Manual lymphatic drainage (MLD) is a specialised, gentle type of skin massage and an important part of lymphoedema treatment. The aim is to encourage the extra lymph fluid to move away from the swollen area so it can drain normally. MLD also encourages and improves lymph drainage in the healthy lymph vessels, which helps keep fluid away from swollen areas. Breathing techniques are an important part of this treatment.
MLD should only be given by a trained and experienced therapist. There are a number of different techniques for MLD including the Vodder, Földi, Leduc or Casley-Smith methods. A therapist should be trained in at least one of these.
MLD is usually combined with compression garments or bandaging to maintain its effects. But it can be particularly useful in areas where it’s difficult to use compression therapy, such as in the head and neck area.
NHS lymphoedema treatment clinics often provide MLD. However, it’s not available at all centres. If you’re having difficulty finding a qualified MLD therapist, contact Manual Lymphatic Drainage UK, who keep a register of their members.
MLD can be done for up to an hour a day or three times a week. A course may last for three or more weeks and can be repeated every three months or every year. Before and after MLD, your therapist will do some breathing exercises with you.
You’ll usually be lying down and may have to remove some of your clothing, unless you have lymphoedema of the head and neck area. Your therapist will begin by treating unaffected lymph nodes using very gentle pressure, and slow, rhythmical movements. MLD isn’t used if you have an infection (cellulitis) in the swollen area or if you have certain medical conditions, such as heart problems.
You can be taught how to do a simplified version of MLD yourself at home. It’s a type of self-massage called simple lymphatic drainage (SLD).