Manual Lymphatic Drainage (MLD), is a very gentle type of treatment technique that addresses swelling (edema) trapped in your body’s tissues. This swelling may be evident in the feet, ankles, legs, arms, etc., when there has been injury or trauma. However, internal swelling, in areas such as the shoulders and spine or even around scar tissue or any post-operative areas, cannot be seen but may be causing symptoms such as pain and stiffness. Because we use a total body balance approach, both internal and external swelling is effectively addressed; we do not need to know exactly where the stagnation is located. MLD consists of gently stretching and directing the skin in order to stimulate the lymphatic system. We prepare the lymph nodes that are easily accessible, to promote whole body (systemic) drainage. This is one of those cases where less is more. The goal is to show the body how to self-correct and move any stagnant fluid that may be having a negative impact on the body.

MLD is most notoriously known for reducing swelling caused by fluid build-up after cancer treatment (lymphedema); it can reduce edema following an injury. It can also reduce fluid retention due to inflammation or a disease process. It is used to decrease pain, reduce stiffness, restore movement, and allow for optimal tissue healing. MLD drains excess fluid from the tissues, while also having a detoxifying effect. Although It is most often used to address medical conditions, it can benefit a healthy person as well. A properly functioning lymphatic system is essential for overall health.

MLD is an advanced type of manual therapy (or medical massage), but it is quite different than classic massage. It consists of gentle, rotating, pumping motions that moves the lymph fluid without increasing the blood circulation. Increasing the blood circulation with deep massage and heat can inhibit the movement of lymph fluid by changing the permeability of the lymph and blood vessels. Do NOT receive a general therapeutic, deep tissue or Swedish Massage in lieu of MLD.

The lymphatic system is a critical part of the immune system, vital for protecting us from illness, as well as  damaging, disease-causing inflammation. Essentially, the lymphatic system is the body’s inner “drainage system.”  MLD addresses the lymphatic network of vessels and lymph nodes that carries fluids from tissues around the body. The lymphatic system has the primary role of protecting the body against outside threats — such as infections, bacteria and cancer cells — while helping keep fluid levels in balance.

The Lymphatic system is our recycling center and plays an integral role in the immune functions of the body. It is our first line of defense against infection and keeps our body’s waste products and fluids in balance. When this system becomes blocked, our fluid thickens and swelling in the blocked area occurs. The swelling is often internal and cannot be seen or felt. The lymphatic system’s network of tissues and organs can be affectively stimulated by utilizing the specific techniques of MLD. When applied properly it will increase the lymphatic flow, stimulating a malfunctioning or fatigued system and clearing up blockages in areas that are stagnant. It can either be used on specific areas or as a total body-balancing approach. By innervating specific areas with MLD, the entire body can be positively affected, and imaging studies have shown that we can increase the speed of flow by about tenfold.

MLD improves health-related quality of life symptoms. In October of 2017, the first MRI of the brain showing the lymphatic channels was obtained. It indicated that the lymphatic vessels of the brain also drain into the same area as the rest of the body. So, when you innervate the other areas, are we also draining the brain? Good chance!

There are different types of approaches to MLD; they include: Vodder, Földi, Casley-Smith, to name a few. These approaches are quite similar and they all look to attain the same goal.

MLD is used to treat a variety of conditions, such as: lymphedema, burns, fluid retention, lymph node removal, allergies, chronic fatigue syndrome, chronic mastitis, headaches and is a commonly requested therapy following liposuction.

It is also believed to aid in the healing of fractures, torn ligaments and relieves fluid congestion, swollen ankles, puffy eyes, headaches and swollen legs during pregnancy. Chronic conditions such as rheumatoid arthritis, sinusitis and fibromyalgia may also improve after receiving MLD. Chronic and acute pain sufferers have found MLD very helpful as well.

The amount of sessions needed can vary based upon many different factors. Very often 2-3 sessions are recommended, although sometimes just having a single session can be tremendously effective. In the case of severe swelling or following surgery, it is not uncommon to need 6-12 sessions.

After an initial consultation, you will undress, lie down on a massage table in the face-up position, covered modestly with a sheet. The atmosphere is the same as a massage treatment room with dim lighting and soft music.  Although you are in a massage setting, it is important to understand that MLD is a specific form of bodywork designed to efficiently move lymph fluid in your body. MLD is completely different from a deep tissue, Swedish or relaxation massage that you may be expecting or have had in the past. Stimulation of the Lymphatic System activates the para-sympathetic nervous system producing an automatic physiological relaxation response. Many clients fall asleep. Only the area being worked on is undraped at any time. Gentle, rotating, pumping motions with the therapist’s hands and fingertips begin at the collarbone area, then focus on areas where there is a concentration of lymph nodes…the underarms, abdomen, groin and back of the knees. Usually the entire session is performed with you lying in the face-up position because all the areas of lymph nodes that need to be decongested are generally located on the front of the body.,

We recommend booking the first session for 50 minutes. The follow-up sessions should be booked for 30 minutes, although if we can shorten the session without compromising your care, we will. A 50- minute session is $100. A 30-minute session is $60 and a 20- minute session is $40.00.

MLD can be done every day. In some countries it is done 3 times a day. How often you need to come is based on your condition and general health. We can discuss this during the initial consultation. Generally, we see patients 2-3 times a week for non-controlled swelling and less often for maintenance and well-being.

The authors of a 2015 systematic review concluded that lymphatic massage might be more effective than connective tissue massage in relieving certain conditions.

It is easy to see a swollen ankle, hand, arm, etc. that has been injured or has undergone a surgical procedure. What may not be so easy to see, is internal swelling at a joint, accompanying scar tissue, etc.

We often recommend patients for MLD that have that have:

Lymphatic drainage is credited with preventing swelling and bruising, healing acne and wrinkles, relieving fatigue and sports injuries, and generally enhancing the immune system, to name a few other benefits.

MLD is a systemic, rhythmic method of purposefully stretching the skin to produce an increase in the volume of flow of the lymph fluid through the filtering system of the body. There is often a tendency for the lymph system to become sluggish for a multitude of reasons such as stress or even spending too much time on the couch or eating unhealthy processed foods. We often describe an MLD session as a needed tune-up that everyone can benefit from. It’s like getting a tune-up for your body. It’s great for the brain giving us of us a much-needed reboot!

Talk to your doctor and make sure you get their approval for a Manual Lymph Drainage session if you have or had congestive heart failure, blood clots, kidney problems, infections, or circulation problems.

MLD is often implemented by specially trained therapists, known as a Certified Lymphatic Therapist (CLT). CLT Therapists not only perform MLD but they are also trained in Complete Decongestive Therapy, which also includes many other treatment approaches. These practitioners are certified, and include Physical Therapists, Occupational Therapists, Licensed Massage Therapists and other Licensed Healthcare Professionals. At a minimum, 135 class hours are required for certification. Marla, a Licensed Massage Therapist and the director, has been a CLT since 2006 and was recertified in 2018.

MLD Certification is also available through some of the same reputable schools that offer CLT certification. Our Certified Manual Lymph Drainage Therapists at Hands On, have completed a 5½ day MLD Certification course based on the techniques developed by Dr. Emil Vodder, Ph.D., MT. They have completed their training through Klose Training.

It is always important to verify the credentials of anyone who claims they do MLD.