Manual Lymph drainage (MLD), is a technique developed by the Vodders (Dr. Emil Vodder and his wife, Estrid) in 1936 in Paris for treatment of swollen lymph nodes.

Lymphatic diseases, especially lymphoedema, represent a serious problem in the health community.

MLD is a light, skin-stretching massage that helps promote the movement of lymphatic fluid out of the swollen limb. It should not be confused with a traditional massage. MLD is specifically focused on the lymph vessels to help the flow of lymphatic fluid. Therapy is applied to your unaffected areas first, making it possible for the fluid to move out of the affected area, or “decongest” the region. MLD helps open the remaining functioning lymph collectors and move protein and fluid into them, as well as to help speed up lymph fluid flow through the lymphatics.

Deep breathing techniques called diaphragmatic breathing are usually done at the beginning and end of a therapy session to help open the deep lymphatic pathways. It’s not only relaxing, but it helps increase movement of fluid toward the heart.

  • The intention behind MLD is to augment the rhythmic contractions and stimulate the lymph nodes to improve their activity in order to reroute stagnant lymphatic fluid.
  • MLD is comprised of four main strokes: stationary circles, scoop technique, pump technique, and rotary technique.
  • It is effective as a preventative and postoperative rehabilitation treatment.
  • MLD is a a key component Complex Lymphoedema Therapy (CLT). It shows optimal results when it is combined with the other CLT elements.
  • MLD also increases blood flow in deep and superficial veins.
  • MLD may be useful in conditions such as post-traumatic and post-surgical oedema and palliative care.

There are various techniques for MLD including the Vodder, Földi, Leduc or Casley-Smith methods.

MLD is recommended as a component of CLT, but is often used in combination with other treatments. MLD in isolation is effective but a combination of the parts of CLT is optimal. CLT has been shown to be effective in reducing lymphedema volume and improving quality of life patient mobility.

It often takes many hours of training in MLD, combined with years of hands-on experience, for a lymphedema therapist to become truly skilled.

The most appropriate techniques, optimal frequency and indications for MLD, as well as the benefits of treatment, all remain to be clarified, but the different methods have several aspects in common, including the following:

  • Usually performed with the patient in the lying position
  • Starts and ends with deep diaphragmatic breathing
  • The unaffected lymph nodes and region of the body are treated first
  • Moves proximal to distal to drain the affected areas
  • Slow and rhythmical movements
  • Uses gentle pressure – this is essential