LDM routine

Lymphatic Drainage Massage Routine

For the LDM the client should be lying supine and the begin with an opening sequence – for initial sequence stand at side of client.  Every single movement is x5. 

Thumbs effleurage –

  • Stroke thumbs from sternum to axillary [x4]
  • Stroke thumbs across clavicle [2] 

Neck: all stationary circles

            Drainage of cervical lymph nodes:

  • Profundus: middle & terminus
  • Base of skull, vertebrae [in 3 places], terminus
  • Chin to angulus –   Chin, angulus, profundus, terminus.
  • Fork on parotid –   Parotid, profundus, terminus
    • Shoulder 1 –                      Ball of shoulder, trapezius, terminus
    • Shoulder 2 –                      Ball over shoulders, over acromium above

                                                      the clavicle,     terminus.

Fan across chest, hands rest on upper arms

Face – [move to head of table – standing behind client’s head]

  • Chin to terminus                tip of chin, angulus, profundus, terminus
  • Upper lip to terminus         upper lip, angulus, profundus, terminus
  • Tip of nose to terminus     upper lip, angulus, profundus, terminus
  • Under eyes to terminus    Under eyes, temporalis, upper lip,
  •                                           outer lip, chin, angulus, profundus, terminus

                                                [Around eyes use ring finger]

  • Eyebrows to terminus       temporalis, upper lip, outer lip, chin,

                                                angulus, profundus, terminus

  • Hairline to terminus           pinch or press eyebrows, hairline,

                                                            temporalis, angulus, profundus,


  • Forehead to terminus        inner, Medial & lateral forehead, outer lateral

                                                forehead, temporalis, angulus, profundus,


            Closing movements                empty profundus [x 4]+ terminus

Arm: [move to side of table] – effleurage – only towards axillary

  • Scoop                                inner arm, towards axillary
  • Pump                                one hand towards deltoid
  • Scoop                                inner arm, towards axillary
  • Deltoid press                     both hand – rotate, press, release
  • Stationary circles  upper arm, shoulder towards axillary nodes
  • Pump and push                 upper arm – elbow to shoulder
  • Thumb circles                   in elbow – around cubital lymph nodes
  • Scoop                                lower arm, over both sides

Hands :

  • Thumb circle                     3 lines over the wrist
  • Thumb strokes                  in between metacarpals starting little finger
  • Finger circles                    2 fingers together
  • Thumb circles                   Down thumb and over palm  

Effleurage – hand and over arm, no return stroke

Abdomen: – [check client OK for abdomen] effleurage from pubic bone to sternum –

  • Strokes                              light strokes over colon

                                                      descending, ascending & transverse

  • Single handed                   Stationary circles – hands side by side

                                                      [descending, ascending + transverse]

  • Double-handed                 One hand on top of other, following line

                                                       of the colon using rotary over transverse colon

  • Panniculosis                      pinching/twisting over abdomen [use thumb +

                                                      middle finger] – direction of inquinal nodes

  • Stationary circles              fingers above pubic bone, deeply towards

                                                Cisterna chyli

Final effleurage – ask client to breathe deeply –

Inspiration –                 strokes from pubic bone to sternum

Expiration                    thumbs through intercostals down to iliac crests


  • Effleurage                         over whole leg – no return
  • Pump                                lines over thigh – anterior, medial, lateral
  • Pump – push                     lines over thigh – anterior, medial, lateral
  • Stationary circles              inguinal nodes, use 8 fingers – drain towards
  •                                           Inguinal nodes – pressure on upward part
  • Knee [flex leg]                   Scoop under the knee – Thumb circles around knee

                                                      Pump over knee

  • Scoop over calf                from Achilles to poplital space –  lower leg
  • Extend leg                         spiral either side of Achilles tendon using 4 fingers


  • Thumb circles                   3 lines over ankle bone
  •                                           In between metatarsals, follow instep
  • Press sole of foot, realign leg and effleurage

 Back: [with client prone] – work on opposite side

  • The back:                    effleurage from shoulder blade, mid-back &

                                             from lumber region

  • Rotary technique  from spine in a lateral direction

                                             over scapula & right side of back

  • Intercostal spaces, flat fingers – lift towards vertebrae
  • Vodder ‘7’ technique         rotary – vertebrae outwards –

                                                      Pump and push to ‘7’ – stroke towards axilla

  • Stationary circles              [on side of body] towards axilla
  • Stationary circles              deltoid area – towards shoulder, working into


            Move to other side of client:

  • Thumb circles                   along trapezius, towards terminus
  • Repeat movement from other side
  • Flat thumb circles             around scapula, towards axilla,
  • Repeat thumb circles       use thumb pads
  • Rotary circles                    first  with alternating hands –

                                                      second repetition with hands together

  • Small stationary circles up and down vertebrae
  • Vibration and final effleurage



  • Effleurage gluts
  • Rotary techniques                   sacrum along lumbar vertebrae –

                                                            With flat hands

  • Rotary techniques                   3 rows, lumbar vertebrae, hip and gluts
  • Stationary circles [double handed] – along iliac crest
  • Stationary circles [with fingers]           right side of lumbar spine pressure towards

                                                                        vertebrae – repeat left side

  • Stationary circles over quadratus lumborum – pressure towards spine -repeat
  • Vibration and effleurage