Everyday signs
Puffiness in the ankles and feet after sitting or standing, rings and shoes feeling tighter as the day goes on, a face that looks puffy in the morning, and bloating that is not related to what you have eaten are all signs that fluid is accumulating faster than it is draining. Heaviness and aching in the legs, stiffness on waking, and skin that holds a dent when you press it for a few seconds point the same way.
Why drainage slows
The lymphatic system depends on movement. Long periods sitting or standing, flights, inactivity after illness or injury, hot weather, a high-salt diet, hormonal changes around periods and menopause, and some medications all slow it. It is usually a functional problem in an otherwise healthy system, which is why movement, hydration and drainage techniques help.
When it is something more
Swelling in one limb only, swelling that does not go down overnight, swelling with pain, redness, warmth or breathlessness, or swelling after cancer treatment or surgery to the lymph nodes may indicate lymphoedema, a clot, infection or a heart, kidney or liver problem. These need a GP or urgent care, not a massage.
What helps
Regular movement, especially walking and anything that works the calf muscles; deep breathing; drinking water; reducing salt; elevating the legs; and manual lymphatic drainage or compression therapy to move fluid that has already accumulated. At our Chiswick clinic we screen for the warning signs above before treating, and refer on where something needs medical assessment.