Manual Lymphatic Drainage (MLD)

Manual Lymphatic Drainage (MLD) is a massage technique that stimulates the lymphatic flow and helps transport the lymph from swollen to non-swollen areas. It is an integral part of Complex Decongestive Therapy (CDT).

Manual Lymphatic Drainage (MLD)

How does Manual Lymphatic Drainage (MLD) work?

MLD is a specific massage technique with gentle, skin-stretching movements. These movements transport the lymphatic fluid from your swollen areas in the direction of the lymph flow and in areas that are draining well. This is called ‘decongesting.’

MLD starts in the areas of the non-swollen parts of your body to open the well-working lymph collectors, make the lymph flow faster, and induce a suction effect. Your therapist will continue with MLD in your swollen body parts to direct the fluid to the open lymph collectors. The gentle, rhythmic motions on your skin can also help to soften any hardened (fibrotic) tissue.

Deep breathing enhances the positive effects of MLD. So-called ‘diaphragmatic breathing’ helps to open deep-seated lymph collectors. Therefore, MLD usually starts and ends with deep breathing exercises. By the way, laughing is a deep breathing technique as well! Besides its effect on the lymphatic flow, it can also relieve stress, anxiety, or even depression.

Who does perform Manual Lymphatic Drainage (MLD)?

Only certified therapists should perform MLD. They are trained on the recognized techniques and have a profound knowledge of the disease. MLD is not suitable for everyone, and there are situations, such as infections, where MLD must not be applied. Always refer to your healthcare professional (HCP) first to make sure that MLD is right for you.

What is Simple Lymphatic Drainage (SLD)?

You can also learn how you can do Lymphatic Drainage by yourself. Simple hand movements can move the lymph fluid out of the affected area as well. This is called Simple Lymphatic Drainage (SLD). Your therapist can show you, or your relatives, how to do it.

What is Mechanical Lymphatic Drainage?

Mechanical Lymphatic Drainage can support lymphedema therapy, if applicable. Whereas Manual Lymphatic Drainage (MLD) is performed with the hand, mechanical Lymphatic Drainage is performed with specific devices.

One example of Mechanical Lymphatic Drainage is the “intermittent pneumatic compression” device. It is an electronic pump that fills sleeves, gloves, or boots with air fitted to the affected part of your body. The device applies a certain amount of pressure over a certain time to transport the lymphatic fluid to the center of your body and reduce the swelling of the affected body parts.

Intermittent pneumatic compression is most suitable for less active patients, e. g., patients who recover from a surgery or illness. It is also an option when MLD or conservative compression therapy is not sufficient to treat your lymphedema.

Devices like intermittent pneumatic compression devices are only used in clinics, but there are also devices for use at home. When appropriate, your HCP can prescribe such a device. In many cases, your health insurance covers these devices.

Who benefits from Manual Lymphatic Drainage (MLD)?

MLD and SLD are key elements of Complex Decongestive Therapy, together with compression therapy, exercise, and skin care. MLD can cause relief in all stages of lymphedema, and also helps to soften fibrotic (hard) tissue that may appear in the later lymphedema stages. SLD is one of the self-management techniques in the treatment of lymphedema.

Learn more about what you can do on your own to improve your lymphedema

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