<![CDATA[Anne the RMT - Drainage Diaries]]>

<![CDATA[Anne the RMT - Drainage Diaries]]>Sun, 03 May 2026 21:55:16 -0400Weebly<![CDATA[Why Deep Sleep Might Be the Missing Piece in Your Healing]]>Sun, 03 May 2026 14:32:07 GMThttps://www.annethermt.com/drainage-diaries-blog/why-deep-sleep-might-be-the-missing-piece-in-your-healing

There are things we do in treatment.
And then there are things your body does when you’re not with me.

This is one of those.

You can have the best manual lymphatic drainage session. The most thoughtful fascial work. The right compression. And still… something doesn’t quite shift the way we expect.

The swelling lingers. The tissue feels dense again. The progress doesn’t hold.

And often, quietly sitting underneath all of that is sleep.
Not just sleep in the general sense.

But deep sleep.

WHAT HAPPENS WHEN YOU ENTER DEEP SLEEP

There is a phase of sleep, often called slow-wave or deep sleep, where your body changes gears completely.
This is not light rest. This is not “just lying down.” This is where your system moves into true repair.

During this phase, the brain activates what’s known as the glymphatic system ~ a fluid-based clearing process that removes metabolic waste.

At the same time:

Your nervous system shifts into parasympathetic dominance
Tissue resistance decreases
Fluid moves more freely
Inflammation is better regulated

It is, quite literally, a drainage state.

YOUR BODY IS DOING ITS OWN VERSION OF TREATMENT

I often explain it this way:

What we do in session is intentional. What your body does in deep sleep is automatic. But they are working toward the same goal: a healthy environment and homeostasis.

During the day:

we move fluid
we soften tissue
we create pathways

At night:

your body continues that movement
redistributes what we’ve shifted
clears what needs to go

Or… it doesn’t.

WHEN DEEP SLEEP IS PRESENT

You’ll feel it.
And I’ll feel it ~ in your tissues.

swelling is often reduced in the morning
tissue has more give
there is less reactivity
progress carries forward

Things don’t reset back to where they started.

WHEN DEEP SLEEP IS NOT PRESENT

This is where it gets interesting.
Because sometimes the treatment is right, but the system isn’t integrating.

You might notice:

edema that feels stagnant rather than fluid
tissue that returns quickly to density
increased tenderness or sensitivity
slower overall change

… and it can feel confusing, especially because you’re doing everything “right.”

POST-SURGICAL HEALING

After surgery, your system is managing:

inflammation
fluid accumulation
tissue repair

Deep sleep becomes essential here.

It supports:

fluid reabsorption
inflammatory regulation
early tissue organization

Without it, swelling can persist longer than expected, and tissue can begin to feel heavier, more resistant.

LIPOEDEMA, LYMPHOEDEMA, INFLAMMATORY CONDITIONS

With these chronic conditions, fluid is part of the story ~ even if it’s not the whole story.

When deep sleep is consistent:

heaviness can feel reduced
tissue may be less reactive
there is often more comfort overall

When it’s not:

the tissue can feel denser, thick, heavy
more sensitive to touch, bruising
less responsive to treatment

Deep sleep doesn’t change the structure of lipedema and other chronic conditions ~ but it absolutely influences how it presents and how it feels to the patient.

FIBROSIS & SCAR TISSUE

This is where integration matters most.

We can create change in session ~ mobilize, soften, improve glide.
But what happens next depends on the environment the tissue returns to.

Deep sleep supports:

more organized collagen remodeling
reduced inflammatory signaling
better tissue adaptation

Without it, the system can default toward:

density
adhesion
holding patterns

THE PART THAT OFTEN GETS MISSED

Sleep is rarely included in treatment plans. Not because it isn’t important, but because it’s not something we “treat.”

And yet, it may be one of the most influential pieces.

Without deep sleep, the body doesn’t fully enter its state of repair and drainage, and is left managing fluid and inflammation more superficially.

In many ways, this is similar to hydration.

We encourage patients to drink water not because we control it, but because we understand how essential it is for circulation and healing.

Sleep belongs in that same category.

It’s not something we prescribe or diagnose, but it is something we recognize as foundational.

As massage therapists, we:

move fluid
support tissue change
create space for better function

But what happens outside the treatment room matters just as much.

