Lymph is Fascia

Many people have heard of the lymph system but they don’t realize that it’s part of the fascial system. All the tissues considered as “specialized connective tissues” of mesodermal derivation, such as blood, bone, cartilage, adipose tissue, hematopoietic tissue, and lymphatic tissue, are regarded as part of the fascial system.1,2 Blood and lymphatic vessels are solid fascial structures that carry liquid fascia.3

Most people know that the lymphatics remove waste products. What most people do not realize is that the lymphatic system is always at work constantly trying to maintain balance. The lymphatic system effectively removes the excess of interstitial fluids, solutes, and various waste products. The lymph system is responsible for constantly maintaining balance in the volume of plasma and interstitial fluids. The lymphatic system is able to process solutes and fluids through small capillaries with discontinuous endothelium and basement membrane that resist flow of fluids and substances (hydrophiles molecules, cells, viruses, and bacteria).

It is well known that lymphatics are aided in their contractile capabilities based on muscle contraction. Less well known is that the lymph system is also able to contract based on artery pulsation. In addition, lymphatics attach to cells via collagen type VII fibers that give the lymphatic system its own autonomous contractions.4

The lymphatic system also has sensory function and can sense flow variation. They are surrounded by both parasympathetic and sympathetic nerve fibers that allow these vessels to adapt and change their elastic capacity, improving or worsening the function of lymphatic transport.4,5

The lymphatic system is subject to aging, losing its elasticity and creating “aneurysms” over time. The number of lymphangions (the lymphatic functional unit) also decrease with age.4

The brain also has a lymphatic system called the glymphatic system. The cerebrospinal fluid (CSF) is drained through the venous system and the lymphatic system. The glymphatic system absorbs the interstitial liquid and the cerebrospinal fluid (CSF) from the subarachnoid space and clears out waste product from the brain. This mechanism is strongest during sleep.6

What can you do to keep your lymphatics healthy?

Good hydration is important to keeping your lymphatics healthy. Hydration helps in maintaining the pressure and volume in the lymphatic system.7

Routine exercise and movement can help keep your lymph system healthy. Exercise and upright movement helps to change the flow and pulsation of blood vessel and influences lymphatic flows (volume, speed, and direction) 8,9 Exercise has also been shown to stimulate AQP4 in the glymphatic system and clear toxins including β-amyloid.10

Sleep is important to allow the glymphatic system to clear toxins. The glymphatic system is most active during sleep.6 PET studies have revealed that Aβ accumulates in the healthy brain after a single night of sleep deprivation.11

Routine visceral and lymph work is also helpful in maintaining lymphatic health.12 In particular, cranial osteopathy can help keep the glymphatic system operating well.13


1. Bordoni B, Marelli F, Morabito B, Castagna R, Sacconi B, Mazzucco P. New Proposal to Define the Fascial System. Complement Med Res. 2018;25(4):257-262. doi:10.1159/000486238

2. Adstrum S, Hedley G, Schleip R, Stecco C, Yucesoy CA. Defining the fascial system. Journal of Bodywork and Movement Therapies. 2017;21(1):173-177. doi:10.1016/j.jbmt.2016.11.003

3. Bordoni B, Lintonbon D, Morabito B. Meaning of the Solid and Liquid Fascia to Reconsider the Model of Biotensegrity. Cureus. July 2018. doi:10.7759/cureus.2922

4. Negrini D, Moriondo A. Lymphatic anatomy and biomechanics: Biomechanics of initial lymphatics. The Journal of Physiology. 2011;589(12):2927-2934. doi:10.1113/jphysiol.2011.206672

5. Mignini F, Sabbatini M, Coppola L, Cavallotti C. Analysis of Nerve Supply Pattern in Human Lymphatic Vessels of Young and Old Men. Lymphatic Research and Biology. 2012;10(4):189-197. doi:10.1089/lrb.2012.0013

6. Aspelund A, Antila S, Proulx ST, et al. A dural lymphatic vascular system that drains brain interstitial fluid and macromolecules. The Journal of Experimental Medicine. 2015;212(7):991-999. doi:10.1084/jem.20142290

7. Bordoni B, Marelli F, Morabito B, Sacconi B. The indeterminable resilience of the fascial system. Journal of Integrative Medicine. 2017;15(5):337-343. doi:10.1016/S2095-4964(17)60351-0

8. Demchenko GA, Vovk EV. [Effect of a passive orthostatic test on lymph circulation]. Kosm Biol Aviakosm Med. 1991;25(3):18-20.

9. Pearson SJ, Hussain SR. A Review on the Mechanisms of Blood-Flow Restriction Resistance Training-Induced Muscle Hypertrophy. Sports Med. 2015;45(2):187-200. doi:10.1007/s40279-014-0264-9

10. Yin M, Pu T, Wang L, Marshall C, Wu T, Xiao M. Astroglial water channel aquaporin 4-mediated glymphatic clearance function: A determined factor for time-sensitive treatment of aerobic exercise in patients with Alzheimer’s disease. Med Hypotheses. 2018;119:18-21. doi:10.1016/j.mehy.2018.07.016

11. Rasmussen MK, Mestre H, Nedergaard M. The glymphatic pathway in neurological disorders. The Lancet Neurology. 2018;17(11):1016-1024. doi:10.1016/S1474-4422(18)30318-1

12. Chikly BJ. Manual techniques addressing the lymphatic system: origins and development. J Am Osteopath Assoc. 2005;105(10):457-464.

13. Hitscherich K, Smith K, Cuoco JA, et al. The Glymphatic-Lymphatic Continuum: Opportunities for Osteopathic Manipulative Medicine. J Am Osteopath Assoc. 2016;116(3):170. doi:10.7556/jaoa.2016.033


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