Full Transcript
https://www.youtube.com/watch?v=-30hudsIXXE
[00:00] Swelling in the legs is extremely common.
[00:03] Swelling in the legs is extremely common and it can be caused by multiple different things.
[00:06] Different things. I'm going to go more in depth on this topic of what causes swelling in the legs in a different video.
[00:12] But today in this video we're going to focus more on how to reduce the swelling specifically.
[00:16] I'm going to show a step-by-step routine on lymphatic drainage to help reduce swelling in the legs, the ankles and the feet.
[00:24] Lymphatic drainage is a massage-like technique that is used in a specific sequence with a specific technique to help guide fluid out of a congested area.
[00:34] My name is Kelly. I'm a physical therapist and I specialize in lymphedema or swelling, as well as oncology.
[00:40] And today in this video we're going to go through a step-by-step routine that you can follow along with.
[00:46] However, if someone wants a handout or a sheet with a diagram and the steps on it, you can find that on my website at cancerrehabpt.com.
[00:54] You can also follow along with us on Instagram or subscribe down below for more related content, but we'll get...
[01:00] More related content, but we'll get started.
[01:02] Started.
[01:12] I'm going to be doing this routine today.
[01:14] I'm going to be doing this routine today, sitting up, maybe laying down for a little bit.
[01:16] Sitting up, maybe laying down for a little bit, but this can be done sitting in a chair or reclined.
[01:18] It can be done in bed.
[01:20] Someone can lay down and put their leg up on one of these bolsters so gravity can help move the fluid out as well.
[01:22] Whatever makes it easy, whatever works for someone.
[01:24] But today I'm going to be doing a lot of it sitting up, so it's easier to see.
[01:26] Easier to see.
[01:28] So the first thing we always want to do is stimulate the deep lymph nodes in your abdomen.
[01:30] You have a lot of lymph nodes in there, and all of the fluid from the legs have to go through the abdomen into those deep channels to get back to the heart.
[01:32] So we want to make sure that we're stimulating this area.
[01:33] So what we'll do is put our hand on the abdomen, gently pressing in.
[01:35] Take a nice big belly breath, feeling your belly expand into your hand.
[01:37] And then let it out.
[02:00] and then let it out.
[02:02] and then i'm going to move just a little.
[02:03] and then i'm going to move just a little bit to another area of the abdomen take a big breath in.
[02:07] a big breath in and out.
[02:11] a third breath in.
[02:15] and out.
[02:18] and then one more breath in.
[02:23] and then one more breath in and out.
[02:25] so one once we've stimulated the abdominal lymph node someone can also go ahead and stimulate the head and neck lymph nodes and the armpit lymph nodes.
[02:32] just doing circles around the collarbone or clavicle below the ear and in the armpits maybe five to ten of each.
[02:40] but we're going to move on pretty quickly to make this shorter.
[02:43] and we're going to start with the lymph nodes in the groin area.
[02:45] so the lymph nodes sit right about where the crease is when someone bends up the hip.
[02:49] they're right about there so either sitting or reclined you can just do circles right on those areas.
[02:56] and so you can do both at the same time.
[02:58] or you can do one at a time whatever.
[03:02] or you can do one at a time whatever works.
[03:05] but we're just doing eight to ten of those.
[03:08] from there what we want to do is to start to clear the area.
[03:13] so if someone just has swelling from the knees down towards the feet you know they might just want to start from the bottom.
[03:18] we really want to make sure there's no congestion up top.
[03:21] so if someone has lymphedema in the legs that and they have you know diagnosed or had lymph nodes removed or have a diagnosis we always want to make sure that we're moving all the fluid out up towards the armpit areas.
[03:36] if someone has a healthy lymphatic system they can go a little bit more towards these lymph nodes but again a lot of it we're working up and so we want to make sure we're clearing that lower abdomen first.
[03:46] and so what we're going to do is we're going to try to work the fluid up the side of the body towards the armpit.
[03:54] so working everything upwards trying to make sure that we're getting as much of this congestion out of the area and up.
[03:58] so we're gonna do
[04:04] Out of the area and up so we're gonna do five to eight strokes on one side.
[04:08] Five to eight strokes on one side and then I'm gonna do the same thing on the other side.
[04:10] So you won't be able to see but it's just working up the side of the body on the other side from the hip to the armpit area.
[04:20] Five to eight times.
