What is Manual Lymphatic Drainage?
- Lymphatic vessels are disrupted during surgery such as a mastectomy, and when lymph nodes are removed. Research shows that Manual Lymphatic Drainage may reduce the risk of swelling and lymphedema after mastectomy.
- Manual Lymphatic Drainage helps the lymphatic fluid in your body find alternate routes back to the heart. Think of it like re-routing traffic when an accident occurs on the highway.
- When your lymph vessels in the armpit and breast area are healing, we can use other routes, such as the nodes near your groin area to get fluid back to the heart and reduce swelling.
- Imagine a traffic jam; until you clear the cars blocking the way, no amount of pushing or honking will get the traffic to flow – you will just end up with an overheated car and a headache. In the body, we need to clear the system that drains to the heart in order as well.
Instructions for Manual Lymphatic Drainage
- Do this 4-5 times daily after mastectomy until you see your physical therapist
- If you perform MLD consistently, it improves the chances that:
- Your drains will come out sooner
- Your pain will be reduced
- You will heal faster
- You will be able to get back to your normal activity sooner
STEP ONE for Manual Lymphatic Drainage
Neck exercises stimulate the end point of the lymphatic system near the collarbone where it re-joins the veins to dump into the heart.
Perform these movements 10 times each:
- YES – nod head up and down
- NO – shake head side to side
- MAYBE – shoulder circles backward
- I DON’T KNOW – tilt ear toward shoulder
STEP TWO for Manual Lymphatic Drainage
Deep Breathing
- Inhale deeply through your nose, allowing your belly to expand like a balloon being blown up with air. Your chest should stay quiet.
- Exhale through your mouth. Slightly squeeze your belly tight at end of exhale
- This should be quiet, relaxed breathing – if you get light-headed, stop and relax and try again.
STEP THREE for Manual Lymphatic Drainage
Use the lymph nodes near your groin area to clear the fluid. 
- In standing, place hands at the front of your groin in the creases. Imagine putting your hand in your pocket.
- Pull skin gently away from the groin, stretching the skin up and to the side, as if your hand is coming out of your pocket. Keep full hand contact.
- Repeat 10 times
STEP FOUR
- Start with your hand in your armpit and pull gently down towards hip area, gently stretching the skin all the way down to the groin. This can be done in standing or in sitting.
- Repeat 10 times
STEP FIVE for Manual Lymphatic Drainage
Finally, the fluid from your arm is ready to move. Think of it like connecting the dots!
- Start at the wrist and gently stretch skin all the way up the arm and towards the neck.
- End at the point right above your collarbone and next to neck.
- Repeat 10 times
A NOTE ABOUT SWELLING AFTER MASTECTOMY
- In conclusion, even if you are consistent with performing Manual Lymphatic Drainage after your mastectomy, you may still develop swelling in the arm on the side of the surgery. If this is the case, a physical therapist trained in lymphedema management is the best resource.
- Compression techniques and continuing MLD with the help of a PT can reduce and manage swelling.