Because sometimes progress isn’t limited by technique, but by whether the system is given the conditions it needs to respond.

And deep sleep is one of those conditions.

A DIFFERENT WAY TO THINK ABOUT IT

Instead of seeing sleep as rest, it may be more useful to see it as:
A continuation of treatment ~ what the doctor ordered!

Not optional. Not passive. But essential.

A SIMPLE REFLECTION

If things feel like they’re not progressing the way they should, it may not always be about:

more pressure
more techniques
more frequency

Sometimes the question is:
Is the body getting the time and state it needs to do its part?

Because healing is never just what happens on the table.

It’s what happens after.

If you’re curious whether MLD is appropriate for your situation, or you’re a therapist wanting to better understand how to work with fluid-based swelling like this, I’m always happy to continue the conversation.

Yours in health and happiness,
Anne

Clinic: www.annethermt.com
Education: www.eluvettmethod.com

Image: pexels.com - SHVETS production
Citations:
Yoon, J, Ji, M, Yun, C Brain water dynamics across sleep stages measured by near-infrared spectroscopy: Implication for glymphatic function https://doi.org/10.1177/0271678X251353142.
Örzsik, Balázs & Palombo, Marco & Asllani, Iris & Dijk, Derk-Jan & Harrison, Neil & Cercignani, Mara. (2023). Higher order diffusion imaging as a putative index of human sleep-related microstructural changes and glymphatic clearanc. NeuroImage. 274. 120124. 10.1016/j.neuroimage.2023.120124.

]]><![CDATA[When Fascia Gets in the Way: A Quiet Driver of Chronic Inflammation]]>Sat, 18 Apr 2026 16:31:06 GMThttps://www.annethermt.com/drainage-diaries-blog/when-fascia-gets-in-the-way-a-quiet-driver-of-chronic-inflammationThere’s a pattern I’ve started to notice more and more in practice.

A patient comes in with persistent swelling, heaviness, or that vague “inflamed” feeling that never quite resolves. They’ve tried stretching, strengthening, even rest… but something still isn’t moving the way it should.

Recently, I worked with a patient I’ll call Sarah. She presented with ongoing lower body swelling, fatigue, and a sense of pressure through her hips and abdomen. Nothing acute. Nothing dramatic. Just, well … stuck.

On assessment, what stood out wasn’t just the fluid, it was the quality of the tissue.

Dense. Dehydrated. Less responsive.

Her fascia didn’t have that subtle elasticity we rely on for healthy movement and flow. And that’s where things started to shift.

THE OVERLOOKED LINK

We often think of the lymphatic system as its own entity, but it doesn’t operate in isolation.

Lymphatic vessels travel within the fascial network. That means fascia isn’t just structural, it is functional. It creates space for vessels, supports fluid exchange, and plays a key role in moving lymph through the body.

Because the lymphatic system doesn’t have a central pump, it depends on:

Movement
Breath
And the natural recoil of healthy, hydrated fascia

When fascia is mobile and well-hydrated, it gently stretches and recoils with movement, creating a subtle pumping effect that helps move lymph forward.

But when fascia becomes restricted?

That’s when we start to see problems.

WHEN FASCIA RESTRICTS FLOW

In Sarah’s case, her history included long hours of sitting, inconsistent regular exercise, and high stress. Over time, this contributed to fascial thickening and reduced hydration.

What does that do?

It compresses lymphatic vessels
Limits fluid uptake at the capillary level
Reduces the mechanical “pump” needed for lymph movement

The result: stagnation and congestion.

And it doesn’t just sit quietly, it contributes to inflammation, swelling, and slower healing.

THE RIPPLE EFFECT

When fascial health is compromised, the effects go beyond the local tissue:

Lymphatic stagnation → fluid buildup, puffiness, edema
Reduced immune efficiency → slower transport of waste and antigens
Pain and stiffness → less movement, which further reduces lymph flow

It becomes the proverbial vicious cycle.

And for many patients, this cycle is happening just below the surface; easy to miss if we’re only looking at muscles or joints in isolation.

NOT JUST THE BODY, BUT THE BRAIN TOO

What’s especially interesting is how this concept extends beyond peripheral tissues.

The brain has its own waste clearance system: the glymphatic system. This system works closely with lymphatic pathways. It clears metabolic waste through cerebrospinal fluid and drains into the deep cervical lymph nodes.

