Treatment of the lymphatics

Treatment of the lymphatics

OMM

OMM

Biomechanics: Muscle contractions
Components of the osteopathic structural examination
Fryette laws
Trigger points
Diagnostic skills
Introduction to muscle energy
Introduction to counterstrain
Introduction to facilitated positional release
Introduction to myofascial release
Introduction to high velocity low amplitude (HVLA)
Diagnosing cervical somatic dysfunction
Spurling test
Cervical muscle energy treatment
Cervical spine counterstrain
Cervical spine HVLA
Still technique for the cervical spine
Cervical spine facilitated positional release
Cervical spine myofascial release
Other cervical spine treatments
Diagnosing thoracic spine somatic dysfunction
Thoracic muscle energy treatment
Thoracic spine counterstrain
Thoracic spine HVLA
Still technique for the thoracic spine
Thoracic spine facilitated positional release
Thoracic spine myofascial release
Other thoracic spine treatments
Diagnosing lumbar spine somatic dysfunction
Lumbar muscle energy treatment
Lumbar spine counterstrain
Lumbar spine HVLA
Still technique for the lumbar spine
Lumbar spine facilitated positional release
Lumbar spine myofascial release
Other lumbar spine treatments
Diagnosing sacral somatic dysfunction
Sacrum muscle energy treatment
Sacrum counterstrain
Sacrum myofascial release
Diagnosing pelvis somatic dysfunction
Pelvis muscle energy treatment
Pelvis counterstrain
Other pelvis treatments
Diagnosing lower limb somatic dysfunction
Special tests for the lower limb
Lower limb muscle energy treatment
Lower limb counterstrain
Lower limb HVLA
Lower limb myofascial release
Other lower limb treatments
Diagnosing upper limb somatic dysfunction
Special tests for the upper limb
Upper limb muscle energy treatment
Upper limb counterstrain
Upper limb HVLA
Upper limb myofascial release
Other upper limb treatments
Diagnosing rib somatic dysfunction
Muscle energy for rib somatic dysfunction
Rib counterstrain
Rib HVLA
Other rib treatments
Viscerosomatics and facilitation
General visceral techniques
Chapman points
Primary respiratory mechanism
Cranial osteopathy: Cranial nerves
Diagnosing cranial somatic dysfunction
Cranial treatments
Treatment of the lymphatics

Notes

Lymphatics

Treatment of the lymphatics

HEENT*
TREATMENT
TECHNIQUE
Auricular drainage
  • Patient is supine with head turned to one side, cephalad hand stabilizes the patient’s head
  • Place caudad hand flat against side of the head with the patient’s ear between the 3rd and 4th fingers
  • Make repetitive circular motions with the caudad hand moving the skin and fascia over the surface of the skull
Mandibular drainage
(Galbreath technique)
  • Patient is supine with head turned toward you, cephalad hand stabilizes the patient’s head
  • Place fingertips of caudad hand along posterior ramus of the mandible and hypothenar eminence along the body of the mandible
  • Instruct the patient to slightly open mouth while you exert gentle pressure on the mandible to draw it slightly forward and toward the midline; repeat in a slow, rhythmic fashion
Trigeminal stimulation
  • Patient is supine
  • Apply gentle pressure in a circular motion at the supraorbital (CN V1), infraorbital (CN V2), and mental (CN V3) foramina
Facial effleurage
  • Patient is supine
  • Place fingertips along the superior aspect of the eyebrows
  • Gently and slowly run the fingers laterally along the supraorbital ridge then inferiorly toward the TMJ
Frontonasal distraction
  • Patient is supine
  • Place cephalad hand on the frontal bone and apply a gentle cephalad traction
  • Place 1st and 2nd finger of caudad hand on either side of the nasal bones and apply a gentle caudad traction
Alternating nasal pressure
  • Patient is supine
  • Place tips of thumbs at the junction of the nasal and frontal bones
  • Exert pressure diagonally and alternate sides
CERVICAL LYMPH NODES
TREATMENT
TECHNIQUE
Cervical chain drainage
  • Patient is supine with head turned to one side
  • Cephalad hand stabilizes the patient’s head, caudad hand makes broad contact over the sternocleidomastoid (SCM)
  • Roll your fingers in a lateral to medial motion and repeat as you move caudally along the SCM
Anterior cervical arches
  • Patient is supine, cephalad hand stabilizes the patient’s head
  • Place 1st and 2nd finger of caudad hand to form a horseshoe over the anterior cervical arches region
  • Alternate contact with the lateral aspects of the hyoid, laryngeal cartilages and upper tracheal rings, gently pushing them from one side to the other
DIAPHRAGM / THORACIC RELEASE
TREATMENT
TECHNIQUE
Thoracic inlet myofascial release
  • Stand behind the seated patient
  • Place hands over thoracic inlet with fingertips touching the clavicles, fingers on scalenes, and thumbs touching at midline at T1 level
  • Assess myofascia in all three planes of motion (rotation, side bending, flexion / extension) and determine which breath cycle exhibits less tension
  • “Stack” the tissues at the position of ease until a release is palpated
Thoracoabdominal diaphragm release
  • Stand behind the seated patient
  • Place hands around thoracic cage and fingers underneath costal margins
  • Move torso and thoracic tissues to determine their directions of ease, then hold the patient’s torso and tissues in this position until the fascia releases and settles into a rhythmic vertical motion
Thoracic pump
  • Patient is supine, stand at the head of the table
  • Place hands on the anterior thoracic wall with thumbs pointing caudally and fingers pointing laterally
  • Induce a rhythmic pumping action (pushing with exhalation and releasing with inhalation)
  • Active variation: apply pressure onto the chest wall with exhalation and  maintain pressure while patient inhales. During the patient’s 3rd or 4th inhalation, rapidly remove hands from their chest to promote large intrathoracic pressure changes
OTHER
TREATMENT
TECHNIQUE
Suboccipital release
  • Patient is supine
  • Place fingertips inferior to the inferior nuchal line at the area of the suboccipital musculature
  • Balance the head and neck on your fingertips and maintain gentle pressure in this position until the tissues soften
Pedal pump
  • Patient is supine
  • Grasp patient’s feet and place them in dorsiflexion
  • Induce a rhythmic motion by alternating dorsiflexion and plantar flexion

* HEENT: these techniques can be performed with you sitting at the head of the table or to one side of the patient
Author: Arman Israelyan, OMS-III
Editor: Matt Lipinski, DO
Editor: Robyn Hughes, MScBMC

Key Takeaways

The lymphatic system plays an important role in immune function and fluid balance in the body. Treatment of the lymphatics depends on the underlying condition or disorder affecting the lymphatic system. Some possible treatments for lymphatic disorders include techniques like auricular drainage, Galbreath technique, and trigeminal stimulation, which are applied in the HEENT (head, eyes, ears, nose, and throat) region; thoracic inlet myofascial release, thoracoabdominal diaphragm release, and thoracic pump techniques which are applied in the chest region; and the suboccipital release technique applied in the neck region; and the pedal pump technique applied on the feet.