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What is Manual Lymph Drainage?

Manual Lymphatic Drainage [MLD] is an unique, gentle type of skin massage technique that promotes lymph to drain out of a limb into an area that drains normally. It is mainly used for lymphedema.


In addition to improving lymphatic circulation, MLD also increases blood flow in deep and superficial veins.


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

• 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


Primary or secondary lymphedema


Phlebo-lymphostatic edema

Postoperative edema

Posttraumatic edema

Chronic venous insufficiency

Palliative care: Provision of comfort and pain relief when other physical therapies are no longer appropriate

Certain digestive symptoms


This technique may be used as a complement in therapies for patients with stress. Furthermore, it may be effective for reducing intracranial pressure in severe cerebral diseases.




Absolute Contraindication:

Decompensated cardiac insufficiency

Cardiac edema

Congestive heart failure

Acute inflammation caused by pathogenic germs (bacteria, fungi, viruses).

The germs could be spread by the manual lymph drainage, with resulting blood poisoning (sepsis).

Acute renal failure

Blood clots

Kidney problems

infections or circulation problems


If a person has any medical conditions, they should talk to a doctor before trying a lymphatic massage.  Condition stated above must not be treated with manual lymph drainage.


Relative Contraindication:

Malignant lymphedema caused by active cancer


The skin is stretched in specific directions using hand movements to promote variations in interstitial pressure with the use of specific detoxification essential blended oil.


Slow repetitive movements are used which incorporate a resting phase allowing skin to return to its normal position.

The pressure is varied according to the underlying tissue with the aim to promote lymphatic drainage.


Areas of fibrosis are treated using deeper and firmer movements in combination with Compression therapy.


Functional and healthy lymph nodes are treated first, followed by proximal and contralateral areas and then ipsilateral and lymphedematous areas.


Breathing techniques used are combined with pressure by the therapist's hands which promotes drainage of deep abdominal lymph nodes.

Limb mobilization and relaxation techniques are often combined with lymphatic drainage.

Benefits of this treatment

While the heart continuously pumps blood through the blood vessels, the lymphatic system relies on the movement of smooth muscles to transport fluid through the lymph vessels.


Health conditions can interrupt the normal flow of lymph, causing lymph fluid to build up in a particular area of the body, often in the arms or legs, where it can causing swelling. This condition is called lymphedema.


People can develop lymphedema as a result of infections, cancer treatments that involve the removal of lymph nodes, and any condition that damages the lymphatic system.


Lymphatic massage can reduce swelling and improve circulation throughout the lymphatic system. Lymphatic massage usually forms part of a treatment program called decongestive lymphatic therapy (DLT).


DLT for lymphedema includes:

lymphatic drainage massage

compression garments


skin car

Who can benefit?

Lymphatic drainage massage can benefit people who are experiencing the following:



swelling or edema

skin disorders




digestive problems


migraine episodes


The authors of a 2015 systematic review concluded that lymphatic massage might be more effective than connective tissue massage in relieving symptoms of stiffness and depression in people living with fibromyalgia.