Manual Lymphatic Drainage (MLD)

How does Manual Lymphatic Drainage (MLD) work?

MLD is a specific massage technique with gentle, skin-stretching movements. These movements transport the lymph fluid from your swollen areas in the direction of the lymph flow towards the areas that are draining well. This is called ‘decongesting.’

MLD starts in the areas of the non-swollen parts of your body to open the well-working lymph collectors, making the lymph fluid flow faster, and induce a suction effect. Your therapist will continue with MLD in your swollen body parts to direct the fluid to the open lymph collectors. The gentle, rhythmic motions on your skin can also help to soften any hardened (fibrotic) tissue.

Deep breathing enhances the positive effects of MLD. So-called ‘diaphragmatic breathing’ helps to open deep-seated lymph collectors. Therefore, MLD usually starts and ends with deep breathing exercises. Laughing is a deep breathing technique and can relieve stress, anxiety, or even depression.

Who performs Manual Lymphatic Drainage (MLD)?

Certified therapists should perform MLD. They are trained on the recognised techniques. MLD is not suitable for everyone, and there are some circumstances, such as an infection, where MLD must not be applied. Always refer to your healthcare professional (HCP) first to make sure that MLD is right for you.

What is Simple Lymphatic Drainage (SLD)?

You can also learn to do Lymphatic Drainage by yourself. Simple hand movements can move the lymph fluid out of the affected area. This is called Simple Lymphatic Drainage (SLD). Your therapist can show you, or your relatives/carer, how to do this technique.

What is Mechanical Lymphatic Drainage?

Mechanical Lymphatic Drainage can support lymphoedema therapy, if needed. Whereas Manual Lymphatic Drainage (MLD) is performed with the hand, Mechanical Lymphatic Drainage is performed with specific mechanical devices.

One example of Mechanical Lymphatic Drainage is the “intermittent pneumatic compression” device. It is an electronic pump that fills sleeves, gloves, or boots with air and is fitted to your affected part of your body. The device applies a certain amount of pressure, over a certain time and transports the lymph fluid to the center of your body to reduce the swelling of the affected body part.

Intermittent pneumatic compression is suitable for less active patients, e. g. patients who are recovering from surgery or illness. It may be an option when your MLD or conservative compression therapy is not sufficient.

Devices like intermittent pneumatic compression devices are mainly used in clinics. Ask your HCP for information about at home devices.

Who benefits from Manual Lymphatic Drainage (MLD)?

MLD and SLD are key elements of Complex Decongestive Therapy, together with compression therapy, exercise, and skin care. MLD can provide relief in all stages of lymphoedema, and also helps to soften fibrotic (hard) tissue that may appear in the later lymphoedema stages. 

Learn more about what you can do on your own to improve your lymphoedema