manual lymphatic drainage

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 To better understand lymphedema, we first must understand the normal lymphatic system (see diagram).

This system functions parallel to the circulatory system and consists of lymph vessels, lymph nodes, and lymphoid tissues. The most important role of the lymphatic system is to absorb and transport large molecules (including protein and cellular debris) which are too large to be collected by veins and venous capillaries. This lymph fluid is then transported to lymph nodes that act as “filtering stations” in the body. In the lymph nodes, cells from the body’s natural defense system, called lymphocytes, help fight bacteria and viruses. 

Networks of the lymphatic system are situated in several areas of the body with a specific drainage pathway for each individual area. 

Axillary: Located under each arm, these nodes receive fluid from the arm, chest, back, and breast tissue.
Inguinal: Located at the bend of the hip, these nodes receive fluid from the leg, lower abdomen, gluteal region, and external genitals. 

Supraclavicular: Located at the neck just above the collar bones, this important node group receives fluid from the head and shoulders. If indicated, the treatment of these lymph nodes precedes all other treatment.  

The abdomen is richly invested in lymph nodes—they surround the organs and intestines. These nodes also receive fluid from the superficial inguinal area as well. Congestion in this area alone can cause swelling in the lower extremities, abdomen, and genitalia.

Lymphatic tissue is found in other areas of the body including the tonsils, spleen, intestinal wall, and bone marrow.  

Lymphedema is a condition in which excess lymphatic fluid collects in the interstitial tissue and causes swelling in specific areas of the body, usually in the arms or legs. Swelling can also occur in other parts of the body, such as the breast , chest wall, genitals and abdomen. 

Lymphedema can develop as a result of cancer, cancer treatment (e.g., surgery, radiation), infection, trauma, scar tissue, or anything that changes, blocks or interrupts the flow of lymph through the lymphatic system. While it is most often associated with breast cancer, lymphedema can result from treatment for other cancers, such as prostate cancer, gynecological cancers, lymphoma and melanoma.

The greater the number of lymph nodes removed, the higher the risk for developing lymphedema. Early diagnosis and treatment for lymphedema is important to help reduce symptoms and prevent the condition from progressing. Untreated lymphedema can lead to decreased function and mobility in the affected limb, skin breakdown, infection and other complications. 

There is no cure for lymphedema; the goal of the therapy therefore is to reduce the swelling and to maintain the reduction.   For the majority of the patients this can be achieved by the skillful application of this therapy, which is safe, reliable and non-invasive.

 Lymphedema treatments vary from person to person, depending on the severity and cause.

Treatments to either prevent or reduce the swelling associated with lymphedema.

Treatment may include skin care, manual lymph drainage, gentle massage and light exercises to help stimulate the lymphatic system. We may combine gentle range-of-motion exercises and other techniques.

We may also recommend compression bandages, pumps, or garments (e.g., sleeves, stockings) to help prevent additional fluid from accumulating in the tissue. 

Treatments for lymphedema are done in a series of appointments.  Applied correctly, a series of MLD treatments decreases the volume of the affected extremity/area to a normal or near normal size and is applied daily in the first phase of therapy. 

MLD is a gentle manual treatment technique that improves the activity of the lymph vessels by mild mechanical stretches on the wall of lymph collectors.  MLD re-routes the lymph flow via tissue channels and lymph vessels around the blocked areas into more centrally located lymph vessels that eventually drain into the venous system.

The Goal of Manual Lymph Drainage (MLD)

The goal of MLD  is to increase the efficiency of the Lymphatic System, thereby decreasing pain & discomfort and providing a healthy cellular environment. 

Complete decongestive therapy (CDT) is a non-invasive treatment that helps manage lymphedema, a condition that causes swelling due to a buildup of lymph in the body's tissues. CDT is considered the gold standard treatment for lymphedema.