Can Moderate or Deep Pressure be Applied in Lymphatic Drainage?

Can Moderate or Deep Pressure be Applied in Lymphatic Drainage?

Author:  Selena Belisle, Owner/Instructor, CE Institute LLC, Miami FL 

Question: Can Moderate or Deep Pressure be Applied in Lymphatic Drainage?

Answer: No, No, No, No, and HELL NO!!!!!

Lymphatic Drainage is typically considered a bodywork to reduce facial or body swelling through specialized skills, techniques and practices.  It is not the same as Swedish massage which would encourage strokes towards the heart to promote venous return.  In massage we promote blood circulation.  In lymphatic drainage, we teach you to work with something entirely different. 

While massage generally promotes strokes towards the heart, some lymphatic strokes work away from the heart to promote true lymphatic drainage.  Lymphatic drainage is different from almost any other form of massage or bodywork.  Lymphatic drainage requires specialized training, and should be sought in a live hands-on class where an instructor can observe and provide feedback of your hands-on practice.

Some leading reasons why a client might want a specialized lymphatic drainage session is because they suffer from lymphedema - which is a permanent medical dysfunction of the lymphatic system.  They could also have swelling from a sports strain, or swelling from oncology treatments such as radiation.  Lymphatic drainage is a wonderful modality to relieve swelling without pharmaceutical intervention for any of these conditions.

In order to relieve swelling in the body via lymphatic drainage, we would want to take extra interstitial fluid within the tissues and encourage this fluid to enter the lymphatic system.  The lymphatic capillaries that collect this fluid are miniscule.  In theory, if you apply too much pressure to these miniscule capillaries, they will simply collapse and not collect any fluid until they reconstitute themselves.  Lymphatic drainage strokes are designed to encourage extra interstitial fluid to be collected by these miniscule capillaries to promote true drainage of the tissues.  This excess fluid will then travel through larger and larger lymphatic vessels and ducts - and eventually make it's way back to the heart.

I believe the reason why some therapists are practicing deep tissue and misnaming it lymphatic drainage, is because there can be some tissue changes leading to some fluid drainage with a deep tissue massage.  That is because common problems such as stress, overuse, and misuse of the body, can lead to muscle tightness.  This muscle tightness will create excessive pressure on circulatory capillaries and vessels which can obstruct overall general circulation.  So, when an effective deep tissue session is provided, the tight tissues that are compressing the microcirculatory vessels relax and allow better "drainage" of the tissues.  However, this deep tissue massage result should NOT be called lymphatic drainage - it's NOT.  Better fluid exchange within the tissues is a simple benefit of general increased circulation with a good massage.  Deep tissue or moderate pressure massage should never be confused with the specialized skills and strokes developed to encourage the uptake of interstitial fluid into miniscule lymphatic capillaries for true lymphatic drainage. 

What's more important to note is that any deep tissue massage practiced on swelling is likely to produce more swelling and tissue damage.  That is because applying pressure to swollen and stretched tissues may further stretch or tear the tissues which will cause more swelling.  That is why swelling is a general massage therapy contraindication; however, swelling IS indicated for lymphatic drainage (minus a few contraindications)

It's one thing when a therapist practices deep tissue massage and increases overall circulation as a result - but it could be damaging and harmful to practice that same deep tissue on a lymphedema and expect something positive to happen - you'll likely be sorely disappointed (or have a claim for malpractice). 

In summary, deep tissue, myofascial release and other moderate to deep pressure techniques are NOT, and will never will be, appropriate lymphatic drainage bodywork techniques - 24/7/never. Please click HERE to if you would like to learn more about lymphatic drainage and other available classes at CE Institute LLC.


Author Selena Belisle is the Founder of CE Institute LLC in Miami FL.  She is a retired professional athlete and has been practicing massage therapy for over 30 years.  Selena is an approved CE Provider with NCBTMB & the Florida Board of Massage.  She now teaches full time for the Complementary and Alternative Health Care Industries. You can learn more about Selena’s training and CE classes at


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