Dry brushing for lymphoedema management

Jennifer Dunn educates us on the self-management technique of dry brushing that can be used as part of your daily lymphoedema management routine.

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Whether you’re actively experiencing lymphoedema or your cancer treatment has placed you in an at-risk category, dry brushing can provide gentle skin manipulation required to effectively move and manage lymphatic fluid build-up within the skin.

Understanding the lymphatic system

The lymphatic system is found throughout the body. It consists of lymphatic vessels, lymph nodes, the thymus, spleen and bone marrow. Lymphatic vessels, like blood vessels, branch out to reach into all the tissues in the body. The lymphatic system absorbs, transports, and recycles products from the spaces between cells in our bodies. Lymph is made up of proteins, water, cells, fats, cell debris, white blood cells, cancer cells, bacteria, viruses, and many other molecules only the lymphatic system can handle. Lymph vessels are mainly located at the skin and the layer of tissue that underlies the skin and can be found throughout the entire body. 

Lymphoedema

If you had a surgery or procedure (radiation) that removes or damages lymph nodes and vessels, the lymphatic system is forced to function without all its parts. In most situations, the body is able to compensate but when the body becomes overwhelmed, lymphatic fluid will start to pool near the area where the damage occurred. This condition is known as lymphoedema.

Treatment options are being researched across the world. The consensus is that compression devices that prevent lymph from entering the damaged area and manual movement of the fluid (like when your lymphatic therapist does manual lymphatic drainage massage) remain the most effective ways to prevent and treat lymphoedema.

Dry brushing 

Sometimes self-massage is hard. Many therapists will teach or recommend dry brushing as an alternative or addition to self-massage as a way for you to manage your lymphoedema at home. A soft-bristled shower brush is great for dry brushing. If you want to start dry brushing right away but you haven’t gotten a brush yet, you can use a facecloth or hand towel.

You should always start and end with clearing your lymph nodes, using a firm circular motion. Your primary lymph node bundles are located in your armpits, base of neck (above the clavicle), in the groin and behind the knees.

Some suggest slow gentle long strokes while others encourage quicker shorter strokes. As long as the stroke of the brush is stretching your skin towards your lymph nodes, your dry brushing will be effective.

Lymphatic drainage works like a traffic system, you need to clear the congestion ahead to make room for what is coming behind. Thus, you start the massage at the top section of the affected limb (thigh or upper arm) and then brush the lower section (forearm and hand or calf and foot).

Basic arm sequence 

1. Clean the lymph nodes under your arm and at your elbow.
2. Brush across your chest (starting from the shoulder of your affected arm to the shoulder of your unaffected arm).
3. Brush from your elbow up to your armpit; make sure to go all the way around your arm.
4. Brush from your wrist to your elbow; make sure to go all the way around your arm. 
5. Brush the back of your hand, down into your forearm. 
6. Massage down each of your fingers. 
7. Now complete steps 1-5 of the above process in reverse order. 

If you’re experiencing lymphoedema or are at-risk, it’s a good idea to complete the above brushing daily for about 10-15 min. Make it part of your routine. When in doubt, brush towards your heart. If you become unsure, simply focus on moving lymph out of the limb and into the torso.

Don’t forget to breathe 

Deep breathing stimulates the vagal nervous system and aids in decreasing stress and inflammation in your body. Use the 4:8 breathing rule. Breathe deeply into your stomach for four seconds and exhale slowly and completely for eight seconds. Repeat 4 – 6 times at the end of your dry brushing routine.

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