Opening The Big 6

Why the Order Matters

If you’ve been to see me for Manual Lymphatic Drainage, you’ve probably heard me talk about opening your Lymph Pathways (aka the Big 6) before doing lymphatic drainage

But why do we always do them in the same order?

Imagine your lymphatic system as a beautiful river flowing through your body. Along the way, the river passes through six major “checkpoints” where lymph is filtered before continuing on its journey.

If one of those checkpoints becomes congested, the river begins to back up.

Now imagine trying to push more water downstream before you’ve cleared the blockage. It doesn’t work very well—and sometimes it can make things feel even more sluggish.

The order matters:

1️⃣ Collarbones (Clavicles) - above and below

2️⃣ Behind the ears (upper neck)

3️⃣ Armpits (Axillary)

4️⃣ Abdomen

5️⃣ Groin (Inguinals)

6️⃣ Behind the knees (Popliteal)

By opening these pathways first, you’re giving your lymph somewhere to go before encouraging more fluid to move through the system.

Think of it as clearing the river downstream before asking more water to flow.

A Few Minutes Makes a Difference

The good news is this self-care routine only takes a couple of minutes.

Using light pressure, gently:

• Rub each area in order 10 times.

• Then lightly tap each area 10 times.

Remember, lymphatic vessels live just beneath the skin. This isn’t a deep tissue massage. Gentle is actually more effective.

Finish with Movement & Breath

Once you’ve opened the Big 6, spend a minute doing calf raises or ankle pumps.

Every time your calf muscles contract, they help squeeze the deep lymphatic and venous vessels in your legs, encouraging fluid to travel upward toward your body’s natural drainage pathways.

Think of your calf muscles as a second heart, helping move fluid back home.

Even 20–30 slow calf raises while brushing your teeth, waiting for your coffee, or standing at the kitchen counter can help support healthy lymph flow.

🌬️ Take 5 Deep Diaphragmatic Breaths

Your diaphragm isn’t just your primary breathing muscle — it’s also one of your lymphatic system’s most important pumps.

As your diaphragm moves down with each deep inhale and rises with each slow exhale, it gently changes the pressure inside your chest and abdomen. That natural pressure change helps encourage lymph to move through some of the body’s largest lymphatic vessels.

Try this:

• Place one hand on your chest and the other on your belly.

• Breathe in slowly through your nose, allowing your belly to gently rise.

• Exhale slowly through your mouth, letting your belly soften.

• Repeat for 5 slow, relaxed breaths.

There’s no need to force a big breath. Slow, comfortable breathing is all your body needs.

Think of your calf muscles as little pumps, working with your diaphragm to keep your lymph moving.

Together, your gentle breathing and calf muscles create a wonderful one-two combination that supports healthy lymph flow.

✨ Little things, done consistently, often make the biggest difference.

Remember, your lymphatic system doesn’t need perfection — it loves consistency.

A few minutes of gentle self-care each day can support the work we do together during your MLD sessions and help keep your “river” flowing smoothly.

💚 A Note for Cancer Survivors & Those Living with Lymphedema

The “Big 6” sequence described in this article is intended for general wellness and for individuals without diagnosed lymphedema or altered lymphatic anatomy.

If you’ve had lymph nodes removed, radiation therapy, cancer treatment, or have been diagnosed with lymphedema, your lymphatic pathways may have changed. The most appropriate sequence — and even which areas should be treated — can be different for you.

For your safety, I recommend following the guidance of your Certified Lymphedema Therapist (CLT) or other qualified healthcare provider, who can teach you a personalized self-care routine based on your individual needs.

Because advanced lymphedema requires specialized training, I do not treat these conditions in my practice. If you have questions about whether these techniques are appropriate for you, I’m happy to help you determine whether a referral to a Certified Lymphedema Therapist would be the best next step.