[04:26] And then we're going to move on.
[04:28] And so if someone then wants to work around the hip area and say they have swelling in the pelvis, we can also work, you know, the lower abdominal.
[04:35] We can work that up a little bit as well.
[04:37] So if someone's congested, if someone has healthy lymphatics, we can actually work towards the lymph nodes.
[04:43] So if we have swelling and back up, we always want to work up.
[04:48] If we have healthy lymphatics and no swelling, we can work out more towards the sides.
[04:54] Doing five to eight in either of those directions.
[04:59] From there we want to make sure we work on the side.
[05:00] So either laying on your side or hopefully you can see here the fluid from the back, the lymph.
[05:06] the fluid from the back the lymph vessels actually wrap around the body.
[05:09] vessels actually wrap around the body towards the front instead of just going.
[05:11] towards the front instead of just going up the back we're actually going to work.
[05:13] up the back we're actually going to work around.
[05:14] around to the front of the body so from through.
[05:17] to the front of the body so from through the hip through the glute area.
[05:19] the hip through the glute area throughout the low back kind of actually.
[05:21] throughout the low back kind of actually wrapping around.
[05:25] if there's congestion there we still.
[05:27] if there's congestion there we still want to work it up towards the armpit.
[05:31] but we're working up and around.
[05:37] so five to eight times in each area.
[05:43] and then from there what we're gonna do.
[05:45] and then from there what we're gonna do is we're gonna start down the leg and so.
[05:47] is we're gonna start down the leg and so we're gonna do one leg at a time someone.
[05:49] we're gonna do one leg at a time someone can do two at the same time one on each.
[05:51] can do two at the same time one on each side that's fine i'm just gonna use two.
[05:52] side that's fine i'm just gonna use two hands for one leg.
[05:54] hands for one leg we're gonna look at the leg in sections.
[05:56] we're gonna look at the leg in sections so we're looking at the thigh the lower.
[05:58] so we're looking at the thigh the lower leg and the foot and the toes.
[06:00] leg and the foot and the toes and so we wanna start with the top the.
[06:03] and so we wanna start with the top the reason we don't start with the bottom is.
[06:04] reason we don't start with the bottom is again because if this is congested this.
[06:07] again because if this is congested this is going to get backed up on the way out.
[06:08] is going to get backed up on the way out so we want to start from the top to.
[06:11] so we want to start from the top to clear the congested area first before we.
[06:14] clear the congested area first before we make our way down and so even if someone.
[06:17] make our way down and so even if someone does not have.
[06:18] does not have thigh swelling maybe they just have.
[06:20] thigh swelling maybe they just have swelling from the knees down we still.
[06:22] swelling from the knees down we still want to make sure we're doing the thigh.
[06:23] want to make sure we're doing the thigh part so.
[06:25] part so i'm going to use both hands.
[06:26] i'm going to use both hands as much surface area as possible.
[06:29] as much surface area as possible we're just going to work up the leg.
[06:33] we want to make sure that we get all.
[06:35] we want to make sure that we get all angles of the leg.
[06:37] angles of the leg but everything is working.
[06:39] but everything is working towards that hip crease towards those.
[06:42] towards that hip crease towards those groin or inguinal lymph nodes.
[06:45] groin or inguinal lymph nodes so five to eight times in the front and.
[06:47] so five to eight times in the front and the sides.
[06:48] the sides now as you get to the true side so i'm.
[06:51] now as you get to the true side so i'm on the inner thigh side of the thigh and.
[06:53] on the inner thigh side of the thigh and the outer at the same time.
[06:55] the outer at the same time as you get closer you actually want to.
[06:57] as you get closer you actually want to start to wrap towards the front.
[06:59] start to wrap towards the front okay because the lymph nodes are in the.
[07:01] okay because the lymph nodes are in the front and the vessels actually wrap.
[07:02] front and the vessels actually wrap around.
[07:04] around towards that front.
[07:07] towards that front so up and then kind of wrapping towards.
[07:09] So up and then kind of wrapping towards the front five to eight times.
[07:15] And then we can also work in the back of.
[07:17] And then we can also work in the back of the thigh so similar thing the vessels.
[07:20] The thigh so similar thing the vessels in the back actually wrap around towards the front.
[07:24] The front and so I'm kind of wrapping the inner thigh and the outer in the same way.
[07:29] Same way I know they're both hard to see but wrapping around towards the front.
