Manual Lymphatic Drainage (MLD) – A New Service in Our Clinic

We are pleased to introduce Manual Lymphatic Drainage (MLD) as a new therapeutic service at our clinic. This specialized technique is based on the work of Dr. Emil Vodder, who developed the original method in 1936. His approach — including the specific movements, sequences, and techniques — remains largely unchanged and is still in use today, with only minor adaptations.

What is Manual Lymphatic Drainage and When is it Used?

Manual Lymphatic Drainage (MLD) is a gentle, highly specialized form of massage that supports the function of the lymphatic system. It involves light, rhythmic, and targeted pressure applied to the skin to stimulate lymphatic flow, reduce lymphatic stasis, and promote fluid balance.

MLD has been shown to positively influence several physiological systems, including:

• The lymphatic system
• The autonomic nervous system
• Pain reflex pathways
• The immune system

The technique facilitates the removal of excess interstitial fluid and proteins, clears metabolic waste and toxins, enhances lymphocyte production, reduces stress and pain, and promotes relaxation and immune resilience.

MLD is always applied segmentally, never to the entire body at once. Treatment follows a defined sequence, with consistent rhythm and pressure, always respecting the anatomical direction of lymphatic flow.

What is Lymph?

Lymph is a clear fluid that continuously circulates throughout the body. It originates in the interstitial spaces of tissues and plays a critical role in transporting proteins, cellular waste products, and immune cells.

Initially, lymph helps deliver nutrients and oxygen from the bloodstream to tissues. It then collects metabolic byproducts, bacteria, and other harmful substances, eventually returning them to the bloodstream via the venous system. These substances are subsequently eliminated by the kidneys through urine.

Lymphatic flow is supported by various physiological mechanisms, including:

• Skeletal muscle contractions
• Joint movement
• Intestinal peristalsis
• Arterial pulsations
• Respiratory pressure changes
• Negative pressure in central veins
• External mechanical stimulation, such as MLD

Clinical and Therapeutic Applications

Manual lymphatic drainage plays a valuable role in:

• Physiotherapy
• Sports medicine
• Post-operative and post-traumatic rehabilitation
• Post-radiation therapy recovery
• Aesthetic and cosmetic treatments for the face and body

Given its low number of contraindications, MLD is widely used as a supportive therapy in a variety of pathological conditions and for general well-being.

Examples of pathological processes in which lymphatic drainage is applied.

• after surgery
• after radiation therapy
• for scars and skin thickening
• for acne and stretch marks
• for wrinkles
• for venous edema
• for migraines
• for sprains, fractures
• for constipation

Beyond Therapy: Preventive Applications of Manual Lymphatic Drainage

In addition to its therapeutic use, manual lymphatic drainage (MLD) can be applied preventively in healthy individuals, most commonly in the following cases:

• Cellulite reduction treatments
• Heavy leg syndrome (swelling and fatigue in the lower limbs)
• Post-intensive physical activity, to promote lactic acid clearance from muscles and help prevent muscle fiber micro tears
• Migraine relief

What is Lymphedema and How Does it Develop?

Lymphedema is a condition characterized by impaired lymphatic flow, leading to fluid accumulation in interstitial tissues anywhere in the body. It results from the inability of the lymphatic system to adequately drain lymph, causing progressive swelling.

Clinical Signs of Lymphedema Include:

• A feeling of tightness and fullness
• Swelling (edema)
• Reduced range of motion in affected joints
• Pain, tingling, or burning sensations
• Recurrent infections
• In advanced cases: skin thickening, fibrosis, and hardening of the affected limb

Several pathological conditions can disrupt fluid balance, leading to edema. Contributing factors include:

• Increased capillary hydrostatic pressure (e.g., salt and water retention)
• Elevated venous pressure (e.g., heart failure)
• Liver disease
• Bacterial infections
• Lymphatic obstruction due to cancer, infection, or scar tissue formation

Trauma, surgical interventions, or radiation therapy for malignant diseases may also damage the lymphatic system and lead to edema. If left untreated, lymphedema may cause chronic inflammation and fibrotic changes in the affected tissues.

Preventing Lymphedema Complications

Effective management includes not only therapy, but also proper skin care to reduce the risk of secondary complications:

• Thorough cleansing and drying of the skin, along with daily use of hydrating creams
• Infection prevention (avoiding cuts, burns, insect bites, and aggressive hair removal techniques)
• Avoid wearing tight or restrictive clothing that limits circulation or movement
• Use of compression garments or bandaging (especially when flying)
• Avoid prolonged immobility or keeping the limb in the same position for too long
• Avoid exposure to heat, which may worsen swelling (e.g., sunbathing, cooking, saunas)
• Active participation in therapy and self-care routines

In Conclusion

Manual lymphatic drainage is an extremely gentle and relaxing treatment that has numerous benefits for the body. However, it is crucial that the therapy is administered by a certified and professionally trained physiotherapist.