This system:

Maintains fluid balance and brain homeostasis
Supports immune surveillance
Is most active during deep sleep

When flow is impaired, waste can accumulate. Interestingly, this is something that research has linked to conditions like Alzheimer's disease and Parkinson's disease.

It’s a reminder that lymphatic health isn’t just about swelling ~ it’s about systemic function.

SUPPORTING HEALING THROUGH THE FASCIA

As I worked with Sarah, the focus wasn’t force; it was gentle, intentional input:

Supporting fascial hydration and mobility
Encouraging subtle movement, self-lymphatic drainage and breathwork
Regular MLD and gentle fascial release treatments
Creating space for vessels to do their job

Over time, the changes were noticeable:

Less heaviness. Improved energy. A sense of things finally “moving” again.

A CLINICAL REFLECTION

If you’re working with patients who present with:

Chronic, low-grade inflammation
Persistent swelling or puffiness
Pain that doesn’t fully resolve
Fatigue or brain fog

…it may be worth asking:
“Is the fascia supporting lymphatic flow - or is it restricting it?

Because sometimes, the issue isn’t just what needs to move. It’s what’s preventing movement in the first place.

Supporting the lymphatic system means looking beyond the vessels themselves. It means considering the environment they live in.

And more often than not, that brings us back to fascia, and its effect on the lymphatic system.

A WHOLE-PERSON APPROACH

One of the reasons MLD is such a valuable treatment is that it meets the body where it’s at, while also supporting the nervous system, emotional state, and overall recovery environment.

Healing isn’t just physical ~
and effective care shouldn’t be either.

If you’re considering MLD, understanding this bigger picture can help you get the most out of your care, and feel more supported every step of the way.

• • • • • • • • • • • •

If you’re curious whether MLD is appropriate for your situation, or you’re a therapist wanting to better understand how to work with fluid-based swelling like this, I’m always happy to continue the conversation.

Yours in health and happiness,
Anne

Clinic: www.annethermt.com
Education: www.eluvettmethod.com

Image: Gogo Osteopathy, Malta
Citations:
Rajai Firouzabadi S, Mohammadi I, Aghajanian S, Aarabi A, Oraee S, Soltani SM, Mehrpour A, Salari M. Glymphatic Dysfunction in Parkinson's Disease: A Systematic Review and Meta-Analysis of Neuroimaging Studies. Mov Disord Clin Pract. 2026 Feb;13(2):331-343. doi: 10.1002/mdc3.70296. Epub 2025 Aug 16. PMID: 40817751; PMCID: PMC12911525.

Thipani Madhu M, Balaji O, Kandi V, Ca J, Harikrishna GV, Metta N, Mudamanchu VK, Sanjay BG, Bhupathiraju P. Role of the Glymphatic System in Alzheimer's Disease and Treatment Approaches: A Narrative Review. Cureus. 2024 Jun 29;16(6):e63448. doi: 10.7759/cureus.63448. PMID: 39077280; PMCID: PMC11285013.

]]><![CDATA[Understanding MLD Through a Biopsychosocial Lens]]>Sat, 11 Apr 2026 12:42:29 GMThttps://www.annethermt.com/drainage-diaries-blog/understanding-mld-through-a-biopsychosocial-lens

Why lymphatic care is about more than just fluid

If you’ve ever received, or are considering Manual Lymphatic Drainage (MLD), you may be wondering: What actually makes this treatment effective?

The answer isn’t just about the lymphatic system itself. MLD works within something called the biopsychosocial model: a way of understanding health that looks at the whole person, not just the physical body.

Let’s break that down in a clear, practical way.

THE BODY (Biological)

This is the most familiar part of MLD.

MLD supports the physical function of the lymphatic system, which plays a key role in fluid balance, immune function, and healing. When this system becomes overwhelmed or sluggish, you may experience:
• Swelling or fluid buildup
• Post-surgical or injury-related congestion
• Tissue tightness, discomfort, or scar restriction

MLD uses gentle, targeted techniques to help move fluid, reduce congestion, and support the body’s natural healing processes. This is why it’s often used in clinical settings, post-surgical care, and for chronic conditions affecting the lymphatic system.

THE MIND (Psychological)

What’s happening mentally and emotionally also matters more than people often realize.

