Manual lymphatic drainage (MLD) is a gentle type of massage therapy which is used to promote and encourage natural lymphatic flow in the body. It is used to increase lymph system activity, increase re absorption of lymph fluid, promote relaxation and create an analgesic (pain relieving) effect. MLD was developed by Dr. Emil Vodder and his wife Estrid Vodder who, in 1932, worked as massage therapists in Cannes on the French Riviera. Many of their patients were seeking treatment for chronic colds when the Vodder’s realized that many of them had swollen lymph nodes in their necks. The Vodder’s developed the technique which they named Manual Lymphatic Drainage to make their patient’s colds vanish (Klose Training, 2018).
The Lymphatic System
The lymph system consists of many vessels, nodes, tissues and organs which work together to help rid the body of toxins and wastes. Lymph vessels work to pump the lymph fluid to the lymph nodes for filtration. There are hundreds of lymph nodes within the body, some deep and some superficial. The most common collections of nodes are present in the neck, underarm, abdomen and groin. When lymph nodes are removed or when the lymph vessels are compromised in any way, the lymph fluid cannot flow properly and swelling can occur. This type of swelling is termed “lymphedema”.
Primary and Secondary Lymphedema
Primary lymphedema occurs when the lymphatic system does not develop properly from birth. It can be hereditary or sporadic, meaning that it can be passed down genetically or can occur with no previous family history. In these unfortunate circumstances, people are born with less lymph nodes than usual or have abnormal lymph vessel development. Depending on the location of the damaged/non-existent lymph nodes, swelling can accumulate in the legs, arms, abdomen, chest, and/or genitals. Some syndromes that are commonly associated with primary lymphedema include Emberger syndrome, Klippel-Trenauney syndrome, Noonan’s syndrome, Prader-Willi syndrome, and Turner’s syndrome.
Secondary lymphedema is caused by known factors that damage the lymphatic system, such as lymph node removal, surgery, or scar tissue build up. Most commonly, women who have had breast cancer treatments are affected by secondary lymphedema. Often lymph nodes are removed from the underarm area as they can easily become infected. Also, scars that result from mastectomies and any scar tissue that builds from radiation treatments can contribute to lymphedema accumulation. Other causes of secondary lymphedema include filariasis, surgery, trauma, infection, chronic venous insufficiency (CVI), and obesity.
There is no cure for lymphedema, but there are treatments to reduce the swelling. Complete Decongestive Therapy (CDT) combines four components of lymphedema therapy. These include compression therapy, MLD, exercise, and skin care. Compression therapy can be used in the form of compression bandaging and/or compression garments. It is important to wear compression garments 23 hours a day, 7 days a week to ensure proper drainage of the lymph fluid and to stop re-accumulation. MLD is used to manually create new pathways for the lymph to travel in order to move it out of the limb and back to healthy lymph nodes for the fluid to be filtered and dispersed. It is a very crucial component to the treatment of lymphedema. Exercise is very important in the treatment process also. It can be done with the compression garments on or off. The contraction of muscles along with the movement of joints can be used as a pump to move and stimulate the lymphatic system. Skin care is also an essential component of CDT in order to decrease the possibility of skin infections including fungal infections and cellulitis.
Health conditions you can treat with MLD include:
- Primary and Secondary Lymphedema
- Post-surgical Edema
- Palliative needs
- Rheumatoid Arthritis
- Chronic Venous Insufficiency (CVI)
- Meniere’s Disease
- Acute sports injuries
- Complex Regional Pain Syndrome (CRPS)
Written by: Kristen Noack, Registered Massage Therapist, Certified Lymphedema Therapist