Archive for Contraindications

Massage Yourself: Self Lymphatic Drainage for the Legs

When I walk in crowds, or people watch at a concert, I inevitably find myself watching the way people move and what their bodies look like. In summer, when it’s hot and everyone wears shorts or skirts, I notice swelling in the legs/ankles and foot. This time of year, in the heat, many people have swollen ankles and feet, especially.

Swelling and edema in the legs can be incredibly uncomfortable and I’ve had a lot of requests for a lymphatic drainage routine for the legs. I’ve put together a video that demonstrates how to work on the legs, but there’s an important piece of information you’ll need to understand. In order to move fluid in the body, you must make space for that fluid further up the line. Because the lymphatic system is a dynamic fluid system, you need to open up areas close to the drains so that fluid can siphon up higher in the system toward the main drains. For legs, that means you must get movement in the neck and throughout the abdomen.

So, to perform this drainage technique on yourself, you’ll need to work on the neck first, then the lymphatic breathing, then abdomen/torso, and finally this leg routine. If you have severe edema, lipodema, or long-standing swelling issues from an unknown cause, you’ll want to work with your physician before trying this on yourself. Keep in mind that you will be using extremely light pressure, and very slow movements. This is light massage, but can make powerful changes throughout the body.

There are important contraindications to lymphatic drainage massage:

As with all lymphatic drainage massage, there are contraindications. While it is a light form of massage, it is very powerful and can have a broad effect on the body. Note that if you are pregnant, you can safely perform the lymphatic breathing routine, but should not perform the routine in the second abdominal video where there is manipulation of and pressing down on the abdomen.

While it doesn’t feel invasive or deep, LDM can have a profound effect on the body because of its function within the immune system and its use of the circulatory system. If you have any of these conditions or problems, consult your physician before performing this on yourself:

  1. Fever, acute infection, early onset inlammatory disease. You need to wait until the acute phase is over and the fever is broken.
  2. Circulatory system problems, especially thrombosis. If there is any risk of embolism of phlebitis, do not use LDM and see your physician immediately
  3. Cardiac issues such as heart disease, acute angina pectoris or coronary thrombosis (heart attack). Using LDM increases the fluid load on the heart, and compromised cardiac systems should not be subjected to LDM.
  4. Active bleeding, internal or external.
  5. Active malignant cancers, undiagnosed lumps, or tumors whose origins have not been determined by your physician.
  6. High risk pregnancy or late term pregnancy with complications

Contraindications specific to the abdominal and leg routine are abdominal aneurism or thrombosis/phlebitis.

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Abdominal Lymph Drainage Part 2

Last week we covered a great technique called Lymphatic Breathing that helps pull fluid from the legs and trunk. This week, we continue that same routine, and move to performing some light lymphatic manipulation of the abdomen, using light pressure on the belly to affect the fluid in the torso and legs.

I’ve found this technique to be a wonderful way to reduce feeling “full” or “heavy” in the torso. It’s also helped, in conjunction with the breathing we showed in part 1 (Reduce the Bloat! Abdominal Lymphatic Massage), reduce swelling in my ankles, legs and feet. It improves digestions, softens the bowels and clients tend to report that it eases stomach issues as well.

Lymphatic work is very light in terms of pressure.  Also, I can’t overstate the importance of the lymphatic breathing in part 1 – it is CRITICAL to pulling fluid up out of the legs and torso.

This technique has the same contraindications of as the previous lymphatic drainage, so look back to this entry before you try this on yourself.  If you are pregnant, you can perform the lymphatic breathing technique, but do not perform these abdominal manipulation techniques.

As always, those seeking massage in Louisville can try these techniques out on the table before trying them on one’s self. Just let me know you’re interested in the abdomen work in your next session and you’ll be able to see how it feels.


“I Think I Just Threw a Clot!”

medical monitor

Blood clots are serious business. It’s important to know the symptoms and risk factors of blot clots. However, it’s estimated that 30-50% of people who suffer blood clots have no prior symptoms. They have serious complications if they are not treated: if they dislodge they could cause a pulmonary embolism.

I did a little research on, one of my favorite medical information sites, and found the following list of symptoms of blood clots:

Symptoms occur in the affected leg when a clot obstructs blood flow and causes inflammation. Symptoms may include the following:

  • Swelling Gradual onset of pain
  • Redness
  • Warmth to the touch
  • Worsening leg pain when bending the foot
  • Leg cramps, especially at night
  • Bluish or whitish discoloration of skin

However, almost 30%-50% of individuals with deep vein thrombosis do not experience symptoms from the condition.

via Deep Vein Thrombosis Blood Clot in the Leg, DVT.

That last sentence is a key piece of information. For 1/3 to 1/2 of all people who have a blood clot there are no outward symptoms. That’s pretty scary.  Because of this, I also wanted to include some risk factors that may lead to deep vein thrombosis.

First of all, what causes the formation of a blood clot in a blood vessel:

Three factors may lead to formation of a clot inside a blood vessel.

  • Damage to the inside of a blood vessel due to trauma or other conditions
  • Changes in normal blood flow, including unusual turbulence, or partial or complete blockage of blood flow
  • Hypercoagulability, a rare state in which the blood is more likely than usual to clot

Any component that contributes to one or more of these three criteria can cause deep vein thrombosis. The more common risk factors are as follows:

  • Prolonged sitting, such as during a long plane or car ride
  • Prolonged bed rest or immobility, such as after injury or during illness (such as stroke)
  • Recent surgery, particularly orthopedic, gynecologic, or heart surgery
  • Recent trauma to the lower body, such as fractures of the bones of the hip, thigh, or lower leg
  • Obesity
  • Heart attack or heart failure
  • Recent childbirth
  • Being at very high altitude, greater than 14,000 feet
  • Use of estrogen replacement (hormone therapy, or HT) or birth control pills
  • Cancer
  • Rare inherited genetic changes in certain blood clotting factors
  • Disseminated intravascular coagulation (DIC), a medical condition in which blood clotting occurs inappropriately, usually caused by overwhelming infection or organ failure
  • Certain heart or respiratory conditions
  • Advanced age

If an individual has one deep vein thrombosis, they are more likely to have a second deep vein thrombosis.

via Deep Vein Thrombosis (Blood Clot in the Leg, DVT). (my emphasis)

This is important for massage therapists, as massage effects the circulation in the legs when strokes are used on the tissue. Massage could even dislodge a blood clot in the legs if deep, vigorous strokes are used. Be aware of your own body, any trauma to the legs and take note of any DVT symptoms in your legs immediately.

Let your massage therapist know if you have any of the symptoms of DVT or if you’re at risk given the factors listed above.  See your physician immediately if you have any symptoms of a blood clot.

Photo from user hamma at