Manual lymphatic drainage (MLD) is a gentle, specialized massage technique used to stimulate the lymphatic system and reduce swelling. The lymphatic system is responsible for filtering waste and fluids from the body.
What is MLD?
It uses light pressure. Unlike regular deep-tissue massage, MLD uses very light, rhythmic circular movements which target lymphatic vessels just beneath the skin.
It involves skin stretching. MLD involves rhythmic, circular, and stretching movements to gently open initial lymph collectors.
It begins with clearing pathways. Therapists first open pathways (like those at the neck, armpits, and groin) and create space before moving fluid from congested or swollen regions.
No skin lubricants are used. MLD is performed on dry skin to ensure a proper grip and accurate stretch of the tissue, unlike traditional massages that use oils or lotions.
Diaphragmatic breathing is encouraged. MLD combines deep, rhythmic breathing exercises at the beginning and end of the session to stimulate deep lymphatic pathways and assist fluid movement.
It is painless and relaxing. MLD moves at a slow, repetitive pace that does not cause pain or skin redness, frequently inducing deep relaxation or sleep.
Methods of MLD
There are different approaches in training and performing manual lymphatic drainage.
Vodder — Several hand motions are used on the skin surface, depending on the part of the body being treated. Vodder also includes edema movements at fibrotic areas. The different motions include “pump,” “scoop,” “stationery circle,” “rotary” and “thumb circle.”
Foldi — This method is based on the Vodder technique but places emphasis on a “thrust” and “relaxation” phase. “Encircling strokes” are included in this approach.
Casley-Smith — This method involves the use of gentle and slow effleurage movements with the side of the hand. The effleurage movements are performed over the “watershed” areas between lymphotomes.
Leduc — This method involves use of “calling up” (or enticing) and “reabsorption” movements which reflect how lymph is absorbed first in the initial lymphatics and then into larger lymphatics.
Foldi and Vodder refer to two methods of MLD. Vodder is the original method, while Foldi is an extension of it, incorporating a thrust and relaxation phase with circular hand motions.
Benefits of MLD
MLD can effectively reduce swelling and can provide symptomatic relief of migraine headaches, fibromyalgia, rheumatoid arthritis, scleroderma, reflex sympathetic dystrophy, stress, fatigue, and more. It is important to seek MLD services from a therapist who is specially trained in one of these methods, as the techniques are specific and require expertise.
Lymphedema relief. MLD is used by certified specialists to manage and reduce swelling caused by cancer treatments or lymph node removal.
Condition support. MLD helps manage swelling linked to chronic venous insufficiency, lipedema, fibromyalgia, and injuries.
Cosmetic effects. Facial techniques can temporarily reduce puffiness and boost local circulation.
Contraindications to MLD
Massage of any kind, including MLD, should not be performed on those who have acute infections, active deep vein thrombosis, or conditions where shifting fluid places dangerous stress on the heart or kidneys, such as congestive heart failure.
Extensions of MLD
Reflexology
Reflexology targets and stimulates specific areas in the hands, feet, face and ears to increase the function of all systems for the greatest optimal health throughout the zones of the body — reflexology gently encourages the body, from the inside out, to heal itself. There are several reflexes for the lymphatic system on the feet and hands. The Reflexology Lymph Drainage technique is a unique sequence which has been researched and found to aid the function of the lymphatic system. Encouraging lymph movement through reflexology is beneficial for clients without insurance, clients who are wanting to remain dressed during treatment, clients who are wanting an alternative to manual lymph drainage, and those clients who are wanting to boost their health.
Manual lymphatic drainage. (n.d.) Physiopedia.
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Research
Lymphatic system research can be found here.
Additional Information
5 reasons why you need applied MLD | Moving Lymph
Benefits of manual lymphatic drainage | Jobst
FAQs about lymphatic drainage massage | Cedars-Sinai
How to perform a lymphatic drainage massage | Medical News Today
Lymphatic drainage massage | Cleveland Clinic
Lymphedema pumps versus manual lymphatic drainage VIDEO | Brooks Rehabilitation
Manual lymph drainage: What to know about exercises for lymphedema relief | University of Texas MD Anderson Cancer Center
Manual lymphatic drainage | Physiopedia
Massage and lymphatic drainage benefits | Dr. Thomas Wright
Reflexology lymph drainage | Reflexology Lymph Drainage
Techniques to use at home to stimulate lymphatic drainage | Gordon Medical
Why MLD should be started as early as possible | Moving Lymph
What are the side effects of lymphatic massage? | Hypervibe
What you need to know about pressotherapy | Healthline