Manual lymphatic drainage massage is a gentle, light-touch, noninvasive technique that mimics the actions of the lymphatic system.  It encourages the body to process and remove stagnant fluid, toxins and waste with a result of improved lymph flow.

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One must have a general understanding of the function of the lymphatic system in order to realize the significance of the lymphatic drainage modality.  Lymph is a body fluid that consists of water, electrolytes, and proteins, along with ions, nutrients, and gasses.  The lymph circulation differs from blood circulation because the lymphatic system lacks a central pump like the heart.  Lymph circulation depends on other factors, like muscular contraction, movement, pressure changes, spontaneous contractility of lymph vessels, and such external factors as massage and gravity.  The important factor in lymph circulation is the lymphatic pump, the rhythmic, wavelike contractions of the lymphangions.  Unlike blood circulation, lymph circulation is not continuous in all parts of the body at all times.

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Basically lymph movement occurs according to three scenarios:  (1) body movement such as abdominal peristalsis, respiration, arterial pulse and contractions of local muscles which cause the lymphatics to open and stimulate the lymph vessels to contract,  (2) body fluid dynamics because as the volume of fluid in the tissues increase, it fills the spaces between the tissue cells and moves them farther apart  As the volume of fluid in the tissues increases, pressure increases.  Fluid tends to move from areas with more pressure to areas with less pressure.  (3) Massage and passive movement encourage the lymph flow and the contractions of the lymphatic vessels.  Massage mechanically moves fluid, like squeezing water through a tube.  It also stimulates the lymph vessels to contract, starting the lymphatic pump so that lymph circulation will continue on its own.

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The creation of manual lymphatic drainage was for the purpose of treating edema, which can be a very serious and chronic condition, in which some cases need the care and treatment of a physician.  This modality has many uses for clients with less serious conditions and include but not limited to:

 

 - Pre-Surgical and Post-Surgical:  used before and after surgery, including cosmetic surgery, to speed healing and reduce edema.  Before surgery it helps to remove stagnant fluid from tissues and increase blood flow, bringing nutrition to the tissues.  After surgery it can help to remove inflammation, speed healing and reduce scar tissue.  It is always suggested to discuss this with your physician.

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-Soft Tissue Injury:  one should not receive massage immediately following any injury.  Examples include sport injuries, car accidents, falls, etc. until they have been cleared of any serious underlying condition, but once they have ruled out any serious condition MLD helps to speed healing and reduce swelling.

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-Sluggish Immune System:  frequent illness, colds, allergies, and slow recovery time from illnesses indicates that the immune system may not be working to its full potential.  MLD will stimulate the lymph circulation and potentially improve the condition.

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-Stress and Tension:  stress triggers the sympathetic nervous system, the well-known fight-or-flight state, arousing all the body's defenses.  Chemicals like adrenaline are secreted into the bloodstream causing muscles to tense.  The heart and respiratory rates increase, organ function decreases and the immune system is suppressed.  Chronic stress results in chronic racing of the human system, with resulting stress on internal organs and functions and decreased disease resistance.  In the long run, physical and mental reactions to stress can contribute to degenerative disease.  Massage and especially manual lymphatic drainage trigger the parasympathetic nervous system, which has the opposite effect on the body.  Muscles relax, heart and breathe rates decrease, and clients move into a drowsy state of relaxation that promotes healing and balance.

 

-Chronic Fatigue, Mild Depression, and Chronic Soft Tissue Pain:  manual lymphatic drainage will stimulate the immune system and has an energizing effect on the body's qi or vital energy.

 

-Inactivity Edema:  sitting for long periods, either from work, traveling or inactivity due to medical reason causes edema.  Swelling occurs in the feet, hands,  and buttocks of a person who has to sit with little movement for a few hours.  MLD can assist in moving the fluid.

 

-Scar Tissue:  scar tissue blocks lymph flow.  Lymph vessels damaged by injury or surgery do not necessarily grow together and they connect through scar tissue.  Tissue on the distal side of the scar tends to accumulate fluid.   MLD reduces edema and also softens and minimizes scars, improving circulation.  Massaging as soon as allowable after an injury or surgery actually helps scars to develop in a more organized way so that they become smaller, smoother, more flexible and stronger.​

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-Improving Cellulite:  cellulite is simply fat cells and fat cells are normal to have for all people.  The problem is when the connective tissue of fats cells are damaged, which contributes to the rippled and lumpy appearance of the skin.  MLD helps to remove inflammation and toxins but should also be combined with connective tissue massage or myofascial release and deep tissue to break down adhesions in the superficial tissues.  Massage will not remove or decrease fat cells (because as stated it is normal to have them), but will improve the condition and appearance of the skin, reduce troublesome adhesions and scars, and increase the circulation of nutrients to tissues. 

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-Unhealthy Skin:  unhealthy skin such as acne, rosacea, eczema caused by poor circulation responds to manual lymphatic drainage

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Contraindications for lymphatic drainage massage include:

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-Cancer:  client's physician may feel that the benefits from touch therapy outweigh the risk and this decision would be based solely on the discussion between the client and their treating physician. 

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-Wounds, Rashes, and Inflamed Skin Conditions  any skin that is contagious, infected, open, discharging fluid, or inflamed (red, hot, swollen, painful - possible infection) are contraindicated for any kind of massage

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-Fever and Infections

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-Heart, Kidney or Liver Disease:  MLD will return fluid to the cardiovascular system and increase blood volume so a weak heart may not be able to handle the stress.  Since the kidneys control blood volume by excreting fluid the failing kidneys cannot handle the increased volume being produced by the movement of fluid.

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-Blood Clots

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