Manual lymphatic drainage
Manual lymphatic drainage (MLD) is a type of massage based on an unproven hypothesis that it will encourage the natural drainage of the lymph, which carries waste products away from the tissues back toward the heart. The lymph system depends on intrinsic contractions of the smooth muscle cells in the walls of lymph vessels (peristalsis) and the movement of skeletal muscles to propel lymph through the vessels to lymph nodes and then to the lymph ducts which return lymph to the cardiovascular system. Manual lymph drainage uses a specific amount of pressure (less than 9 ounces per square inch or about 4 kPa) and rhythmic circular movements to stimulate lymph flow. Clinical studies of MLD conclude that further study of the practice is required before recommending it as an effective health treatment.
Manual lymphatic drainage was pioneered by Danish Drs. Emil Vodder and Estrid Vodder in the 1930s for the treatment of chronic sinusitis and other immune disorders. While working on the French Riviera treating patients with chronic colds, the Vodders noticed these patients had swollen lymph nodes. In the 1930s, the lymphatic system was poorly understood. The Vodders were not deterred by this and, in 1932, began to study the lymph system, developing light, rhythmic hand movements to promote lymph movement. In 1936, they introduced this technique in Paris, France, and after World War II, they returned to Copenhagen to teach other practitioners to use this therapy.
Therapists can today receive certification through special classes conducted by various organizations specializing in MLD, or through a complete lymphedema treatment certification course. Scientific studies show mixed results regarding the efficacy of the method in treating lymphedema and further studies are needed. A 2013 systematic review of manual lymphatic drainage with regard to breast cancer related lymphedema found no clear support for the effectiveness of the intervention in either preventing limb edema in at-risk women or treating women for the condition.
- Milady's Guide to Lymph Drainage Massage; Ramona Moody French; Delmar/Cengage; 2004
- Stillerman, Elaine (2009). Modalities for Massage and Bodywork. Mosby. pp. 129–143. ISBN 032305255X.
- Levine, Andrew (1998). The Bodywork and Massage Sourcebook. Lowell House. pp. 173–84. ISBN 9780737300987.
- "Complete Lymphedema Certification". Courses. Academy of Lymphatic Studies. Retrieved 16 July 2013.
- "Manual Lymph Drainage Combined With Compression Therapy for Arm Lymph- edema Following Breast Cancer Treatment" (PDF). Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU). Retrieved 25 April 2014.
- Huang TW, Tseng SH, Lin CC, Bai CH, Chen CS, Hung CS, Wu CH, Tam KW (2013). "Effects of manual lymphatic drainage on breast cancer-related lymphedema: a systematic review and meta-analysis of randomized controlled trials". World J Surg Oncol. 11 (15). doi:10.1186/1477-7819-11-15. PMC 3562193. PMID 23347817.