Manual Lymphatic Drainage

I have been practicing Manual lymphatic drainage for 2 years now, and it has been very rewarding, as any of the many therapist I offer at my practice.

Manual lymph drainage consist of very gentle manual technique, designed to have the effect on fluid components and lymphatic structures located in the superficial tissues, such as the skin and the subcutis. Lymphedema almost exclusively manifest itself in the subcutis, which is a layer of connective tissue between skin and muscle tissues.

The lymph system is the body’s natural cleansing mechanism, ridding our cells of toxic fluids. Without a functional lymphatic system, the body swells and aches, and we feel sluggish and even sick. Manual Lymphatic drainage therapy can help the lymphatic system flush these fluids, and jump start the cleansing process when the body has built up too much swelling.

What Is Lymphatic Drainage Massage?
Manual Lymphatic drainage therapy, was originally developed in Germany. It was intended to treat lymphedema, swelling caused by accumulated fluid that happens after the surgical removal of lymph nodes, which happens most frequently during mastectomy surgeries. Primary lymphedema can also occur although its cause is unknown; when it does, it typically happens throughout life and can affect many parts of the body. Various other conditions cause lymphedema as a secondary symptom.The Vodder Method
Manual lymphatic drainage or MLD therapy was developed in the 1930’s by Emil and Estrid Vodder and is widely prescribed by physicians in Europe and in the United States and Canada.

The Benefits of the Vodder Method

• Removes metabolic waste, excess water, toxins, bacteria, large protein molecules and foreign substances from the tissues.
• MLD, through its gentle rhythmical precise hand movements, alleviates pain by greatly reducing the pain signals sent to the brain.
• MLD relaxes the sympathetic nervous system, thus helping to relieve stress.
• MLD supports and enhances the action of the immune system.
• MLD helps the body to heal more quickly from surgical trauma.
• MLD helps to minimize scar formation.

Why Is Lymphatic Drainage Massage Important?

A working lymphatic system is essential to the body’s ability to regenerate tissues, drain fluids, filter out foreign substances and toxins, detoxify, and maintain a healthy immune system. The lymphatic system is complex, and made up mostly of nodes and lymph vessels working together to achieve these aims. The lymph itself carries fatty acids, hormone cells, immune cells, proteins, and toxins to be processed by the lymph nodes. When the body is under stress, fatigued, experiencing infections, fighting a disease process, or—in certain cases—recovering from surgery, the process may be slowed down.

Lymphatic Drainage Massage After Cosmetic Surgery

Cosmetic surgeries all produce swelling to some extent, because it is part of the body’s normal healing process. Some cosmetic surgeries, such as liposuction procedures, tummy tucks and fat transfer (brazilian butt lift) disrupt the natural pathways taken by the lymphatic system because of the location of the surgery. Other regions of the body, such as the nose after a rhinoplasty, produce swelling that can last for a long time—even up to one year. Other cosmetic procedures that impact the face can also produce months of swelling. However, because of the extensive areas of disruption, tummy tucks and liposuction procedures are usually the cosmetic surgeries with the greatest amount of lymphatic swelling.
When the lymph drifts out into surrounding tissue after a surgical procedure disrupts the normal lymphatic pathways, swelling is the result, but there are ways to combat this problem.
Post-Surgery Garments to Assist Lymphatic Drainage Massage
Compression garments help the entire process. They prevent the buildup of too much toxin-carrying fluids in any one area of the body, and help the body keep excess fluids from sticking around where they don’t belong. They also make manual lymphatic drainage therapy more effective, keeping the body more receptive and ready for the process. It’s easy to find the right kinds of compression garments for after your procedure, and your cosmetic surgeon will be able to recommend the right garments for you.
If you have questions about manual lymphatic drainage therapy after cosmetic surgery or what to expect after a cosmetic procedure you’re considering, the best thing you can do is have a conversation with your surgeon. Clearly, manual lymphatic drainage therapy is helpful in the prevention of excessive swelling and pain which will make your overall healing from cosmetic surgery much faster and more comfortable.

Contraindications and Precautions:

Congestive heart and renal failure

“Certainly, if someone’s had active congestive failure or active renal failure, for example, they should not be seen for manual lymphatic drainage for at least two months,” Thompson explains. “We need to make sure they’re medically stable.” According to Thompson, you don’t want to move fluid that’s there as an indication of a health problem, like a failing heart or kidney.

Blood Clot

Often, says Thompson, a blood clot will cause swelling, but an active blood clot is not something you want to perform MLD over. Be on the lookout for symptoms of deep vein thrombosis (DVT), as well, which is a blood clot that forms in a vein deep in the body. Warmth and tenderness over a vein, skin redness and pain or swelling are all symptoms of DVT, and massage should stop if you notice any of these in a client.
Related, if you’re working with a person who has diabetes and may have circulation problems or arterial insufficiency—any condition where blood and fluid isn’t getting into the limb because there’s a transport issue—you want to postpone therapy. “If they’re not getting good blood flow and fluid into the limb,” Thompson says, “we certainly don’t want to move the blood and fluid that’s making it there out of the limb.”


Active infection in the limb area you’re going to treat is also a contraindication, Thompson says. “Infection and inflammation are not the same,” she adds. “Infection always has inflammation, but inflammation is not always infection.” So here, you should look for signs and symptoms of cellulitis, for example, which include red streaking, fever and chills.
Additionally, some conditions, though not strictly contraindications, should be treated as precautions by massage therapists. For example, if your client has any devices that are implanted, such as an insulin pump or pacemaker, you need to work carefully and consider when massage might need to be postponed.
Also, if a client presents with new-onset edema that you haven’t seen or worked with before and you don’t know the origin, consider postponing the session. Any phlebitic areas—where a vein is inflamed and may cause pain and swelling—need to be treated with caution, too, Thompson advises.
In all of these instances, massage therapists should ask clients to get medical clearance and permission from their physician before a massage therapy session.
As more and more research proves the benefits of massage therapy, learning new techniques that can help your clients deal with a wide variety of health conditions is a great way to foster loyalty and reach potential new clients. “Manual lymphatic drainage has been the single most effective tool I’ve added to my toolbox,” Thompson says. “All modalities are helpful. But we have so many clients we come into contact with, especially if we’re working in medical populations, who can’t tolerate the deep work, especially if there’s new onset edema, bruising and pain. MLD is a tool to use with those clients sooner rather than later and help them reach their outcomes.”

Blog written by Precision MD