How to do self-lymphatic massage on your head and neck

Source: Lymphoedema services

Reference No: 6669-1

Issue date: 8/10/20

Review date: 8/20/23

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How to do self-lymphatic massage on

your head and neck

What to avoid

• Do not strain your shoulders, neck, arm or hand

• Do not self-massage in a way that causes pain

• Do not continue self-massage if it is causing you pain

• Do not self-massage if you have an infection in that area

Important: Do not do self-massage if you have an infection in your head or neck.

Signs of infection may include:

• Swelling in these areas and redness of the skin (this redness can quickly

spread)

• Feeling pain in the head and/or neck

• Feeling tenderness and/or warmth in the head/neck

• Having a fever or chills and feeling unwell

If you have an infection or think you have an infection, go to:

• Your GP

• Walk in centre

• Urgent care clinic

• Emergency department

• NHS 111 out of hours service

You will require x2 weeks of double strength antibiotics, as per the British

Lymphology Society guidelines, available at:

https://www.lymphoedema.org/images/pdf/cellulitisconsensus.pdf

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What is the lymphatic system?

Your lymphatic system removes fluid build-up and

waste from your body and plays an important role in

your immune function. It is made up of lymph nodes

that are connected by lymph vessels.

Large groups or chains of lymph nodes can be found in

your neck, under your arms and in your groin (see

picture to the right).

How does self-massage help with

lymphoedema?

Self-lymph drainage, or SLD, is a special type of gentle

massage that helps move extra fluid from an area that

is swollen (or is at risk of becoming swollen), into an

area where the lymph nodes are working properly.

This is done by stimulating contractions of lymphatic

vessels.

The anatomy of the lymphatic system in the head and neck

Occipital lymph

nodes

Parotid lymph nodes

Submental lymph nodes

Submandibular lymph nodes

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The normal flow of lymphatic fluid in the head and

neck.

Instructions for doing self-massage

• Use a light pressure and keep your hands soft and relaxed. The pressure of your

hands on your skin should be just enough to gently stretch the skin as far as it

naturally goes, and then releasing. If you can feel your muscles underneath your

fingers, then you are pressing too hard.

• Use the flats of your hands instead of your fingertips. This allows more contact with

the skin to stimulate the lymph vessels

• Massage towards areas of your body that have not been affected with

lymphoedema.

• Try to do the massage when you are comfortably warm because your muscles will

be more flexible.

• Make sure you are comfortable while doing the massage. You can try a seated,

standing or lying down position.

• Try to do self-massage every day.

• If you need to do the massage on both sides of your body, start on one side of your

body and go through each step. Once you have completed the steps on one side,

repeat them on the other side of your body.

Try different ways to make self-massage a part of your routine. Some people prefer to

do self-massage while they are watching TV or having a shower so that it does not

take time away from their day. Other people prefer to use self-massage as time for

themselves or as part of their relaxation routine.

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1. Stimulate your lymphatic system with deep breathing

A very important part of your self-care is deep breathing. Deep breathing helps to

stimulate lymphatic system in your whole body. You can practice deep breathing

anytime!

• Place the palms/flats of your hands on your stomach

• Slowly, breathe in deeply through your nose, and let your stomach expand

• Breathe out slowly through pursed lips, and let your stomach flatten

• Repeat 5 times. Take a short rest between each breath so you do not get dizzy

2. Prepare your lymph nodes BEFORE Massage

This step prepares the lymph nodes that sit just above your collarbone and your

underarm to take in lymph fluid from your face and neck during massage.

• Place the flats of your 2nd and 3rd fingers on either side

of your neck, just above your collarbone. Do a shoulder

shrug up and feel the dip in the skin. This is the correct

position.

• Massage down and inwards towards your collarbone.

Always keep your fingers above your collarbone. Gently

stretch the skin just as far as it naturally goes and release.

• This massage will look like two “J” strokes facing one

another.

• Repeat 15 times.

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You can massage one side at a time or both sides at the same time. Cross your

hands if you are doing both at the same time.

