
- Compression or bandaging afterwards if needed
- Exercises for home that support drainage
- Progress notes for the next appointment
Typical reasons
Why patients come to us
The prescription usually comes from the hospital, the GP practice, or orthopaedic aftercare – these are the reasons we see most often.
- Swelling after joint surgery on the knee, hip, ankle or shoulder
- Arm swelling after breast surgery and lymph node removal
- Oedema after injuries: bruises, torn ligaments, fractures after cast removal
- Chronic lymphoedema in arms or legs over longer treatment periods
- Lipoedema with a feeling of tightness and pressure sensitivity in the legs
- Swelling after prolonged immobilisation or limited mobility
Treatment process
How a decongestion session works with us
Manual lymphatic drainage is not a firm massage but a very gentle hand technique applied directly to the skin. We work with circular, pushing and pumping movements and light pressure so that the fine lymphatic vessels open and the stored tissue fluid can flow towards the healthy lymph nodes. That is why every session begins not at the swelling itself but at the neck and torso. How long each section takes depends on the prescribed treatment time and on the affected part of the body.
The four phases of a session
The order and content follow the same structure for every treatment; we set the priorities according to findings.
Recording the swelling
We examine the affected region, palpate the tissue and check whether it can be gently indented or has already hardened. On the arm or leg, we measure the circumference at fixed points as needed, so that changes can be tracked over the course of treatment.
Questions about your history
What matters to us are operations, removed or irradiated lymph nodes, wound conditions, heart and kidney disease, and acute infections. Some of these factors speak against treatment on a given day, in which case we consult with the referring practice.
Opening the drainage pathway first
Lymph ultimately drains into the bloodstream near the collarbone hollow. We work on this final stretch first, using calm, circular strokes on the neck. Only once space has been created there can fluid flow in from more distant parts of the body.
Calm breathing
We incorporate deep abdominal breathing. The movement of the diaphragm acts like a pump on the deep lymphatic vessels in the trunk and noticeably supports the manual techniques.
From the trunk towards the swelling
We work from areas closer to the trunk towards those further away — for the leg, from the groin over the thigh to the knee, and only then to the lower leg and foot. This way, the fluid is moved along step by step rather than pushed against a full, blocked stretch.
Using rerouting pathways
If lymph nodes have been removed, for example in the armpit after breast surgery, we reroute drainage across watershed areas to the healthy side of the body or towards the groin. These rerouting techniques are the core of treatment after surgery.
Compression and movement
Directly after decongestion, the tissue is soft. To help keep it that way, we recommend compression with bandages or the medically prescribed compression stocking, along with gentle movement such as ankle pumps or calm walking.
Exercises for home
You will receive a few easy-to-remember exercises: breathing exercises, joint movements for the affected limb, and guidance on skin care, since dry skin tears more easily and can create entry points for infection.
What to bring to your first appointment
Prescription and practice
Prescription, treatment time and typical cases
Manual lymphatic drainage is a remedial therapy and is prescribed by a doctor. Along with the diagnosis, the prescription specifies the treatment duration — usually 30, 45 or 60 minutes. This duration determines how many body areas can be treated in one session. Compression bandaging is often prescribed in addition. Patients with statutory health insurance pay the legal co-payment, while privately insured and self-paying patients receive an invoice according to our price list.
Questions about: physiotherapy, manual therapy
Briefly describe what it's about – Physiopraxis Nord will get back to you with an initial assessment.