Manual Lymphatic Drainage for Lymphedema

Manual Lymph Drainage (MLD)
MLD is a very gentle manual treatment that improves the function of the lymphatic system throughout the body. In the 1930s the techniques of MLD were first introduced by Dr. Emil Vodder, PhD, MT from Denmark. MLD is becoming widely recognized in the United States as a treatment for many pathologies including post surgical swelling, post traumatic edema (e.g., sports injuries), migraine headaches, rheumatoid arthritis, and fibromyalgia. MLD is further used to promote general relaxation and for cleansing (detoxification) of the skin and superficial fascia. In lymphedema therapy MLD is used to reroute the lymph flow from congested areas into healthy lymph vessels, which drain into the venous circulation thereby reducing swelling.

MLD is a highly effective treatment for managing and lowering blood pressure as well as increasing low blood pressure levels.

Lymphatic Drainage is often recognized as a vascular compression therapy and as  a natural, soothing and stress free way to aid in the elimination of metabolic wastes and stimulate the immune system.

The lymphatic system is an important part of the circulatory system. It aids the body's absorption of nutrients and helps to remove waste from the tissue. The lymph collects the body's waste and then deposits it in the lymph nodes as it passes through. The lymph nodes also assist the spleen and the bones in producing new white blood cells.

How does lymphatic drainage reduce high blood pressure?

 


There is a specific process where toxic waste is eliminated from the blood stream. It is an actual pressurized system that creates a pressured force that removes toxic waste called arterial pressure. This arterial pressure forces the blood through tiny capillaries and out into the cells' interstitial spaces to effect their exchange with waste which the cells have produced. In this process, the water, or interstitial fluid filled with toxic waste, is gathered by tiny lymphatic tubules and then sent back through the lymphatic system to be detoxified. If the body or lymphatic system has any congestion or sluggishness ( slow fluid transport) this can create a condition where the arterial pressure has to increase (higher blood pressure) to force the blood through the cleansing process - thereby impacting overall body blood pressure.  MLD aids the lymphatic system's ability to absorb fluid from the interstitium into the lymphatic tubules resulting in an eventual decrease in arterial (blood) pressure.  This decrease can usually be measured after the completion of just one session.

MLD for Lymphedema

 
MLD is performed on individuals who are experiencing a specific type of swelling diagnosed as lymphedema.  Lymphedema must be properly diagnosed by a physician before receiving this type of massage since there are other swelling conditions which may present like lymphedema but for which this treatment should NOT be performed.

Lymphedema may appear anywhere in the body with some of the more common areas being upper and lower extremeties (arms, hands, legs, feet), neck and torso.  Lymphedema may be primary meaning it has existed since birth or it my be secondary meaning it is the result of physical trauma (such as radiation or surgery) or injury.  In primary lymphedema both sides of the body may be affected and have swelling.  In the case of secondary lymphedema usually only one side of the body is affected.  In either case the same treatment approach is followed.

The standard treatment for lymphedema - and an important first step - is manual lymphatic drainage (MLD) massage.  MLD is a slow, gentle, rhythmic massage that is performed using dry hands without lotions, creams or oils. MLD follows carefully plotted routines that press, stroke, stretch and pump the tissues to encourage lymph to flow freely and eliminate waste products from your system. MLD techniques are designed to move excess fluid from the body by rerouting the lymph flow around "blocked" areas (where lymphatics may be damaged or removed) into healthy lymph vessels, which then drain into the venous circulation.  
 
An example of secondary right leg lymphedema before and after several sessions of MLD.

In cases of extreme swelling, or initial onset of lymphedema a protocol known as Complete Decongestive Therapy (CDT) may need to be performed.  This protocol involves taking measurements of the affected area, applying MLD techniques to reduce swelling and then wrapping the affected limb(s) or area(s) with multi-layered compression bandages that are worn and reapplied over a series of days or weeks.  This protocol returns the limb or area to its smallest possible size and is followed by measuring and fitting the affected are with compression garments to help keep the swelling out of the affected area.  Exercises and self wrapping may also be required.
 
An example of extreme primary lymphedema before treatment, and after 6 days of CDT on right leg.
 
Normal standards of practice set forth by the International Lymphatic Society (ILS) and National Lymphedama Network (NLN) state that once an individual has been diagnosed with lymphedema then it is a lifelong condition that requires lifelong management.  MLD can help manage lymphedema when swelling arises and does not spontaneously subside.

MLD should only be performed by a Certified Lymphedema Therapist who has received training from a school or training program accredited by the International Lymphatic Society (ILS),  National Lymphedama Network (NLN) or equivalent national organization. 

 
Temple Stewart and Joan Woods completed the Introduction to Manual Lymphatic Therapy course in Richmond, VA  November 2010, taught by Carmen Thompson of Lymphatic Care Specialists, LLC.  This training allows both therapists to perform MLD protocols on healthy lymphedema-free individuals who choose MLD for health maintenance.  
Additionally, in July 2011, Joan Woods completed a rigourous 140 CEU hour certification program approved by the National Lymphedema Network (NLN) taught by Carmen Thompson. Joan passed her written and practical certification exam in July and is now a Certified Lymphedema Therapist.  Since completion of her training in 2011 Joan has worked with a variety of people presenting with both primary and secondary lymphedema to provide pain relief, swelling and other symptom reduction and client education.