Manual lymphatic drainage (MLD)

The manual lymphatic drainage technique was presented by Dr. Emil Vodder in 1936 at a congress in Paris.

It is currently one of the well-studied manual therapy methods – a special type of massage whose goal is to improve the function of lymphatic system without enhancing the blood flow in the process. 

There is a difference between a correctly performed manual lymphatic drainage and a classic massage. Unfortunately, quite brutal techniques like anti-cellulite or sculpting massage etc. are often called manual lymphatic drainage. However, these methods are not used in lymphedema treatment! Even slight reddening of the skin is considered an error of the specialist in manual lymphatic drainage: the procedure should not increase blood flow at all because it increases the load on the lymphatic system which is unacceptable in lymphedema. 

There are a few techniques in manual lymphatic drainage, but they can all be reduced to one and the most important technique – “circles around a spot”. A hand of the CDT (complete decongestive therapy) specialist is applied to a certain area; it then moves in a desired direction (along the lymphatic vessels) together with the skin, without sliding, and easily comes back afterwards. All these steps are performed softly and painlessly. Manual lymphatic drainage specifically focuses on improving the lymph transport, its outflow. Depending on the part of the body where the “circles around a spot” technique is applied, the positioning of the hands may change; one or two hands may be used. Manual lymphatic drainage is never limited to the affected limb. It always starts with the central part (lymphatic nodes – supraclavicular, anterior cervical, cervical, occipital) because its goal is to activate the function of the whole lymphatic system to help the affected part of the body cope with the load.

Breathing exercises – the abdominal breathing – is an important stage. It allows to decrease the pressure in large lymphatic vessels located withing a body. Breathing exercises reduce the pressure in the lymphatic system and stimulate its function. 

It is very good when a patient (or their relatives who were taught by CDT specialists during the treatment) continues to perform the manual lymphatic drainage at home following the treatment at the clinic; then the phase II of CDT (the result retainment phase) is even more effective. 

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