[07:36] Towards the front from the back.
[07:39] And someone can spend two minutes there doing their five five-day times or they can spend more time there if they really have a lot of congestion or swelling.
[07:50] But once we've done the whole thigh then I'm going to stop and do is do some circles behind the knee.
[07:55] Circles behind the knee you have some lymph nodes that sit right behind the knee so we just want to stimulate those lymph nodes.
[08:02] Stimulate those lymph nodes five to eight circles and then I'm also going to work around the knees turns a little so you can see I'm going to work around the kneecap.
[08:11] I'm going to work around the kneecap, around that bony area.
[08:15] The fluid likes to sit in little crevices.
[08:18] Or anytime there's a little space and around bony areas, there tends to be more space.
[08:20] We just want to work around the bones.
[08:24] And then from there we're going to move down towards the lower leg.
[08:26] And so I'm going to work from the ankle to the knee.
[08:31] Same thing, using as much surface area as I can with my hands.
[08:36] And then work on the sides.
[08:53] Five to eight times there.
[08:55] And then for the back of the leg, we don't necessarily need to do the same thing as the thigh because those lymph nodes are actually right behind the knee.
[09:03] We can go directly upwards in the back.
[09:06] We don't have to wrap around towards the front.
[09:09] We're guiding that fluid.
[09:12] we're guiding that fluid from the ankle.
[09:13] from the ankle to the knee.
[09:16] to the knee use as much of your hands as you have.
[09:17] use as much of your hands as you have available.
[09:22] again spend as much time as you need so.
[09:24] again spend as much time as you need so a lot of people have swelling around that ankle.
[09:25] a lot of people have swelling around that ankle so they'll spend a little bit more time there and that's great.
[09:27] that ankle so they'll spend a little bit more time there and that's great.
[09:30] from there when someone's ready to move.
[09:32] from there when someone's ready to move on what we're going to do is work around the ankle.
[09:34] on what we're going to do is work around the ankle so around those ankle bones on either side the inside and outside.
[09:37] the ankle so around those ankle bones on either side the inside and outside just making circles around the bone it's.
[09:40] either side the inside and outside just making circles around the bone it's another area that a lot of fluid likes.
[09:44] just making circles around the bone it's another area that a lot of fluid likes to sit so we just want to use our.
[09:46] another area that a lot of fluid likes to sit so we just want to use our fingers a little bit more and just.
[09:47] to sit so we just want to use our fingers a little bit more and just really get in between.
[09:49] fingers a little bit more and just really get in between and around those bones.
[09:51] really get in between and around those bones and then we're going to work on the top.
[09:55] and then we're going to work on the top of the foot.
[09:56] and then we're going to work on the top of the foot and if someone has some tendons that are a little more prominent in that area you.
[10:01] and if someone has some tendons that are a little more prominent in that area you can use your fingertips to kind of get in between those tendons.
[10:03] a little more prominent in that area you can use your fingertips to kind of get in between those tendons.
[10:05] can use your fingertips to kind of get in between those tendons and then same thing with the toes.
[10:07] and then same thing with the toes.
[10:13] And then same thing with the toes, we can do all the toes together.
[10:16] We can do all the toes together, or if someone has more swelling, they can do each toe individually.
[10:26] Whatever is needed.
[10:31] Everything is working upwards.
[10:34] Everything is working upwards, so again, if someone's laying down with one of those bolsters or they can put their leg up in the air, gravity can help with that.
[10:41] So we've made our way from the abdomen, the pelvis, all the way down the leg to clear the area.
[10:48] Now we're going to go in reverse to help get the fluid moving up and out of the area.
[10:52] So we're just going to go back up towards the foot.
[10:57] And then we're going to go back around that ankle.
[11:02] Between five to eight or more if needed.
[11:09] And then we're gonna go from the ankle to the knee, so working.