Stress, anxiety, and emotional strain can increase tension in the body and amplify how pain or swelling is experienced. On the other hand, feeling calm, supported, and safe can shift how the body responds to treatment.

MLD is known for its calming, rhythmic nature. Many people notice:
• Reduced stress and anxiety
• A sense of relaxation and ease
• Improved comfort and body awareness

This doesn’t just “feel nice” ~ it can actually support the body’s ability to heal and regulate.

THE ENVIRONMENT (Social)

Health doesn’t happen in isolation.
Access to care, support systems, and your environment all play a role in how effective treatment is.

This can include:
• Access to trained therapists
• Support from family or caregivers
• Ability to follow through with home care
• Financial or scheduling barriers

Even the relationship between therapist and patient matters; feeling heard, respected, and understood can make a meaningful difference in outcomes.

HOW THIS ALL WORKS TOGETHER

MLD is not just about moving fluid.

It’s about supporting the body while also considering the person as a whole:
• Biological: helping reduce swelling and physical discomfort
• Psychological: creating calm, reducing stress, improving perception of pain
• Social: supporting consistency, access, and long-term care

When these pieces come together, people often experience better comfort, improved function, and a greater sense of well-being.

A SIMPLE EXAMPLE

Imagine someone recovering from surgery:
• Biological: swelling and limited movement
• Psychological: concern about healing and body changes
• Social: support from family and access to care

MLD can support the physical swelling, however, the overall experience of healing is shaped by all three.

A WHOLE-PERSON APPROACH
One of the reasons MLD is such a valuable treatment is that it meets the body where it’s at, while also supporting the nervous system, emotional state, and overall recovery environment.

Healing isn’t just physical ~
and effective care shouldn’t be either.

If you’re considering MLD, understanding this bigger picture can help you get the most out of your care, and feel more supported every step of the way.

A Gentle Disclaimer
The information shared here is intended for educational purposes only. It is not a substitute for individualized medical advice, diagnosis, or treatment. Always consult with your healthcare provider for guidance specific to your situation.

]]><![CDATA[A Thoughtful Share on Women’s Health (and a Big Thank You)]]>Thu, 09 Apr 2026 13:25:26 GMThttps://www.annethermt.com/drainage-diaries-blog/a-thoughtful-share-on-womens-health-and-a-big-thank-you

I recently received a kind message from a homeschool educator who shared a student-discovered article on women’s health ~ and I wanted to take a moment to acknowledge it here.

First, thank you. Truly.

There are so many meaningful, well-researched articles that speak to the complexity and importance of women’s health. It’s always encouraging to see young people engaging with this topic, asking questions, and learning how to explore the body with curiosity and respect.

That kind of early awareness? It matters more than we often realize.

The article she shared highlights the wide-reaching influence of hormones on the body; something that deeply aligns with the work I do in Manual Lymphatic Drainage (MLD) and lymphatic care. The lymphatic system is closely intertwined with immune function, fluid balance, inflammation, and yes, even hormonal shifts!

Many women experience changes in swelling, tissue sensitivity, and overall wellbeing throughout different phases of life, and lymphatic support can play a quiet but powerful role in helping the body adapt and restore balance.

This is why education ~ at every level ~ is so important.

To the students learning how to research and think critically: keep exploring!

To the teachers guiding them toward body awareness and health literacy: thank you for the work you’re doing.

And to everyone reading: this is your reminder that understanding your body is not just empowering… it’s essential.
There are many paths into women’s health knowledge. I’m always grateful to see another one being explored.

Warmly, Anne

If you’re curious whether MLD is appropriate for your situation, or you’re a therapist wanting to better understand how to work with fluid-based swelling like this, I’m always happy to continue the conversation.

Yours in health and happiness,
Anne
Clinic: www.annethermt.com
Education: www.eluvettmethod.com

Image: Photo by RDNE Stock project: https:pexels.com
Reference: email from educator:
Hi,
I'm an educator for homeschooling students, and we’ve found your webpage invaluable for our women's health class.
For extra-credit research, one of our students, [D], discovered this resource:
https://npprograms.org/how-hormones-affect-everything-womens-health/
She suggested it could be a good addition to your page. Could you consider linking to this resource, even temporarily? Your support would be incredibly motivating for our students.
Thank you for your time!
Best Regards,

Ms. [RR]
Homeschool Teacher

]]><![CDATA["Moon Face" - can MLD reduce steroid swelling?]]>Thu, 02 Apr 2026 13:32:59 GMThttps://www.annethermt.com/drainage-diaries-blog/moon-face-can-mld-reduce-steroid-swelling

If you or someone you care for has experienced facial puffiness while taking steroid medication, you’re not alone. Often referred to as “moon face,” this type of swelling can feel frustrating, especially when it changes how you look and feel day to day.

