Most manual osteopathy treatments have an effect on lymphatic circulation. All lymphatic techniques begin with treatment of somatic dysfunction in areas known as “choke points.” The choke points, when dysfunctional, are areas that can obstruct the flow of lymph between body compartments. Choke points are usually treated with myofascial release techniques assisted by respiration. Once the obstruction is reduced, other lymphatic pump techniques are used to promote fluid movement, such as pectoral traction, postural drainage, effleurage, thoracic expansion, and rhythmic passive dorsiflexion of the feet. The goal is to enhance lymphatic return either by influencing negative intrathoracic pressure or mechanically assisting return of lymph from the lower extremities. As somatic dysfunction resolves, the body’s natural homeostatic mechanisms are restored and lymphatic drainage is naturally enhanced. Lymphatic treatments remove obstructions to lymphatic flow and augment the clearance of lymph and other immune elements from specific congested tissues. Lymphatic techniques are contraindicated in the presence of metastatic cancer, certain infections (e.g., tuberculosis), and hypercoagulable states.
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