[11:14] to the knee so working upwards
[11:21] making sure we're getting all sides of
[11:23] making sure we're getting all sides of the leg
[11:25] the leg can spend more time at the ankle if that
[11:27] can spend more time at the ankle if that area is more swollen
[11:33] and then same thing in the back of the
[11:35] and then same thing in the back of the lower leg you can go straight up the
[11:37] lower leg you can go straight up the back
[11:43] and you don't have to press hard with
[11:45] and you don't have to press hard with this massage it's actually a light
[11:47] this massage it's actually a light massage you're doing more of a skin
[11:49] massage you're doing more of a skin stretch than anything
[11:51] stretch than anything if someone has had fluid for a long time
[11:54] if someone has had fluid for a long time maybe their skin or the tissue is a
[11:56] maybe their skin or the tissue is a little thicker we call that fibrosis
[11:58] little thicker we call that fibrosis we might work a little bit more deep
[12:00] we might work a little bit more deep into those areas but otherwise for
[12:03] into those areas but otherwise for lymphatic drainage it is very light
[12:06] lymphatic drainage it is very light so after we've done the lower leg you
[12:07] so after we've done the lower leg you can stop and do a little behind the knee
[12:09] can stop and do a little behind the knee do a couple more circles to stimulate
[12:11] do a couple more circles to stimulate those lymph nodes again
[12:15] and then I'm going to work in the front.
[12:17] and then I'm going to work in the front of the knee.
[12:19] of the knee to work around that kneecap.
[12:27] and then we're going to go back to the thigh.
[12:31] thigh working towards the front of that hip.
[12:34] working towards the front of that hip so the front of the thigh is pretty straightforward.
[12:36] you're just going straightforward.
[12:37] you're just going straight up.
[12:42] and then when we get to the sides.
[12:45] and then when we get to the sides we're kind of starting to wrap towards the front a little bit.
[12:48] especially that inner thigh make sure that you're scooping it up towards the front.
[12:50] especially that inner thigh make sure that you're scooping it up towards the front.
[12:52] that you're scooping it up towards the front.
[12:57] and then after we've done that we're going to go to the back of the thigh.
[12:58] and then after we've done that we're going to go to the back of the thigh.
[13:01] going to go to the back of the thigh and remember this is when we're trying to wrap towards the front as we go.
[13:03] and remember this is when we're trying to wrap towards the front as we go because that is the direction the lymphatic vessels run.
[13:07] because that is the direction the lymphatic vessels run we're just guiding the fluids through those vessels.
[13:21] we're going to do three to five times.
[13:22] we're going to do three to five times there.
[13:24] there i'm going a little fast so slow down and
[13:26] i'm going a little fast so slow down and pause if you need to spend more time.
[13:28] pause if you need to spend more time where you need to.
[13:33] and then once we get
[13:35] and then once we get all the way back to the front or toward the inside
[13:37] all the way back to the front or toward the inside we're going to make sure that
[13:38] the inside we're going to make sure that we clear this area we moved it all to here.
[13:40] here we want to make sure it's moving so if someone has lymphatic issues we're going to go up the side of the body.
[13:42] if someone has lymphatic issues we're going to go up the side of the body.
[13:44] going to go up the side of the body towards the armpit lymph nodes.
[13:46] towards the armpit lymph nodes making sure you can work into that hip.
[13:50] making sure you can work into that hip too kind of up and around.
[13:52] or if someone has that lower pelvis we can kind of work that up as well.
[13:59] or if someone has that lower pelvis we can kind of work that up as well.
[14:01] can kind of work that up as well or if it's healthy lymph nodes we can go directly to those lymph nodes.
[14:04] or if it's healthy lymph nodes we can go directly to those lymph nodes.
[14:06] directly to those lymph nodes it just depends on the cause again which i'll talk about in another video.
[14:09] it just depends on the cause again which i'll talk about in another video.
[14:11] i'll talk about in another video [Applause]
[14:14] [Applause] so after we've done that we're going to
[14:18] so after we've done that we're going to do the same thing on the other side so
[14:20] so
[14:22] Do the same thing on the other side.
[14:22] So I'm going to turn so someone can see.
[14:24] I'm going to turn so someone can see.
[14:24] We're going to start at the top and so.
[14:26] We're going to start at the top and so we want to make sure that we're working.
[14:27] We want to make sure that we're working on decongesting so we're going to do.
[14:30] On decongesting so we're going to do circles if you need to redo them.
[14:34] And then from there we're going to work.
[14:35] And then from there we're going to work up towards the side so.
[14:38] Up towards the side so from the hip to the armpit.
[14:49] If they have lower pelvis swelling we're.
[14:51] If they have lower pelvis swelling we're going to kind of work upwards.
[14:54] Going to kind of work upwards if there's congestion away from those.
[14:56] If there's congestion away from those lymph nodes if there's no congestion or.