I am often asked: Can MLD help with this?

The short answer generally is YES!

Manual lymphatic drainage can be a supportive, gentle way to reduce fluid-related puffiness due to steroid medication, with some important context.

Important Note: Using steroid medication like prednisone for a long time is often the cause. But it can also be a sign of a health condition like Cushing’s syndrome or hypothyroidism. This article is speaking about swelling due to steroid medications, and not other health conditions.

Visit clevelandclinic.org more info: Cushing's & hypothyroidism.

UNDERSTANDING WHAT IS HAPPENING ...

Steroid medications ~ especially when taken in higher doses or over longer periods ~ can lead to fluid retention in the face and neck. This is partly due to how steroids affect:

Fluid balance
Blood vessels
The lymphatic system’s ability to keep things moving efficiently

This is why the face can appear fuller, swollen, or puffy, and often referred to as “Moon Face”.

It’s important to know that not all of this fullness is fluid. Some changes are related to fat redistribution from the medication, which behaves differently than swelling and congestion.

HOW CAN MLD HELP?

Manual Lymphatic Drainage is a light, rhythmic, and highly targeted technique designed to:

Encourage movement of lymphatic fluid
Reduce congestion in tissues
Support the body’s natural drainage pathways

For steroid-related facial puffiness, MLD can:

Decrease fluid buildup and congestion in the face and neck
Help you feel less “heavy” or tight through the tissues, reducing pain or discomfort
Create a more refreshed, less “full” appearance

This is similar to how MLD is used in post-surgical care: supporting the body in clearing excess fluid.

WHAT IT WON'T DO ...

MLD does not remove fat deposits caused by long-term metabolic effects of steroids. So results may be partial, but still meaningful, and a healthy treatment for supporting your lymphatic health and overall wellness.

PROFESSIONAL TREATMENT vs. AT-HOME SELF-CARE

Working with a trained MLD therapist ensures:

Proper technique and pressure (this is not deep massage)
Treatment tailored to your lymphatic pathways and overall (whole body) health
Safe, appropriate care if you have other medical considerations

That said, gentle self-care techniques can be helpful between treatments. Simple, light movements, especially in the morning and before bed, can support daily fluid movement when done correctly.

If you’re unsure how to do this safely, this is something I often teach both patients and therapists in a clear, accessible way.

SUPPORTIVE HABITS THAT MAKE A DIFFERENCE

MLD works best as part of a bigger picture wellness plan. Small daily habits can support your lymphatic system to:

Stay well hydrated ~ fluid helps fluid move
Reduce excess sodium intake ~ helps minimize fluid retention
Sleep with your head slightly elevated
Incorporate light movement ~ especially deep diaphragmatic breathing and calf engagement - even a short walk supports lymph flow!

These are simple, but they truly add up.

IS "MOON FACE" PERMANENT?

In most cases, no - it is not permanent.

Facial swelling related to steroids is often reversible, particularly when medication is reduced or discontinued under medical guidance. However, this process can take:

Several weeks
Sometimes a few months

MLD can be a helpful support during this transition, making the process feel more comfortable along the way.

A FEW IMPORTANT CONSIDERATONS

Never stop or reduce steroid medication abruptly
This can be dangerous and must always be guided by your healthcare provider.
MLD is supportive care ~ not a replacement for medical treatment
It works alongside your broader care plan.
Always consult your healthcare provider
Especially if swelling is new, worsening, or accompanied by other symptoms.

A GENTLE, SUPPORTIVE APPROACH

One of the things I value most about MLD is that it meets the body where it is at. When you’re dealing with medication side effects, recovery, or chronic conditions, sometimes what you need most is a supportive, non-invasive way to feel more like yourself again, and give your body some support in finding balance.

