MLD (Manual Lymphatic Drainage) was designed by the Vodder School in 1935. It is a gentle massage technique applied to the skin with no oil. It is very specific in how it is applied in conjunction with lymphatic pathways of the body. The aim is to move fluid along the lymphatic vessels to areas where it can drain more efficiently.
MLD can be used in conjunction with low level laser which is great for breaking down scar tissue and fibrotic tissue as well as stimulating the lymphatic system. Lymph Taping may also be used post treatment as an extra aid to support the lymphatic system. It is placed on the skin with no stretch on tape to create a rippling effect that creates a change in pressure under the skin which encourages the lymph to flow up to where it needs to drain.
- Bandaging may also be used post treatment.
- Long term may need to wear compression to help manage swelling between treatments.
MLD can be used on those that have:
- Lymphoedema
- Lipodema
- Sinus Problems/Headaches
- Post Hip/Knee/Ankle reconstruction
- Post cosmetic surgeries; lipo, tummy tuck, breast reduction etc.
- General Retention of Fluid
- Frozen Shoulder
https://www.lymphaustralia.org.au/resources/what-is-lymphoedema/
Lymphoedema Symptoms
Typical indicators of lymphoedema may include:
- Sensation of heaviness in the affected area
- Tightness of the skin, with clothing or accessories feeling constrictive
- Elevated skin temperature compared to surrounding areas
- Aching sensations
- Tingling or pins and needles
- Discomfort or stiffness in the joints
- Swelling
Lymphoedema Signs
Common signs and symptoms encompass:
- Swelling in specific body regions
- Feelings of heaviness and tension
- Temporary swelling post-surgery, usually resolving within weeks. Not all post-surgical swelling indicates chronic lymphoedema.
Diagnosis
Your GP, oncologist, or lymphoedema specialist can diagnose lymphoedema based on your symptoms, medical history, and changes in volume. Diagnostic tests such as bioimpedance spectroscopy, lymphoscintigraphy, ICG, and doppler may be employed.
Types of Lymphoedema
There are two primary types of lymphoedema:
Primary Lymphoedema:
This arises from inherent structural defects in the lymphatic system, potentially involving sluggish lymphatic pumping or an insufficient number of vessels. It can manifest from birth or develop later in life due to triggers like injury, pregnancy, or infection.
Secondary Lymphoedema:
Resulting from external factors such as infection, trauma, obesity, or cancer treatment impacting the lymphatic system. Treatments like radiation therapy or lymph node removal during cancer treatment can damage lymphatics and lead to lymphoedema.
Lipoedema
Lipoedema predominantly affects women, characterized by abnormal fat deposition, often triggered by hormonal fluctuations. This condition can progress to lipolymphoedema, a type of secondary lymphoedema. According to WHO, lipoedema affects approximately 1 in 10 women.
Lymphoedema Stages
There are three primary stages of lymphoedema:
- Stage 0: Impaired lymph transport without visible swelling
- Stage 1: Early onset with fluid accumulation that subsides upon limb elevation. Pitting oedema may occur.
- Stage 2: Swelling persists despite limb elevation, accompanied by pitting.
- Late Stage 2: Swelling becomes firmer or fibrotic.
- Stage 3: Firm tissue without pitting, with thickened, discolored skin and increased folds, fat deposits, and overgrowths.
Treatment Options
Conservative methods such as Manual Lymphatic Drainage (MLD), exercise, diet, pneumatic pumps, dry brushing, skincare, and compression can help manage lymphoedema. Surgery, including liposuction and tissue debulking, may be considered for advanced cases by specialized surgeons to preserve healthy lymphatics and reduce risks of recurrence or further complications.
MLD is generally avoided during chemotherapy or radiation therapy and may be contraindicated in conditions like congenital heart disease, acute infections, blood clots, or kidney disease due to potential risks and additional strain on the system.