[14:58] Lymph nodes if there's no congestion or no issues towards the lymph nodes.
[15:04] And then if we're working around the.
[15:05] And then if we're working around the back and the hip we're kind of working.
[15:07] Back and the hip we're kind of working up towards the front.
[15:10] Up towards the front up and around.
[15:13] Up and around not straight up the back until you get.
[15:15] Not straight up the back until you get to the side.
[15:17] To the side but up and around either towards lymph.
[15:19] but up and around either towards lymph nodes or up towards the armpit.
[15:22] nodes or up towards the armpit again i know that can get confusing.
[15:25] again i know that can get confusing so a lymphedema therapist.
[15:27] so a lymphedema therapist can help guide you for your personal.
[15:29] can help guide you for your personal needs.
[15:32] and once we've done that then we're.
[15:34] and once we've done that then we're going to go down the leg so i'm going to.
[15:35] going to go down the leg so i'm going to start with the thigh we're going to.
[15:37] start with the thigh we're going to clear the area first.
[15:39] clear the area first so working on the front.
[15:48] as much surface area of the hand as.
[15:50] as much surface area of the hand as possible.
[15:56] and then after we've done a few on the.
[15:58] and then after we've done a few on the front we're going to work more towards.
[15:59] front we're going to work more towards the sides starting to work towards the.
[16:02] the sides starting to work towards the front as we get there.
[16:05] front as we get there wrap towards the front.
[16:12] and after we've done about five we're.
[16:14] and after we've done about five we're gonna work towards the back of the thigh.
[16:17] gonna work towards the back of the thigh same thing starting to wrap around.
[16:20] same thing starting to wrap around towards the front.
[16:33] and after we've done the whole thigh or
[16:36] and after we've done the whole thigh or as much time as someone wants we're
[16:38] as much time as someone wants we're going to stop and do some circles behind
[16:40] going to stop and do some circles behind the back of the knee
[16:43] we'll do about five to eight
[16:49] and then we'll work around the knee so
[16:51] and then we'll work around the knee so again working around the kneecap
[16:58] if there are any pockets of swelling you
[17:00] if there are any pockets of swelling you can spend more time there
[17:08] and then we're going to go on to the
[17:10] and then we're going to go on to the lower legs working from the ankle to the
[17:13] lower legs working from the ankle to the knee
[17:22] do five in the front
[17:30] and then once we've done that we're
[17:31] and then once we've done that we're going to go on to the sides
[17:34] going to go on to the sides going straight up.
[17:41] i'm doing the inside and outside at the.
[17:42] i'm doing the inside and outside at the same time.
[17:47] and then remember when we get to the.
[17:49] and then remember when we get to the back.
[17:50] back you can go straight directly up you.
[17:52] you can go straight directly up you don't need to wrap around so working.
[17:54] don't need to wrap around so working straight upwards.
[17:56] straight upwards towards the back of the knee towards.
[17:58] towards the back of the knee towards those lymph nodes behind the knee.
[18:13] and after we've done the whole lower leg.
[18:15] and after we've done the whole lower leg then we're going to go around towards.
[18:16] then we're going to go around towards the ankle so i'm going to start around.
[18:19] the ankle so i'm going to start around those ankle bones so just scooping.
[18:21] those ankle bones so just scooping around the bones on the inside and the.
[18:22] around the bones on the inside and the outside.
[18:28] kind of work back into that heel.
[18:31] kind of work back into that heel the achilles that tendon behind the.
[18:34] the achilles that tendon behind the ankle.
[18:35] Ankle can really hold some fluid.
[18:38] Can really hold some fluid and then we're going to work on the top.
[18:39] And then we're going to work on the top of the foot.
[18:49] And then we'll also work into the toes.
[18:51] And then we'll also work into the toes but again if you have a lot in between.
[18:53] But again if you have a lot in between those tendons you can use your.
[18:54] Those tendons you can use your fingertips to kind of get in between the.
[18:56] Fingertips to kind of get in between the tendons.
[18:58] Tendons and then we can go into the toe so.
[18:59] And then we can go into the toe so either the whole hand.
[19:02] Either the whole hand or if you want to go individual you can.
[19:04] Or if you want to go individual you can go each toe by itself.
[19:15] And then like we did the other leg we're.
[19:17] And then like we did the other leg we're going to reverse.
[19:19] Going to reverse in the other direction we've cleared the.
