What is Manual Lymphatic Drainage?
Manual lymphatic drainage, or MLD, is a form of manual therapy that targets the lymphatic
system. The lymphatic system is a network of organs, ducts, nodes and vessels that move
lymph, a fluid made up of white blood cells, proteins and other cellular waste products as well
as bacteria and viruses, into the bloodstream. Along the way the lymph is filtered through
lymph nodes, removing the bacteria, viruses and cancer cells.
Normally, the natural action of muscles in the body facilitates this fluid flow, however, surgery,
medical conditions and other damage can interrupt it and cause fluid to build up in the tissues.
Initially developed for individuals with Lymphedema, a condition resulting from damage to the
lymphatic system, MLD is also effective in reducing fluid build-up and pain associated with
various other conditions including:
- - Chronic venous insufficiency
- - Post-surgical swelling
- - Fibromyalgia
- - Rheumatoid arthritis
- - Osteoarthritis
- - Swelling/edema due to acute/chronic injuries
- - Skin disorders
- - Migraine
- - Sinusitis
Lymphatic drainage is also beneficial to reduce fluid in legs due to pregnancy or after a long
What Happens During a Treatment and How You Will Feel After
Manual lymphatic drainage treatment is performed by a certified lymphedema therapist (CLT),
and usually takes place in a massage or physiotherapy clinic. The process is very similar to a that
of a massage therapy treatment.
During a session the skin is gently stretched, tugging on the lymphatic vessel underneath,
allowing excess fluid from the surrounding tissue to enter the vessel and drain away, eventually
filtering it through the lymph nodes. Some clients show an immediate improvement, showing a
decreased size of the affected area. Chronic conditions require more intensive sessions over
Every body responds differently to lymphatic drainage. Most clients report feeling relaxed and
sleeping very well the night after their treatment, as well as a decrease in symptoms. A small
proportion of individuals may have a stronger response and experience some side-effects such
as headache, body ache, diarrhea or skin rash.
How Many Appointments Will I Need?
This will depend on the reason for receiving treatment. Some conditions, such as Lymphedema,
require a specific treatment regimen (see sections on Lymphedema and CDT).
Post-surgical clients should expect to receive treatment once per week for 3-4 weeks, then
every 2 weeks for 4 weeks.
If you are coming for reasons other than these please schedule an appointment once per week
for 3 weeks. This will allow time for you and your therapist to determine how you are
responding to the therapy and how to proceed.
What is Lymphedema
Lymphedema is a build-up of protein-rich fluid (lymph) that is normally drained through the
lymphatic system, commonly affecting the arms or legs, and sometimes the chest wall,
abdomen, neck and genitals. In particular, cancer treatments that remove or damage lymph
nodes, blocking the drainage of fluid, can cause lymphedema. Severe cases can affect a
person’s ability to move the limb, increase the risk of skin infections and lead to skin changes
Symptoms of lymphedema can be managed using a treatment approach called Combined
Decongestive Therapy (CDT). CDT is a combination of manual lymphatic drainage, compression
bandaging and garments, skin care and exercises. Treatment typically begins with an initial
intense (reductive) phase to bring it under control, during which a therapist is seen 5 days per
week over the course of 3 to 8 weeks, followed by an ongoing maintenance phase.
What is Combined Decongestive Therapy
Developed as a treatment for post-mastectomy lymphedema, Combined Decongestive Therapy
(CDT) is a combination of manual lymphatic drainage, compression bandaging and garments
and exercise. A trained therapist manages the treatment in two phases – a reductive phase and
a maintenance phase.
The initial reductive phase is aimed at getting the extra fluid out of the limb and other affected
areas. This is an intense period of treatment when therapy is received 5 days per week for 3 to
8 weeks with compression bandages worn around the clock, removing them only for showering
and MLD treatments. you for your patience