If you’re navigating steroid-related swelling, know that there are options to support your comfort ~ and that even small shifts can make a meaningful difference.

If you’re curious whether MLD is appropriate for your situation, or you’re a therapist wanting to better understand how to work with fluid-based swelling like this, I’m always happy to continue the conversation.

Yours in health and happiness,

Anne
Clinic: www.annethermt.com
Education: www.eluvettmethod.com

Image: myclevelandclinic.org

Citations:
Ramadan F. Manual lymphatic drainage: the evidence behind the efficacy. Br J Community Nurs. 2024 Feb 2;29(2):83-84. doi: 10.12968/bjcn.2024.29.2.83. PMID: 3830024
Thompson B, Gaitatzis K, Janse de Jonge X, Blackwell R, Koelmeyer LA. Manual lymphatic drainage treatment for lymphedema: a systematic review of the literature. J Cancer Surviv. 2021 Apr;15(2):244-258. doi: 10.1007/s11764-020-00928-1. Epub 2020 Aug 15. PMID: 32803533.

]]><![CDATA[Welcome to the Drainage Diaries!]]>Mon, 30 Mar 2026 15:52:06 GMThttps://www.annethermt.com/drainage-diaries-blog/welcome-to-the-drainage-diariesReal talk on lymphatic health, care, and self-awareness

If you’ve found your way here, welcome! I’m so glad you came to visit.

This space has been a long time coming. As a Manual Lymphatic Drainage (MLD) Therapist and Registered Massage Therapist practicing in Ontario, I’ve spent nearly 20 years working with patients navigating swelling, recovery, chronic conditions, and the often-overlooked complexities of the lymphatic system.

Over time, I’ve noticed something consistent:
there are a lot of questions… and not nearly enough clear, accessible answers.

Why This Blog Exists
In both my clinical practice and my teaching, I’ve had the privilege of witnessing meaningful change when the lymphatic system is properly understood and supported. Sometimes subtle. Sometimes profound.
I’ve also seen how misunderstood and underserved this system can be.

Patients often arrive feeling:

Confused about their symptoms
Unsure of what’s “normal”
Overwhelmed by conflicting information

At the same time, many manual therapists are looking for:

Practical ways to integrate lymphatic work into their treatments
A clearer understanding of when and how to apply MLD
Guidance that bridges foundational education with real clinical application

This blog is here to help meet both of those needs.

What You Can Expect from The Drainage Diaries…
This blog will be a space where I share:

Common questions I hear in practice
Real-world case reflections (shared with care and confidentiality)
Clinical insights translated into clear, approachable language
Education for therapists looking to build confidence in lymphatic work
Support for patients and the public navigating their own health journeys

My goal is to make lymphatic health feel less intimidating, more understandable, and more accessible ~ whether you’re receiving care, exploring it, or providing it.

A Shared Journey in Understanding
One of the most important pieces of this work is self-awareness.
Your body is not a template.

The way your lymphatic system presents; how you experience swelling, fluid retention, or recovery is unique to you.
Through this blog, I hope to support you in:

Building confidence in understanding your body
Recognizing patterns and responses
Feeling more informed in your care decisions

For therapists, my hope is that this becomes a place where learning feels grounded, practical, and reflective of what you actually see in the treatment room.

Rooted in Practice, Growing Through Teaching
My practice is located in London, Ontario, where my clinical focus is centered on lymphatic care. Alongside my practice, I develop and teach MLD-focused courses for Registered Massage Therapists ~ work that continues to evolve as both the profession and our understanding of the lymphatic system grow.

Teaching has reinforced something I deeply believe:
When knowledge is shared clearly and responsibly, it elevates care for everyone.

An Open Invitation
If there’s a question you’ve been wondering about, a topic you’d like to see explored, or a clinical scenario you’re curious about ~ I welcome that conversation.

This platform is not just about sharing information, but about growing awareness and visibility for lymphatic health and care in a way that is thoughtful, respectful, and grounded in real experience.

Thank you for being here, and for taking a step ~ however big or small ~ toward understanding your body a little more.
warmly,
Anne

If you’re curious whether MLD is appropriate for your situation, or you’re a therapist wanting to better understand how to work with fluid-based swelling like this, I’m always happy to continue the conversation.
Clinic: www.annethermt.com
Education: www.eluvettmethod.com

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