[19:21] In the other direction we've cleared the area we're going to now move fluid so.
[19:23] Area we're going to now move fluid so we're gonna go back up to the foot.
[19:31] Five to eight times and then we're gonna.
[19:33] Five to eight times and then we're gonna go around the heel again around the.
[19:35] Go around the heel again around the ankles.
[19:36] ankles around those bones.
[19:43] and then we're going to go back up.
[19:44] and then we're going to go back up working on the lower leg.
[19:52] if someone was doing this sitting in a chair it'd be easy to try to cross the ankle over the knee.
[19:57] i know that's hard sometimes putting the foot up on a step stool can also help.
[20:05] and if someone's unable to reach their feet and can only do the lower leg then doing just the lower leg is just fine.
[20:10] whatever you are able to do something is better than nothing.
[20:17] working towards the back.
[20:29] and then after we've done the whole lower leg i'm going to stop and do a little bit behind the knee.
[20:33] kind of work into those lymph nodes again.
[20:38] and then we'll also make sure we do the
[20:39] and then we'll also make sure we do the front of the knee
[20:44] around that
[20:45] around that kneecap around the bone
[20:52] and then we're going to go back to the
[20:53] and then we're going to go back to the thigh so working in the front
[20:56] thigh so working in the front towards the front of the hip
[21:11] and then we're going to work in the
[21:12] and then we're going to work in the sides
[21:14] sides wrapping towards the front especially at
[21:17] wrapping towards the front especially at the end there
[21:24] and then also in the back and this is
[21:26] and then also in the back and this is where we want to start to wrap around
[21:29] where we want to start to wrap around towards the front
[21:46] and once we've done
[21:48] and once we've done as much as someone would like in the
[21:50] as much as someone would like in the thigh or at least a few times in each
[21:51] thigh or at least a few times in each area
[21:53] area we can also finish with that hip kind of
[21:55] we can also finish with that hip kind of wrapping up and around
[22:06] and then again you can finish with
[22:07] and then again you can finish with working that fluid up the side
[22:11] working that fluid up the side of the body towards the armpit
[22:24] and then once we've done the lower legs
[22:27] and then once we've done the lower legs and the pelvis or as much as someone
[22:28] and the pelvis or as much as someone will need then we're always going to
[22:30] will need then we're always going to finish with a few more belly breaths so
[22:32] finish with a few more belly breaths so putting the hand on the belly gently
[22:34] putting the hand on the belly gently pressing inwards taking a big deep
[22:36] pressing inwards taking a big deep breath
[22:38] breath feel your belly expand into your hands
[22:40] feel your belly expand into your hands let your breath go
[22:42] let your breath go gently sinking the hands deeper into the
[22:45] gently sinking the hands deeper into the abdomen
[22:46] abdomen same thing another one number two breath
[22:49] same thing another one number two breath in
[22:51] and then breath out
[22:55] number three breath in
[22:59] and out
[23:03] and then one more breath in
[23:08] and out
[23:14] and so that's a full routine for
[23:16] and so that's a full routine for lymphatic drainage for both legs if
[23:19] lymphatic drainage for both legs if someone has lymphedema and some
[23:20] someone has lymphedema and some modifications too if someone has a
[23:22] modifications too if someone has a healthy lymphatics
[23:24] healthy lymphatics either way all the fluid moves upwards
[23:26] either way all the fluid moves upwards no matter what type of
[23:28] no matter what type of lymphedema or
[23:30] lymphedema or lymphatic system someone has but it just
[23:33] lymphatic system someone has but it just alters a little bit based on the lymph
[23:35] alters a little bit based on the lymph nodes up above
[23:36] nodes up above if you have other videos that you want
[23:39] if you have other videos that you want to see similar to this be sure to
[23:40] to see similar to this be sure to comment those down below and again if
[23:42] comment those down below and again if someone is looking for a handout with a
[23:44] someone is looking for a handout with a diagram and pictures and step-by-step
[23:46] diagram and pictures and step-by-step instructions on which direction and the
[23:48] instructions on which direction and the sequencing of lymphatic drainage i have
[23:51] sequencing of lymphatic drainage i have that on my website so you can check that
[23:53] that on my website so you can check that out further otherwise we will see you
[23:55] out further otherwise we will see you all next week for another video thanks
[23:57] all next week for another video thanks everyone
[23:59] everyone [Music]