How to do Lymphatic
Self-Massage on Your
Face, Head and Neck
For patients of Princess Margaret Cancer Centre who
were treated for head and neck cancer with:
• Surgery to remove a tumour(s) or lymph nodes
• Radiation therapy
Read this resource to learn:
• What is your lymphatic system
• What lymphatic self-massage is and why it is important
• How to do lymphatic self-massage step-by-step
Form: D-8668
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What is your lymphatic system?
Your lymphatic system lters and removes extra uid and waste from your
body. It plays an important role in your immune function. Your lymphatic
system is made up of many lymph nodes that are connected together by
lymph vessels.
Your lymph nodes are bean-shaped organs that are found all over your body.
Large groups or chains of lymph nodes can be found in your neck, under
your arms and in your groin (see the image below).
Surgery or radiation to your lymph nodes damage your lymph nodes and
vessels. This damage prevents uid from owing well and causes swelling.
Swelling from damaged lymph nodes and vessels is called lymphedema.
Lymph node clusters in the:
The lymphatic system
The image above
shows the normal ow
of uid in the face,
head and neck.
neck
under arms
groin
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What is lymphatic self-massage and why is it important?
Lymphatic self-massage is a gentle skin massage where the skin is gently
stretched and released along lymph pathways. Lymphatic self-massage helps
move extra uid from swollen areas damaged by cancer treatment. This extra
uid can be moved into an area where the lymph nodes are working well.
Lymphatic self-massage can help soften and move extra uid away from:
• areas of your face that have had treatment
• areas of your neck that have had treatment
Lymphatic self-massage can help to move extra uid to:
• lymph vessels and lymph nodes in areas of your face or neck not
aected by treatment
• lymph vessels and lymph nodes in your underarms
The image below shows the lymph nodes and
lymph vessels in the face, head and neck.
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How to do lymphatic self-massage
• Keep your hands soft and relaxed. Use a light pressure on your skin. The
pressure of your hands should be just enough to gently stretch the skin.
Only stretch the skin as far as it can go naturally without causing pain.
Release the pressure and let your skin come back as it was. If you can
feel your muscles under your skin you are pressing too hard.
• Use the at part of your hands (palms and ngers) instead of your
ngertips. Your palms allow more contact with the skin to stimulate
(pump) the lymph vessels.
• Massage towards areas of your body that have not been treated for
cancer such as your chest and underarms.
• Make sure you are in a comfortable position with good posture. You can
self-massage while sitting, standing or lying down. Choose a position
that is most comfortable for you.
• Massage when you are comfortably warm or when you are in a nice,
warm room. If your muscles are warm, they are more exible.
• Do self-massage regularly. You can use self-massage as time to relax,
breathe, and take care of yourself.
What to avoid
Do not strain your shoulders, neck, arm or hand
Do not self-massage if it causes pain
Do not do self-massage if you have an infection in the area that has swelling
Important: Do not do self-massage if you think you have an infection.
Infections can occur more easily in your head, neck or face where your
lymph nodes have been removed or you have had radiation.
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Signs that an area may be infected are:
• Swelling in these areas and changes in the colour of the skin
In darker skin tones, the skin may appear more purple, gray, or may
not change colour at all. In lighter skin tones, the skin may appear
red. This redness can quickly spread.
• Skin becoming raised, thick or pitted.
• Feeling of tenderness and/or warmth in the aected area.
• Having a fever or chills and feeling unwell.
If you think you have an infection, get medical attention right away. You may
go to:
• Your family doctor
• Walk-in Clinic
• Urgent Care Clinic
• Emergency department
If you have had an infection, only start self-massage again when the
antibiotics (medicine) are taking eects, your infection is improving,
and it is comfortable for you to do so. Or if your doctor says it is okay to
start again.
Try dierent ways to make self-massage a part of your routine. Try self-
massage while you are watching TV or having a shower so it does not take
time away from your day. Try to make self-massage a time for yourself. Or
make it a part of your routine for relaxing
Below are the steps for doing a lymphatic self-massage. Follow the
instructions closely. Talk to your health care team if you have any questions.
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1. Deep breathing
Deep breathing is an important part
of your self-care. Deep breathing
works like a pump in your body. This
pump helps the lymph nodes and
vessels move uid. You can practice
deep breathing at any time!
What to do:
• Place the palms of both hands on your stomach.
• Take a deep breath in through your nose until your stomach pushes
against your hands.
• Breathe out slowly through pursed lips (like you are blowing out
candles). Then let your stomach go at.
• Repeat 5 times. Take a short rest between each breath so you do not
feel dizzy.
2. Stretch and release the skin at the front of your neck
This motion helps lymph uid drain
back to your heart. You can massage
one side at a time.
What to do:
• Place the ats of your 2nd and 3rd ngers on one side of your neck just
above your collarbone.
• Massage down and inwards toward your collarbone. Always keep your
ngers above your collarbone. Start massage on the area of your neck
that is close to your shoulder and gently stretch the skin towards the
middle of your neck.
• Gently stretch the skin just as far as it goes without pain. Then let go of
the skin.
• This massage will look like the letter “J”.
• Repeat 10 – 15 times on each side.
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3. Prepare your underarm lymph nodes
This prepares the lymph vessels and
nodes under your arm to take in
lymph uid from your face and neck.
Place your arm in a comfortable
position. Your arm should be slightly
raised and supported. You may want
to place your arm on an armrest or
table for comfort.
What to do:
• Place your palm of your opposite hand against your underarm.
• Gently pull up and in toward your body, then release. Pause for a
moment and then start again. Repeat 10 – 15 times
• Do the same pumping on your other underarm. Repeat 10 – 15 times.
