Manual Lymphatic Drainage
The Manual Lymphatic Drainage (MLD) method, developed by Dr. Emil Vodder fifty years ago, is a gentle circular massage which is carried out with precise, rhythmic movements exerting different intensities of pressure. The result of this method is an increase in the transporting capacity of the lymph collecting vessels. The “additional circular- pumping and cupping” motions aim to transport the lymphatic oedema fluid to the centre.
MLD treats the whole body, not only the affected parts. The massage starts in the neck area where the big lymph vessels join the clavicular vein. This should stimulate a central lymphatic flow to enable the drainage from other parts of the body. Afterwards the trunk and extremities are treated.
The therapist tries to increase the transport of the liquid by special pumping techniques in order to reduce the oedema. MLD should never be the only decongestive therapy, but should always be combined with other compression methods (compression bandaging, medical compression garments). In case of acute inflammation, thrombosis, tumor spread in the lymph vessels near the skin and cardiac oedema (oedema resulting from congestive heart failure), MLD should not be used.
Additional bandaging or the wearing of compression garments, supports MLD and a renewed collection of liquid in the tissue is avoided. With this therapy acute or chronic lymphoedema, lipoedema and idiopathic oedema can be treated.
The intermittent compression with pumps
This method, as well as bandaging and compression garments, has been a standard practice in the physical treatment of mostly venous diseases, and to a lesser extent also of lymphatic diseases. The compression using pumps is able to reduce the volume of oedema. Nevertheless, it is not totally clear how it works. Experimental studies have not produced definite results. The multi-chambered intermittent pneumatic pump compression should only be used as a support in the second phase of the complex decongestive therapy (CDT) to maintain the therapeutic success. Without combining a consequently followed course of CDT the results have not been convincing.
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