Fluid movement is an important part of the environment in which our muscles, nerves, fascia and joints function. It is particularly relevant when tissues are swollen, heavy, pressured or recovering from injury or surgery.

​When pain, swelling, or discomfort lingers, one contributing factor can be slowed fluid and drainage flow in the body. This influences how well tissues receive nutrients, how waste and inflammatory signals are cleared, and how easily healing can progress.
What is the lymphatic system?
Blood delivers oxygen and nutrients to tissues throughout the body. After this exchange, the fluid surrounding cells — containing waste products and inflammatory by-products — needs to return to circulation so it can be processed and cleared. This is the role of the lymphatic system.
Lymphatic vessels collect this “used” fluid (called lymph) and return it to the bloodstream, helping prevent fluid buildup, support immune balance, and assist tissue repair.
Why fluid movement affects pain and healing
Nerves, muscles, joints, and fascia exist in a fluid-rich environment, and that fluid is meant to move continuously. Unlike blood circulation, the lymphatic system has no central pump. Although larger lymphatic vessels have smooth muscle that contracts rhythmically, lymph movement is mainly supported by breathing, everyday movement, changes in tissue pressure, and pressure changes between the chest, abdomen and pelvis.
After surgery or injury, lymphatic vessels may be damaged or temporarily overwhelmed. Reduced movement can also diminish some of the external pressure changes that normally assist fluid transport. When fluid accumulates, tissues may feel swollen, heavy, tight or stiff and can sometimes become more sensitive.
​Inflammation is more complex than simply “poor drainage.” Early inflammation usually increases fluid movement into an area and can also increase lymph flow. Difficulties are more likely when fluid formation exceeds the tissue’s capacity to transport it, or when lymphatic pathways have been damaged or remain impaired.
Brain drainage
The brain has its own lymph-like drainage system that helps clear waste products and inflammatory by-products, especially during rest and sleep. This developing area of research is often described as the glymphatic system. Sleep, vascular pulsation and nervous-system activity appear to influence these processes, but the precise mechanisms are still being investigated.
Why this matters for joint health
Joints aren’t just mechanical structures made of bones, ligaments and cartilage—they are also fluid environments. Most movable joints are lined by a thin, vascular tissue called the synovium, which helps produce and regulate the synovial fluid inside the joint. Synovial fluid acts a little like oil in a hinge, helping the joint surfaces move with very little friction—but it does more than simply lubricate. It also helps nutrients reach articular cartilage, which has no direct blood supply. Synovial fluid is not lymph, but the two systems are connected through local fluid exchange: lymphatic vessels within the synovial tissues help return excess fluid, proteins and immune-related substances to the circulation.
When a joint is injured or irritated, the synovium may become inflamed and additional fluid can accumulate as swelling or joint effusion. This can be a normal part of early healing, although persistent synovial inflammation and altered local drainage may contribute to some ongoing joint conditions.
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Joints aren’t designed to handle load purely through hard surfaces pressing together. Instead, they rely on these fluid, elastic tissues and changing pressure within the cartilage to help spread forces and absorb shock as you walk, stand or change position. A healthy joint behaves less like a rigid hinge and more like a hydrated, pressure-sharing system.
This fluid dimension of joint health is often overlooked. While the spine is a familiar example (pictured above), a similar pressure-sharing principle supports joints throughout the body, helping them stay resilient and adaptable over time. 

Regular movement helps circulate fluid and provides the changing loads that cartilage requires. Walking, comfortable joint movement and rhythmic activity are ways to support these normal processes. Alongside regular movement, simple self-care techniques can support fluid movement more systemically, such as the Big 6 routine that follows.

Lymphatic Self Care at Home: The Big 6

What is the BIG 6 ?
The Big 6 is a simple self-care sequence designed to support healthy fluid movement in the body. It works with key areas involved in lymphatic drainage and blood flow, helping nutrients move into tissues and supporting the removal of waste products and inflammatory by-products.

This sequence is done in a specific order to encourage fluid to move from areas of higher pressure toward areas of lower pressure, particularly toward the drainage points near the collarbone. You can follow along with the video below, taught by Perry Nickelston from Stop Chasing Pain.
by Perry Nickelston from Stop Chasing Pain​
What are the BIG 6 points?
The six areas are:
  1. The collarbone (above and below)
  2. The side of the neck (around the upper cervical area)
  3. The pectoral and armpit region (shoulder drainage area)
  4. The abdomen
  5. The groin crease (inguinal region)
  6. Behind the knees
For best results, the Big 6 should always be performed in this order, as each step helps prepare the body for the next.
Before you start
Before doing the Big 6, make sure you are:
  • well hydrated
  • not constipated
Both are important for healthy fluid movement.
How often should you do the Big 6?
For most people, once a day is a good starting point. Pay attention to how your body responds.

When first starting, some people notice temporary reactions such as tiredness, brain fog, mild soreness, or a short-term increase in symptoms. These responses are generally linked to changes in fluid movement and immune activity as the body adjusts. If this happens, take a break and wait until you feel more settled before repeating the sequence.

Once your body tolerates the Big 6 comfortably, additional sessions can be added if needed.

When to be cautious
Do not perform the Big 6 if you:
  • are pregnant
  • have significant heart or circulation conditions
  • have an acute infection
  • have been diagnosed with cancer
This technique is not a substitute for medical care. Always check with your healthcare provider before starting any new self-care program.
Source: Stop Chasing Pain: The Big 6
The fluid side of nerve health
​Nerves are soft, hydrated living tissues—thousands of delicate fibres supported within a fine framework, bundled inside protective layers and supplied by tiny blood vessels. The familiar experience of an arm “falling asleep” after lying on it shows how sensitive nerves are to pressure, which can temporarily affect their signalling and local blood flow. If pressure is stronger or more sustained, the small veins within a nerve may be compressed and fluid can accumulate. If surrounding tissues restrict the nerve’s normal glide, movement may also expose it to repeated tension or local pressure, potentially contributing to tingling, numbness or sensitivity.
How informed manual therapy supports fluid flow
Modern manual therapy — including lymphatic, fascial, visceral, neural-informed, and pressure-based approaches — doesn’t just focus on muscles and joints. It can also work with the tissue environment in ways that may support the body’s natural fluid dynamics.
Lymphatic vessels (in green) weave through the body’s fascial layers, helping collect tissue fluid and guide it back into the circulation (source).
Hands-on work that supports breathing, tissue movement, and overall pressure relationships may help create conditions that are more favourable for fluid exchange through the tissues. This can be part of a broader approach when tissues feel congested, puffy, pressured, or slow to settle.

If blood flow is the body’s supply line, the lymphatic system is its drainage landscape — slow-moving rivers and deltas that help tissues avoid becoming waterlogged and irritated.
⚠️ Disclaimer:
This page is here to support—not replace—medical advice. If you're experiencing intense, unusual, or worsening symptoms, it's a good idea to check in with your GP or health care provider.

🩺 For Referrers:
We’re always happy to collaborate with referring providers. Feel free to get in touch to discuss an approach or referral.
Sources & Further Reading:
by Joe Liguori
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