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What is Manual Lymphatic Drainage Massage?

Manual Lymph Drainage (MLD) is a technique developed by the Vodders (Dr. Emil Vodder and his wife, Estrid) in 1936 in Paris for treatment of swollen lymph nodes [1],  MLD is a light, skin-stretching massage that uses gentle pressure which helps promote the movement of lymphatic fluid out of the swollen limb.  It should not be confused with a traditional massage.  MLD is specifically focused on the lymph vessels to the help the flow of lymphatic fluid.  Therapy is applied to your unaffected areas first, making it possible for the fluid to move out of the affected area, or “decongest” the region.  MLD helps open the remaining functioning lymph collectors and move protein and fluid into them, as well as to help speed up lymph fluid flow through the lymphatics.

Deep breathing techniques call diaphragmatic breathing are usually done at the beginning and end of a therapy session to help open the deep lymphatic pathways.  It’s not only relaxing, but it helps increase movement of fluid toward the heart [2].

MLD:

  • Is intended to stimulate lymph nodes and increase rhythmic contractions of the lymphatics to enhance their activity so that stagnant lymphatic fluid can be rerouted.
  • Is usually performed with the patient in the lying position.
  • Starts and ends with deep diaphragmatic breathing.
  • Moves proximal to distal to drain the affected areas.

MLD Techniques:

  • Slow repetitive movements are used which incorporate a resting phase allowing skin to return to its normal position.
  • The pressure is varied according to the underlying tissue with the aim to promote lymphatic drainage.
  • Areas of fibrosis are treated using the deeper and firmer movements.
  • The lymphatic drainage starts centrally and proximally with treatments usually starting around the neck.
  • Functional and healthy lymph nodes are treated first.
  • The way duration of treatment varies depending on the stage of lymphedema the client has, eg, intensive treatment may be for 2-4 weeks and less intensive treatments could last for months or years [3].
  • This technique may be used as a complement in therapies for patients with stress [4].

Want more info?  Read “What is a lymphatic drainage massage and how does it work?” from Livescience.com

Absolute Contraindication:

  • Decompensated cardiac insufficiency
  • Untreated congestive heart failure (CHF- cardiac edema)
  • Acute inflammation caused by pathogenic germs (bacteria, fungi, viruses).  The germs could be spread by the manual lymph drainage, with resulting blood poisoning (sepsis).
  • Acute renal failure
  • Acute deep venous thrombosis (DVT)

Conditions stated above must not be treated with manual lymph drainage.

References:

1. Dr Vodder School International. Manual Lymph Drainage History (MLD). Available from: https://vodderschool.com/manual_lymph_drainage_history
(Accessed 3 September 2020)
2. Lymph care, MLD Available from: https://www.lymphcareusa.com/patient/therapy-solutions/complete-decongestive-therapy/manual-lymphatic-drainage-mld.html
(last accessed 17.8.2020)
3. Tzani I, Tsichlaki M, Zerva E, Papathanasiou G, Dimakakos E. Physiotherapeutic rehabilitation of lymphedema State-of-the-art. Lymphology. 2018 Jul 2;51(1):1-2. Available from: https://www.researchgate.net/publication/326301004_Physiotherapeutic_rehabilitation_of_lymphedema_State-of-the-art
(last accessed 16.8.2020).
4. Jung-Myo S, Sung-Joong K. Manual Lymph Drainage Attenuates Frontal EEG Asymmetry in Subjects with Psychological Stress: A Preliminary Study. J Phys Ther Sci. 2014 Apr; 26(4): 529-531.