MLD (Manual Lymphatic Drainage) is an advanced gentle massage technique that promotes the movement of fluids in the Lymphatic System. It stimulates the contraction of lymphatic vessels, increasing the speed of lymph transport, providing cellular nutrition through the increased blood supply.
It was pioneered by Danish physicians, the Drs. Emil Vodder and Estrid Vodder in the 1930s as a treatment for Lymphedema (when swelling occurs on one or more extremities and results from impaired flow of the Lymphatic System). The technique encourages the flow of lymph fluid out of the arm or leg. It is a way of reducing swelling caused by fluid build-up after cancer treatment, infection, injury, surgery, or genetic disorders affecting the Lymphatic system. Lymphedema can cause a range of symptoms, such as leg or arm heaviness, weakness, and pain.
While working on the French Riviera treating patients with chronic colds, the Vodders noticed these patients had swollen lymph nodes. During the 1930s, the Lymphatic system was poorly understood. Still, the Vodders were not deterred by this and, in 1932, began to study the lymph system, developing light, rhythmic hand movements to promote lymph movement.
In 1936, they introduced the technique in Paris, France. After World War II, they returned to Copenhagen to teach other practitioners to use this therapy.
How it works:
The therapy works with the Lymphatic system, which works as a third circulation, in addition to arterial and venous. The lymph is the fluid that circulates through this network of lymphatic vessels. It is rich in proteins, white blood cells, microorganism, blood cells and also carry bacterium and toxins. Its appearance is viscous and yellowish. The lymph is like blood, performs metabolic changes with the cells and then are collected by the vessels of the lymphatic system, returning to the Lymph nodes.
The Lymph nodes are found throughout the body. They are an essential part of the immune system. Its function is to help the body recognize and fight off germs, infections and other foreign substances. It is for them that the lymph collected from the vessels are directed to be filtered, with the impurities from the lymph drained into the lymph nodes. The Lymphatic system is encouraged to work better and better, making us feel lighter and healthier.
Manual Lymphatic drainage has several benefits. It can be beneficial for people dealing with several issues, such as the following:
. problem with post-exercise recovery
. to eliminate oedemas (accumulation of liquids)
. Lymphedema (reducing swelling in one or more extremities caused by fluid build-up after cancer treatment)
. Chronic venous insufficiency, in the post-cosmetic surgery (to accelerate the recovery period, relieving pain and reducing inflammation).
It also helps to prevent cellulitis, decreases menstrual cramps and improves Pre Menstrual Syndrome (PMS), contributes to the treatment of Fibromyalgia.
Not only promotes relaxation but detoxifies the body, eliminates toxins, boosts immunity, improves metabolism and digestion as well as improves the circulation.
Scientific studies show how Lymphatic drainage is beneficial for treating several health problems.
Post Exercise Recovery: (1) In a report published in the American Journal of Physical Medicine & Rehabilitation.85(6):516-520, JUNE 2006, Andy Schillinger, for instance, analyzed the effect of Manual Lymphatic Drainage on the course of serum levels of muscle enzymes after treadmill exercise. Fourteen recreational athletes (seven women, seven men) were included in the study. After an increase immediately after exercise, a fast decrease in lactate dehydrogenase (LDH) and in aspartate aminotransferase (AST) concentration was observed, with significantly lower values for LDH after 48 hrs. In the subjects having received lymph drainage treatment was found that Manual lymph drainage after treadmill exercise was associated with a faster decrease in serum levels of muscle enzymes. This may indicate improved regenerative processes related to structural damage of muscle cell integrity.
Post Cosmetic Surgery:(2)In a report published in Brazilian Journal on Health Promotion, vol. 18,num.4,2005,pp.199-204, L.M.A Soares made a comparative study of the manual and mechanical lymphatic drainage effectiveness in the dermolipectomy postoperative
period. A randomized clinical research was accomplished with 14 women from 35 to 45 years old, between the eighth to twenty-sixth postoperative days, appraised after a period of ten attendances by means of perimeter measures and symptoms relief, there was also a qualitative approach accomplished with a questionnaire to analyze both the patient’s and the researcher’s satisfaction level to the applied treatments.
Improvement was observed regarding the postoperative symptoms and their intensity in the two treatment groups. DLM showed to be more effective than DLME in the reduction of oedema, especially in the abdominal measures (p=0.01). Therefore, it’s concluded that the two techniques were effective and that MLD showed to be more efficient than MELD in the postoperative period of the patients submitted to abdominoplasty-dermo lipectomy.
Chronic Venous Insufficiency:(3)In a report published in Arch Med Sci. 2013 Jun 20; 9(3): 452–458, Pawel Molski, Jacek Kruczyński, Andrzej Molski, Stanislaw Molski evidenced that Manual Lymphatic Drainage improves the quality of life in patients with chronic venous disease: a randomized controlled trial. The study included 216 consecutive patients with a diagnosis of CVD ( Chronic venous disease ), qualified for elective surgery and compression therapy for this reason. Concluded that Manual Lymphatic Drainage decreases the degree of disease severity and foot and lower limb volume in patients with chronic venous disease, as well as improving their quality of life, MLD was applied in patients with chronic venous disease pre-operatively provides better effects of treatment, which is manifested by a decrease in the degree of disease severity, foot and lower limb volume, and improvement of quality of life.
Lymphedema:(4) In a report published in International Journal of Radiation Oncology, Biology and Physics, March 1,2007Volume 67, Issue 3, Pages 841–846, was evidenced that of the 250 patients,138 were included in the final analysis. The mean age at presentation was 54.3 years. Patients were stratified based on the treatment modality used for breast cancer management. Lymphedema was managed with combined decongestive therapy in 55%, Manual Lymphatic Drainage alone in 32%, and the home program in 13%. The mean pretreatment volume of the affected and normal arms was 2929 and 2531 mL. At the end of 1 year, the posttreatment volume of the affected arm was 2741 mL. The absolute volume of the affected arm was reduced by a mean of 188 ml (p < 0.0001). The type of surgery(p = 0.0142), age (p = 0.0354), and body mass index (p < 0.0001) were related to the severity of Lymphedema,concluded that combined decongestive therapy and Manual Lymphatic Drainage with exercises were associated with a significant reduction in the Lymphedema volume.
Manual Lymphatic Drainage should be avoided by individuals experiencing any of the following:
- Any active cancer
- Acute infection
- DVT (Deep vein thrombosis)
- Acute allergies
- Terminal cancer
- Precancerous skin lesions or raised moles
- Kidney failure
- Heart failure
- Liver disease
MLD is a treatment that should be part of a routine, can be done weekly, two times per week, depending on the client’s need. These needs are usually based on the levels of fluid retention, bloating, toxicity and discomfort of each person.
Ana Trida Therapist
(Specialist in Lymphatic Drainage, Brazilian Nurse)