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Manual lymphatic drainage (MLD) is a type of massage based on the hypothesis that it will encourage the natural drainage of the lymph, which carries waste products away from the tissues back toward the heart. The lymph system depends on intrinsic contractions of the smooth muscle cells in the walls of lymph vessels (peristalsis) and the movement of skeletal muscles to propel lymph through the vessels to lymph nodes and then to the lymph ducts which return lymph to the cardiovascular system. Manual lymph drainage uses a specific amount of pressure (less than 9 ounces per square inch or about 4 kPa) and rhythmic circular movements to stimulate lymph flow.[1][2] Clinical studies of MLD conclude that further study of the practice is required before recommending it as an effective health treatment.

Medical use[edit]

Studies show mixed results regarding the efficacy of the method in treating lymphedema and further studies are needed.[3] A 2013 systematic review of manual lymphatic drainage with regard to breast cancer related lymphedema found no clear support for the effectiveness of the intervention in either preventing limb edema in at-risk women or treating women for the condition.[4]

History[edit]

Manual lymphatic drainage was pioneered by Danish Drs. Emil Vodder and Estrid Vodder in the 1930s[2] for the treatment of chronic sinusitis and other immune disorders. While working on the French Riviera treating patients with chronic colds, the Vodders noticed these patients had swollen lymph nodes. In the 1930s, the lymphatic system was poorly understood. 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 this technique in Paris, France, and after World War II, they returned to Copenhagen to teach other practitioners to use this therapy.[5]

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References[edit]

  1. ^Milady's Guide to Lymph Drainage Massage; Ramona Moody French; Delmar/Cengage; 2004
  2. ^ abStillerman, Elaine (2009). Modalities for Massage and Bodywork. Mosby. pp. 129–143. ISBN032305255X.
  3. ^'Manual Lymph Drainage Combined With Compression Therapy for Arm Lymph- edema Following Breast Cancer Treatment'(PDF). Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU). Retrieved 25 April 2014.
  4. ^Huang TW, Tseng SH, Lin CC, Bai CH, Chen CS, Hung CS, Wu CH, Tam KW (2013). 'Effects of manual lymphatic drainage on breast cancer-related lymphedema: a systematic review and meta-analysis of randomized controlled trials'. World J Surg Oncol. 11 (15). doi:10.1186/1477-7819-11-15. PMC3562193. PMID23347817.
  5. ^Levine, Andrew (1998). The Bodywork and Massage Sourcebook. Lowell House. pp. 173–84. ISBN9780737300987.

External links[edit]

  • Explanation of Manual lymphedema therapy on the National Cancer Institute web site.
Retrieved from 'https://en.wikipedia.org/w/index.php?title=Manual_lymphatic_drainage&oldid=933658811'

Manual lymphatic drainage (MLD) is a way of reducing swelling caused by fluid build up after cancer treatment. There are different types of manual lymphatic drainage (MLD). They include Vodder, Földi, Casley-Smith and Fluoroscopy guided manual lymphatic drainage (FG-MLD).

You should only have MLD from a specially trained therapist in one of these types.

How it works

The aim of MLD is to move fluid from the swollen area into a place where the lymphatic system is working normally.

To do this, the specialist first uses specialised skin movements to clear the area that they want the fluid to drain into.

It might seem strange to have skin movements on your chest and neck if you have lymphoedema in your arm. But it means that the fluid has somewhere to drain to when the therapist treats your arm.

How you have MLD

You usually lie down to have MLD. But if you have lymphoedema in your head and neck, you sit up.

When you have MLD, you feel a gentle pressure. The skin movements are very light so that the small lymph vessels are not flattened. Flattened lymph vessels would prevent the lymph fluid from draining. The movements are slow and rhythmic so that the lymph vessels open up.

You might have MLD daily from Monday to Friday. Or you might have it 3 times a week, for about 3 weeks.

The number of treatments you have depends on the type of MLD and what you need. Your specialist will also take into account the amount of swelling you have.

After MLD

The specialist might bandage the area. They use a specialised bandaging technique called multi-layered lymphoedema bandaging. If it is not possible or necessary to use bandages, you will need to wear a compression garment.

Your lymphoedema specialist will regularly check how well your treatment is working. They’ll look at whether the tissues are softening and how much the swelling is going down.

Once the swelling is under control, you might need another compression garment to wear.

Remember that you are the person who will notice changes in the swelling first. You need to talk to your specialist about how your treatment is working. Managing lymphoedema is very much about you and the specialist working together.

Simple lymphatic drainage

Simple lymphatic drainage (SLD) means that you learn how to do an easier version of MLD yourself. It is sometimes called self massage.

A specialist needs to teach you how to do this. Your lymphoedema specialist might teach you to do SLD in only the areas where you don’t have lymphoedema. This frees up space for the lymph fluid to drain into from the swollen area.

You don’t do SLD in the area where you have swelling. The skin movements in the swollen area are more difficult to do. Your therapist will show you how to move the skin in the surrounding areas. Ask them questions if anything is not clear.

You do SLD twice a day, for about 20 minutes each time. Only apply light pressure, as your lymphoedema specialist taught you.

When you shouldn't have MLD or SLD

There are some situations when you should not have MLD or SLD. Your lymphoedema specialist will tell you whether you can or can’t. Always check with them if you aren't sure.

You might not be able to have MLD or SLD if you have any of the following:

  • an infection or inflammation in the swollen area
  • a blood clot
  • heart problems
  • cancer in the area

If you are uncertain about having MLD or doing SLD, talk to your doctor or lymphoedema specialist.