Place your arm in a comfortable position slightly elevated

and supported. If needed, try placing your arm on an

armrest or table for comfort.

• Place your palm against your underarm

• Gently pull up and in towards your body, then release

• Repeat 10 to 15 times.

• Repeat this action on your other underarm

3. Stretch and release the skin at the side of your neck

You can massage one side at a time, or do both sides together.

• Place your flat hands on either side of your neck,

just under your ears

• Gently stretch the skin back (away from your face)

and down, then release

• Try to massage your neck in a slow, gentle way,

following a rhythm

• Repeat 10 to 15 times

Remember: Keep your pressure light.

4. Stretch and release the skin on the back of your neck

• Place your flat hands on the back of

your neck, just below your hairline

on either side of your spine

• Stretch the skin towards your spine

and then down towards the base of

your neck and release

• Repeat 10 - 15 times

Tip: This can also be done using a soft ball, rolled up flannel or hand towel and

pumping your arm against your chest wall.

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5. Stretch and release the skin from your upper chest downwards

away from the head and neck

• Place you hand on your collarbone. Move your hand

down toward your underarm. This massage will move

the lymph fluid from your neck and chest to your

underarm lymph nodes.

• Gently stretch the skin (not muscles) down your chest

and towards your underarm. Then let go of the skin.

• Repeat this massage 10 - 15 times.

6. Massage your scar

Massage your scar. This massage is

only if you have had surgery. Do not

massage until three weeks after

surgery. Do not massage until all

staples and clips have been removed.

Your scar may feel very sensitive,

tight or itchy. Scar massage will help

reduce these feelings.

This massage helps soften the scar

and allows better blood flow to the

area. You should not experience pain

when massaging your scar.

• Place the palm of your hand over the scar

• Move up and down in a zigzag pattern or circle pattern along the scar (as above)

• Apply firm but gentle pressure whilst moving along the scar - try to move the skin, if

possible lift the skin along the scar

• Repeat 5 times along the scar

• Now place your fingertips just above the scar and gently strech the skin away from

the scar and release. Repeat this action 5 times.

• Place your fingertips below the scar, gently stretching the skin away from the scar,

and releasing. Repeat 5 times.

Tip: Do not use oil while doing the scar massage. Apply any lotions or oils after the

massage.

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7. Massage for face swelling

• Stroke above and below your lips finishing in front of

your ears where your side burns are

• Stroke from bridge of nose outwards across your cheeks

finishing in front of your ears. Start at the tip of your

nose.

• As above working upwards towards your eyes, being

careful not to press too hard around the eye area

• Lightly pinch the eyebrows, starting from the inner brow

moving outwards to the outer eyebrows to facilitate

lymphatic drainage towards the peri-auricular lymph

nodes in front of your ears

Peri-auricular lymph nodes

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• Stretch the skin from the outer forehead, working down to

your side burns.

8. Massage for swelling inside the mouth

9. Massage for the back of the head

Gently stretch the skin from the outer back of the head down towards the neck.

Follow the numbered diagram above starting at number 1. Then continue to

stretch the skin at the level of number 2, then 3 (see next page).

Tip: Do not massage inside your mouth if you have got any sores, cuts or

pains.

Ensure hands are clean.

You can use an electric toothbrush to assist in massaging the inside of your

mouth but remember to keep the pressure light.

A good exercise for assisting in facial swelling is to try and stretch your mouth

open wide. You can do this whilst pronouncing “A, E, I, O, U”.

Do not stretch your mouth wide open if it is painful.

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Repeat each row x3 then stroke down to armpit across the central shoulder blades,

following the large arrows above.

If you would like any information regarding access to the West Suffolk Hospital and its

facilities please visit the website for AccessAble (the new name for DisabledGo)

https://www.accessable.co.uk/organisations/west-suffolk-nhs-foundation-trust

Contact information

If you have questions about self-lymphatic massage, please contact the

Lymphoedema Clinic:

Telephone: Landline: 01284 712732 – the answerphone is monitored

regularly so please leave a message if there is no answer

E-mail: wsh-tr.wslymphoedemaserv[email protected]