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What is Manual Lymphatic Drainage?

  • 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 Manual lymphatic drainage STEP TWO

  • 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. Manual lymphatic drainage STEP THREE.

  • 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


  • 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 Manual lymphatic drainage STEP FOUR.

STEP FIVE for Manual Lymphatic Drainage

Finally, the fluid from your arm is ready to move. Think of it like connecting the dots! Manual lymphatic drainage STEP FIVE.

  • 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


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