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Physio FULL

Manual Lymphatic Drainage

What is the Lymphatic System

The lymphatic system consists of a network of lymphatic vessels that drain extra fluid (called lymph) that has passed out of the blood into tissues and returns it back to the circulatory system. The lymphatic system includes the lymph vessels, lymph nodes, thymus, spleen, appendix and tonsils.


The main functions of the lymphatic system are to collect and transport interstitial fluids from all tissues and transport is to the venous system. A healthy lymphatic system can return 2 to 3 litres of fluid back to the venous system per day, this helps maintain fluid balance in the body. Another key function is to absorb and transport fatty acids from the digestive track to the bloodstream. The lymphatic system also plays a crucial role in the body’s immune response.


Unlike the arteries in the circulatory system, which uses the pumping of the heart to circulate blood flow, lymph vessels rely upon hundreds of tiny muscular units (lymphangions) contracting throughout the body to propel lymph fluid. These contractions enable the lymph vessels to transport numerous substances in the lymph fluid (I.e proteins, fatty acids, toxins, hormones, immune cells) to lymph nodes which can then filter the fluids and facilitate transportation back to the bloodstream.


The lymphatic system can be hindered or blocked due to genetic abnormalities, surgery, trauma, burns, infections, substantial swelling, fatigue, stress or age. When the lymph circulation slows, fluids, proteins, cells and toxins accumulate with the tissue. Prolonged fluid accumulation that is rich in protein can lead to lymphedema.

What is Manual Lymphatic Drainage

Manual Lymphatic Drainage (MLD) Therapy is a gentle manual treatment technique performed by a Certified Lymphedema Therapist that improves the activity of the lymph vessels by applying a light mechanical stretch on the walls which increase lymph flow. MLD can re-route lymph flow around blocked areas into healthy vessels. The gentle techniques activate lymph and interstitial fluid circulation, stimulates both the immune function and parasympathetic nervous system. It can help reduce swelling from post surgery or injuries, inflammation, pain, headaches, migraines, fibromyalgia, reflex sympathetic dystrophy syndrome and much more. Lymphedema can sometimes develop due to cancer or cancer treatment. Lymphatic Drainage Therapy is performed by a Certified Lymphedema Therapist/Registered Massage Therapist and is billed under massage therapy.



What is a Certified Lymphedema Therapist?

A CLT will have taken an approved 135 hour lymphatic course, these therapists are trained to treat clients that have primary or secondary lymphedema, including those clients that have had lymph nodes removed. A CLT therapist has been trained in decongest therapy including compression bandaging.

What is a lymphatic drainage massage?

Manual lymph drainage, also known as lymphatic drainage massage, is a gentle manual treatment technique that improves the activity of the lymph vessels. The massage technique reroutes the lymph flow to move the fluid in the appropriate direction.

“The goal is to bring all of this inflammatory fluid full of immune cells and other byproducts (lymph) back into our regular circulation,” says Karan Lal, D.O., M.S., F.A.A.D., double board certified adult pediatric and fellowship-trained cosmetic dermatologist affiliated with Northwell Dermatology in New York. “Then, the lymph nodes can process all of these bacteria and proteins so that we remain healthy.”

Lymphatic drainage massage is mainly used for people with lymphedema, which is a condition categorized by an accumulation of protein-rich fluid in the tissues which results in swelling. Lymphedema is usually due to damage to the lymphatic system from lymph node removal and cancer treatments, or a malformation of the lymphatic system.

How to perform a lymphatic drainage massage

The lymphatic system is located everywhere, as there are lymphatic vessels all throughout the body, Lymphatic drainage massages can be performed anywhere on the body there is swelling, or all over to promote the flow of lymphatic fluid.

It’s a very gentle manual technique. You will want to use light, circular, and sweeping motions which will then stimulate and mobilize the lymph vessels. The lymph vessels and nodes are “very superficial in the skin,” which is why only very light pressure is needed.

Are lymphatic drainage massages safe?

Lymphatic drainage massages are safe to be performed at home provided there are no underlying health conditions, and the technique is rather simple.

Benefits of lymphatic drainage massage

While lymphatic drainage massage is a necessary treatment for those with lymphedema, the technique may have some potential benefits for those who don’t have the condition too.

Reduction of swelling

The primary and most functional benefit of lymphatic drainage massage is the reduction of swelling throughout the body. When lymph fluid is not moving throughout the body properly, it can collect and create swelling, but manual lymph drainage can help correct that.

Immune system stimulation

Since lymphatic drainage massage works by moving lymph fluid to clear toxins, that therefore reduces risk of infection and helps stimulate your immune system.

Reducing common cold symptoms

When sick with the common cold or sinus infection, swollen lymph nodes in the neck often accompany the various uncomfortable symptoms. In these cases, lymphatic drainage massage can potentially be beneficial by stimulating lymph vessels to work a bit more quickly, which is important for clearing toxins and speeding up the recovery process.

Improvement of various skin conditions

Performing a lymphatic drainage massage around the neck may help treat or improve various skin conditions on the face area. Using a firm but gentle pressure downwards on the neck “is an easy way to bring some lymphatic fluid from your face down into your body so you can get rid of those inflammatory cells,” which then may help with acne, psoriasis, or eczema, explains Dr. Lal.

When you shouldn't have MLD

There are some situations when you should not have MLD. Your lymphedema specialist will tell you whether you can or can’t have manual or simple lymphatic drainage. Always check with them if you aren't sure.

You might not be able to have MLD if you have any of the following:

  • an infection or inflammation in the swollen area

  • a blood clot

  • heart problems

  • cancer in the area

  • Cardiac edema

  • Renal failure

  • Acute infection

  • Acute bronchitis

  • Acute deep vein thrombosis.

  • Malignancies If you are uncertain about having MLD, talk to your doctor or our lymphedema specialist.


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