Manual Lymphatic Drainage

Manual Lymphatic Drainage (MLD) encourages lymph flow, reduces face and body swelling, provides deep relaxation and boosts the immune system, increases body’s own natural detoxification process.

The lymph system is largely a passive one and depends on contractions of the smooth muscle cells in the walls of lymph vessels and the movement of skeletal muscles to move lymph through the vessels to the lymph nodes and then beyond the lymph nodes to the lymph ducts which return lymph to the cardiovascular system. Massage Therapists use light, repetitive techniques to pump the lymphatic fluid through the lymphatic capillaries. The slow, rhythmic nature of these techniques also decreases pain perception and the effects of the sympathetic nervous system.

Indications for Manual Lymphatic Drainage:

  • Primary and secondary Lymphedema;
  • Pre-operative MLD before plastic and facial surgeries (to prepare lymph system and skin);
  • Post-operative MLD after plastic and facial surgeries (to eliminate body/face swelling);
  • Rheumatic conditions;
  • Cosmetic disorders (acne, rosacea, scars, stretch marks);
  • Chronic Venous Insufficiency;
  • Heavy and fatigued legs;
  • Surgical/Trauma-related disorders such as acute whiplash, burns, keloids, traumatic and post-surgical edema;
  • Gynecological disorders such as mastodynia (breast pain), lactation disorders and menstrual cramps;
  • Sleep and Mood disorders;
  • Overall body Detoxification;
  • Post-cold or flu congestion;


Lymphedema is a chronic swelling of a body part, most often the extremities. It may also occur in the face, the trunk, the abdomen or the genital area. Lymphedema can have significant pathological and clinical consequences for the patient if left untreated. Once present, the chronic and progressive condition will not disappear by itself.

Causes of Lymphedema includes:

  • Congenital malformation of Lymphatic system (Primary Lymphedema)
  • Cancer surgery (mastectomy, lumpectomy, lymph node removal) or/and radiation treatment
  • Trauma, surgery
  • Infection (Filariasis)
  • Chronic Venous Insufficiency (CVI)
  • Lymphedema in combination with Lipedema, Diabetes, Arthritis, etc.

In OsteoMed Clinic we use an integrated approach to lymphedema management called Complete Decongestive Therapy (CDT). The therapy consists of four components:

  1. Manual Lymphatic Drainage
  2. Graduated Compression Bandages and garments
  3. Skin Care
  4. Therapeutic Exercises

Complete Decongestive Therapy works in two phases, the first being to move the lymph fluid out of affected area and reduce the swelling using MLD techniques and bandaging. Ideally these treatments are performed in clinic daily, five days a week for 2-4 weeks, depending on the severity and affected body area. Treatment schedule can be adjusted according to your needs. Once swelling is reduced, the patient is fitted with compression garment. Self-manual lymphatic drainage and homecare exercises are shown to the patient at the end of phase one.

During the second phase the patient plays a large role in his or her ongoing self-care. Wearing compression garments, performing self-manual lymphatic drainage and exercises are extremely important.

Manual Lymphatic Drainage can also be used as part of a maintenance program for Lymphedema patients in combination with compression, self-MLD and exercises. In this case treatments can be performed on weekly, biweekly or monthly basis.