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Manual Lymphatic Drainage

Manual Lymphatic Drainage aka MLD

What in the world is manual lymph drainage (MLD)? That then begs the questions, what is lymph? What does MLD accomplish? What pathologies is it used for?

Although there are many pathologies in which MLD can be used for treatment, the most common use for MDL is for those diagnosed with Lymphedema.

Lymphedema is a chronic disease of the lymphatic system in which it is unable to perform its’ various critical functions. The lymphatic system in our body is a complex and vast system that works in conjunction with our circulatory system.

The lymphatic system has several important functions:

  1. It maintains fluid balance in the body by collecting excess fluid and proteins and returns them back to the heart.
  2. It absorbs proteins, fat and fat-soluble vitamins in the intestines and returns them to the heart as well.
  3. It removes impurities, waste products, cancer cells, viruses and bacteria from tissues throughout the body and filters or destroys these products as they pass through the lymph nodes
  4. It participates in creating antibodies (cells called B-cells and T-cells, or lymphocytes) that are custom-designed to fight cancer, infection and foreign protein.

What is Lymphedema?

Lymphedema affects millions of people in the United States as well as around the globe. Unfortunately not as many people know about it or understand its’ implications. One can be born with a poorly developed lymphatic system or their system can be damaged as a result of surgery, radiation treatments, removal of lymph nodes after a mastectomy, injury or even infection. When transport of lymph fluid is interrupted preventing its transport and drainage back to the heart via the lymphatic system, swelling occurs. This swelling can be in any part of the body, most often in the arms and legs, but also the breast or chest wall, abdomen, head and neck, or genitals. The fluid (called ‘lymph’ once it enters the lymphatic system) becomes extra rich with proteins and other cells, which when left untreated can fester and cause infections as well as tissue damage. Lymphedema has no known cure, but its symptoms can be managed. If you have this condition it’s important to educate yourself well so you can manage your lymphedema as effectively as possible. Your doctor or primary Certified Lymphedema Therapist (CLT) can educate you. There are also the many resources that are available on the Web. Some of those valuable resources are listed below.

What is Complete Decongestive Therapy for Lymphedema?

People diagnosed with Lymphedema should or will likely receive Complete Decongestive Therapy (CDT) to help reduce their swelling, increase mobility and range of motion and to help prevent infections, tissue damage and improve their well being. The components of CDT include Manual Lymph Drainage, compression therapy, exercise, skin and nail care, and education and include 2 phases- decongestive phase and maintenance phase. As it is a chronic disease one will have for life, patients will need to talk and decide with their doctor or therapist about the best options available for maintaining the positive results they’ve achieved through CDT once they are in the maintenance stage. Many times it can be with compression garments worn at night, day or both. Others may be taught how to do self-MLD or be referred for continued Manual Lymph Drainage to a therapist specializing and trained in MLD. And that is where I come in as a Certified Complete Decongestive Therapist. As such, I am well trained and specialize in the process of Manual Lymph Drainage. And since I am a Certified Lymphedema Therapist, I can help review or answer many of your questions about the CDT process and lymphedema, review with you your home care program which your primary CLT will likely have given you, or if you need a reminder in self-bandaging or self-MLD techniques, I can give you a refresher course. I'd be more than happy to collaborate with your primary CLT so together we can offer you the best maintenance program possible.

So what does Manual Lymph Drainage entail?

MLD is a potent way to activate the lymphatic system and can be used to treat many pathologies (listed below) other than Lymphedema. 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 you may receive at a spa. 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 as we say, “decongest.” 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.

Deep breathing techniques called diaphragmatic breathing are usually done near the beginning and end of a therapy session to help open your deep lymphatic pathways. It’s not only relaxing, but it helps increase movement of fluid toward your heart. Laughing naturally causes diaphragmatic breathing, so go ahead; laugh as often as you can! It’ll help move your lymphatic fluid and can help release stress, anxiety, and even depression.

A Certified Lymphedema Therapist - Me! - who has been specially trained in MLD can perform this therapy. There are medical reasons that MLD might not be used, called contraindications, so it’s important to ask your primary CLT and discuss any changes in your medical history before you start your maintenance MLD.

Other conditions treated with Manual Lymph Drainage

(as with any condition, it is important to consult with your doctor before beginning any treatment!)

→ Sprain

→ Whiplash

→ Bruising

→ Post-Surgical Edema

→ Oncology settings: MLD can assist with post-surgical, radiation and chemotherapy recovery, edema reduction, pain control, infection prevention, hematoma reduction/resolution, constipation relief, relaxation, stress reduction, and improved sleep. CANCER TREATMENT AND CARE CAN BE A VERY COMPLEX PROCESS. ALWAYS CONSULT WITH YOUR HEALTHCARE PROVIDER BEFORE BEGINNING TREATMENT. Your primary CLT will also be abreast of your current lab and test results when preparing your CDT treatment with them.

→ Palliative Care/Hospice

→ Fibromyalgia

→ Chronic Fatigue Syndrome

→ Rheumatoid Arthritis

→ Scleroderma

→ Rheumatoid Arthritis

→ Neurological disorders such as; Complex Regional Pain Syndrome (CRPS), Parkinson’s disease, Multiple Sclerosis, Lupus and traumatic brain injuries

→ Migraine and Sinus headaches

Depending on the condition, MLD objectives would include;

Reduction of swelling and bruising by enhancing circulation

Decreasing pain

Promoting normal range of motion

Preventing fibrosis and scar tissue formation

Softening hardened tissues

Reducing recovery and healing times

Reducing risk of skin breakdown

Decreasing hypersensitivity

Reduction of spasticity and tremors (due to relaxation of nervous system)

Promoting restful sleep

General detoxification of tissues

Relaxation and improved quality of life.

Valuable Resources to learn more about Lymphedema

National Lymphedema Network

Certified Lymphedema Therapist directory

Lighthouse Lymphedema Network

LymphActivist’s Site

Lymphatic Education & Research Network

Lymph Care

Johnston Integrative Therapy LLC

Judith H. Johnston MS/OTR, LMT, CLT

Board Certified Licensed Massage Therapist

Registered Occupational Therapist

Certified Lymphedema Therapist

128 S. Concord Ave.

Watertown, WI


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