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MANUAL LYMPHATIC DRAINAGE 

This is a gentle, non-invasive manual technique that has a powerful effect on the body. Research in Australia, Europe and North America has proven it’s efficacy as a stand-alone treatment and in combination with other therapies. Developed in France in 1932 by Emil and Estrid Vodder, MLD has grown to be the most well-known manual technique to assist lymph flow and aid in the drainage of tissues. 

Therapists are required to have a high level of education and study a total of 160 hours above their standard level for their professional accreditation. Always 
check to make sure your therapist has been certified in MLD therapy before beginning MLD treatment.


Techniques

This technique is distinctive in its circular or spiral strokes and does not involve the application of oils or lotions. There is a gentle application of pressure (30 torr or approx. 4 kPascal) to absolutely no pressure which generates a pumping effect. The strokes are performed in a steady and rhythmic pattern specific to the area being treated. The neck is always treated first in every treatment before addressing the needs of the patient. 

For MLD to be effective, the use of proper specialist technique and adaptation of the length of individual therapy session to meet the needs of the pathology 
concerned are essential. In comparison with other forms of massage, MLD sessions are lengthy. A typical MLD session is 1 hour but can be extended to 90 
minutes depending on the condition and if supportive therapy such as taping or compression bandaging is required.

Effects 

Decongestive- any swelling of the body- with the exceptions of cardiac(heart) and renal (kidney) edema can be successfully treated with MLD. 
The MLD technique induces a pumping effect in the tissue. The lymphatic pathway’s own rhythm is accelerated up to 20x its normal rate. The excess fluids 
in the tissue (lymphatic load) is transported through the lymph vessels up to the right ventricle of the heart and reintroduced into the circulatory system. This 
enhanced drainage effect results in rapid decongestion and restoration of normal tissue condition. 

Sympatholyic Effect- MLD is very soothing. Frequently patients will fall asleep during treatment. It is a wonderful preventative measure against burnout. 

Analgesic Effect- Pain relief through MLD works by stimulating large areas of the body to reduce the feeling of pain. (Gate control theory) Moreover, MLD 
results in pain mediators being drained into the lymphatic system more rapidly, so they are no longer active in the tissue. Any prolonged pain, such as the pain generated by migraines, acute injuries, Sudeck’s disease, fibromyalgia, Chronic Regional Pain Sydrome (CRPS) etc. are conditions benefitted by MLD treatment. 

Immunological Effect- MLD helps to accelerate the transportation of bacteria and allergens to the places where the body’s defense system is located- 
the lymph nodes. The increased rate of lymphatic drainage heightens the sensitization of lymphocytes and macrophages. This improves the body’s 
response to and rate of recovery from illnesses.

Conditions Indicated for MLD 

Extensive Lymphedemas of the limbs- primary (congenital) or secondary (after trauma to or removal of lymph nodes, typically as a result of cancer 
treatment). It is important to understand that MLD rarely achieves complete removal of edemas in such cases. It does help greatly by reducing the size of the edematous area and improves the quality of life and is usually combined with exercise, compression bandaging and eventually custom stockings. With 
prolonged edema there is a serious risk of tissue changes to the affected area which can greatly impact a person’s ability to function and have a quality life. 

Traumatic Injuries- hematomas, burns, muscle fibre tears, joint dislocations/sprains, fractures, concussions. Treatment can be started very early in the healing process compared to other therapies due to its ability to be done proximal to the area and can be highly successful in promoting return to normal health especially in combination with other therapies. 

Scars/Wound Healing- MLD has been proven to improve wound healing and optimizes the scarring process. Post-surgical scarring can be addressed and 
the impact of local edema and discolouration can be minimized. This includes orthopedic and plastic surgeries alike. 

Dental issues/procedures- treatment of TMJ dysfunction in acute stages can be benefitted from MLD treatment as well as post periodontal surgery such as 
root canal and jaw realignment. The analgesic and anti-inflammatory effects can be very beneficial. 

Chronic Inflammatory Conditions- relief from rheumatic disorders including Osteoarthritis, tendonitis, sinus issues or bronchitis/asthma can be 
aided by MLD in conjunction with other forms of massage or other therapies. 

Dermatological conditions such as acne and rosacea can also be helped. 

Pregnancy related edema and varicosities- MLD can help short term with edema from pregnancy and can aid the effectiveness of compression stocking for both pregnant women and those suffering from the pain and frustration of varicose veins. 

Chronic Health Conditions- MS, post stroke, Fibromyalgia, Endometriosis, 

Migraines  can benefit greatly from the anti-inflammatory and analgesic effects of MLD

Contraindications- safety is always a priority for any therapy and MLD is no exception. MLD is not appropriate for the following conditions:

- Any metastatic or systemic malignant condition
- Acute inflammation caused by bacteria, viruses or foreign bodies 
- Any thrombosis at risk of causing an embolism

Precautions must be taken with the following conditions and your MLD trained therapist can discuss those with you:
- Edema following carcinoma treatment 
- Thyroid dysfunction
- Chronic inflammation
- Bronchial asthma (during flareups)
- Hypotension
- Edema caused by cardiac decompensation (CCHF)
- Diabetes


Copied in part from Wittlinger Clinic website
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