What is a lymphatic drainage massage used for?

Lymphatic drainage massage, also known as manual lymphatic drainage, is a gentle form of massage used to relieve painful swelling in your arms and legs caused by lymphedema. Lymphedema often affects people recovering from breast cancer surgery. Manual Lymph drainage (MLD), is a technique developed by the Vodders (Dr. Emil Vodder and his wife, Estrid) in 1936 in Paris for treatment of swollen lymph nodes. Lymphatic diseases, especially lymphedema, represent a serious problem in the health community.

MLD is a light, skin-stretching massage that helps promote the movement of lymphatic fluid out of the swollen limb. It should not be confused with a traditional massage. MLD is specifically focused on the lymph vessels to help the flow of lymphatic fluid. Therapy is applied to your unaffected areas first, making it possible for the fluid to move out of the affected area, or “decongest” the region. MLD helps open the remaining functioning lymph collectors and move protein and fluid into them, as well as to help speed up lymph fluid flow through the lymphatics.

Lymphedema happens when your tissues retain fluid left behind after your cardiovascular system sends blood to your tissues and organs.

The remaining fluid is called lymph. Normally, your lymphatic system collects your lymph and returns it to your heart via a network of lymph vessels and lymph nodes. When something disrupts your lymphatic system’s process, lymph collects in your arms and legs, making them swell.

A massage therapist uses lymphatic drainage massage techniques to move lymph from your tissues to your lymph nodes, which eases the swelling in your tissues.

 How are lymphatic drainage massages done?

A lymphatic drainage massage is a two-step process:

• Clearing: This step releases lymphatic fluid in your tissues.
• Reabsorption: This step moves your lymphatic fluid to your lymph nodes.
• The intention behind MLD is to augment the rhythmic contractions and stimulate the lymph nodes to improve their activity in order to reroute stagnant lymphatic fluid.
• MLD is comprised of four main strokes: stationary circles, scoop technique, pump technique, and rotary technique.
• It is effective as a preventative and postoperative rehabilitation treatment.
• MLD is a a key component Complete Decongestive Therapy (CDT). It shows optimal results when it is combined with the other CDT elements.
• MLD also increases blood flow in deep and superficial veins.
• MLD may be useful in conditions such as post-traumatic and post-surgical oedema and palliative care..

 What are some conditions that can benefit from lymphatic drainage massage?

Lymphatic drainage massages are often used to relieve lymphedema following breast cancer surgery. Other conditions that benefit from lymphatic drainage massages are:

• Rheumatoid arthritis: This is ongoing arthritis in your joints causing joint pain, swelling and stiffness.
• Fibromyalgia: This condition causes chronic muscle and joint pain.
• Chronic venous insufficiency: This happens when your leg veins aren’t working effectively, making it hard for your blood to return to your heart from your legs.
• Lipoedema: This happens when excess fat accumulates in your lower body, blocking your lymphatic pathway and causing lymphedema.

MLD is indicated in primary or secondary lymphedema in the following situations:

• When there is swelling at a limb’s root
• When trunk and midline oedema is present
• When comfort and pain relief is required but other therapies are no longer appropriate – palliative
• As an adjunct to pain management
• As a preventative treatment
• Chronic venous insufficiency 

MLD may also be helpful in the below situations:

• It may be used as a complement treatment for patients with psychological stress. 
• It (craniocervical MLD) may be effective for reducing intracranial pressure in people with severe cerebral diseases.

Principles of MLD

• The skin is stretched in specific directions using hand movements to promote variations in interstitial pressure without the use of oils.

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

• The pressure is varied according to the underlying tissue with the aim to promote lymphatic drainage. The pressure however is softer than in traditional massage.

• Areas of fibrosclerosis are treated using deeper and firmer movements in combination with compression therapy.

• The lymphatic drainage starts centrally and proximally with treatments usually starting around the neck.

• Functional and healthy lymph nodes are treated first.

• There is emphasis on treatment of anterior and posterior trunk in the early phases before the swollen limb is treated.

• Breathing techniques are combined with pressure by the therapist’s hands to promote drainage of deep abdominal lymph nodes and vessels.

• Limb mobilization and relaxation techniques are often combined with MLD.

It is often given as part of Complete Decongestive Therapy (CDT) which has two phases – phase I and II. MLD is performed in phase I and II, but phase II has more MLD. The two phases consist of the following:

 Phase I

• MLD
• lymphological compression bandages
• remedial exercises
• physiotherapy where patients are struggling with mobility or joint mobility/function
• Education regarding self-management and skin care

 Phase II

• MLD
• wearing of fitted compression stockings

Those who use lymphatic drainage massages may notice that their swelling reduces. At the very least, swelling should not worsen.

People who have lymphedema should continue using compression socks or sleeves to prevent swelling.

Individuals with fibromyalgia might experience less stiffness and pain and also notice improvements in their overall health status.

People can also boost their lymphatic system function and help remove more waste from the body using the following methods:

• drinking plenty of water
• engaging in physical activity
• eating vegetables and fruits
• limiting their intake of processed foods