4. Stretch and release the skin from your chest to your underarm
Chest to underarm
Place your at, relaxed, hand on your
collarbone. Move your hand down
your chest toward your underarm.
Massage your chest to help reduce
swelling. This massage will move
the lymph uid from your neck
and chest to your underarm lymph
vessels and nodes.
What to do:
• Place your hand over your collar bone
• Gently stretch the skin (not muscles) down your chest and towards
your underarm. Then let go of the skin. Pause for a moment.
Now repeat this massage stroke as you gradually move your hand
down your chest towards your underarm.
• Repeat this massage 10 – 15 times.
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5. Stretch and release the skin from the front of your neck to
your chest
Neck to chest
Massage the front of your neck to
help reduce swelling. This massage
will move the lymph uid from your
neck to your chest.
Place your hand on the front of your
neck where you have swelling. Move
your hand down your neck towards
your collar bone and chest in short
strokes.
What to do:
• Place your hand over the swelling at the front of your neck
• Gently stretch the skin (not muscles) towards your collarbone. Then
let go of the skin. Pause for a moment. Now repeat this massage
stroke as you gradually move your hand past your collar bone and
down your chest.
• Repeat this massage 10 – 15 times.
6. Stretch and release the skin at the side of your neck
Massage the side of your neck to
lower or prevent the swelling in your
face and neck. This massage helps
stimulate (pump) the vessels at the
side of your neck. Do not massage
both sides of your neck at the same
time if you have radiation treatment.
Do one side at a time.
What to do:
• Place your hand at on the side of your neck (for example, right hand
to the right side of the neck). If this is uncomfortable or dicult, try
the opposite hand (left hand to the right side of neck).
• Gently stretch the skin towards the back of your neck and down.
Then release.
• Massage your neck and side of the face in a slow and gentle way.
• Repeat 10 – 15 times.
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7. Stretch and release the skin on the back of your neck
Massage the back of your neck to
lower or prevent the swelling in your
face and neck. This massage helps
stimulate (pump) the vessels at the
back of your neck.
What to do:
• Place the palms of your hands on the back of your neck, just below
your hairline.
• Stretch the skin towards your spine and then down towards your back.
• Repeat 10 – 15 times.
8. Massage your scar
Massage your scar. This massage
is only if you have had surgery. Do
not massage until three weeks after
surgery and the scar is well healed.
Do not massage until all staples and
clips have been removed. Your scar
may feel very sensitive, tight or itchy.
Scar massage will help reduce these
feelings.
This massage helps soften the scar
and allows better blood ow to the
area. Scar massage should always be
pain-free. Do not use oil while doing
the scar massage. Apply any lotions
or oils after the massage. This part
of the massage may involve rmer
pressure than the other steps.
Zigzag motion Circle motion
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What to do:
• Place the palm of your hand over the scar.
• Move up and down in a zigzag pattern or circle pattern along the
scar. See pictures above for help.
• Apply rm but gentle pressure while moving along the scar. Try to
move the skin.
• If possible, gently lift the skin along the scar.
• Repeat 5 or 6 times on the scar.
• Now place your ngertips just above the scar. Gently stretch the skin
away from the scar and release.
• Repeat 5 times.
• Place your ngertips below the scar. Gently stretch the skin away
from the scar. Then release the skin.
• Repeat 5 times.
If your skin and swollen tissue in your neck or face feels hard, ask your
therapist to show you gentle kneading techniques to help soften the rm
tissue. Softening rm areas helps improve lymph drainage.
Here is how you will soften the rm tissue on your own at home:
• Gently place the pads of your ngers on the tissue or skin that feels
rm or hard.
• Gently press down with the pads of your ngers and let go. As you
release the pressure, move your ngers down slightly.
• Repeat 10 – 15 times in one area. Move to another area and repeat.
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9. Massage for face swelling
Your therapist will draw
arrows on the image.
This will show you the
way you should do your
self-massage.
Notes:
10. Massage for swelling inside the mouth
Your therapist will draw
arrows on the image.
This will show you the
way you should do your
self-massage.
• Do not massage
inside your mouth if
you have any sores
or cuts or pain.
• Make sure your hand
is clean before you
start to massage
inside your mouth.
Notes:
11. Stretch and release the skin at the front of your neck
This motion helps lymph uid
drain back to your heart. Massage
one side at a time if you have had
radiation.
What to do:
• Place the ats of your 2nd and 3rd ngers on either side of your neck
just above your collarbone.
• Massage down and inwards toward your collarbone. Always keep
your ngers above your collarbone. Start massage on the area of
your neck that is close to your shoulder and gently stretch the skin
towards the middle of your neck.
• Gently stretch the skin just as far as it goes without pain. Then let go
of the skin.
• This massage will look like the letter “J”.
• Repeat 15 times on each side.
Contact information
If you have questions about self-lymphatic massage, contact the Survivorship
Clinic at 416 946 4501, ext. 2363 and ask to speak to a Combined Decongestive
Therapist (CDT).
Notes:
Visit www.uhnpatienteducation.ca for more health information. Contact us to provide feedback or
request this brochure in a dierent format, such as large print or electronic formats: pfep@uhn.ca
The development of patient education resources is supported by the Princess Margaret Cancer
Foundation.
© 2023 University Health Network. All rights reserved. Use this material for your information only. It does not replace advice from your
doctor or other health care professional. Do not use this information for diagnosis or treatment. Ask your health care provider for advice
about a specic medical condition. You may print 1 copy of this brochure for non-commercial and personal use only.
Form: D-8668 | Author: Pam Hammond | Revised: 12/2023
