Manual Lymphatic Drainage Massage
Manual Lymphatic Drainage Massage (MLD) is a gentle, light-touch, noninvasive technique that mimics the action of the lymphatic system which encourages the body to process and remove stagnant fluid, toxins and waste as a result of improved lymph flow.
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 most 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 time.” (French, 19)
Basically lymph movement occurs according to three scenarios: (1) body movement such as abdominal peristalsis, respiration, arterial pulse and contractions of local muscles which causes the lymphatics to open and stimulate the lymph vessels to contract, (2) body fluid dynamics because “as the volume of fluid in the tissues increases, 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.” (French, 20) (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.” (French, 23)
The creation of MLD 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), the modality has many uses for clients with less serious problems.
- Pre-Surgery and Post-Surgery: 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 the surgery it can help to remove inflammation, speed healing and reduce scar tissue. After surgery it always necessary to receive permission from the physician to obtain LDM and any necessary instructions the physician feels is pertinent.
- Soft Tissue Injury: one should not receive massage immediately following any injury for example sports 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.
- 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.
- 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 MLD, 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.” (French, 43)
- Chronic Fatigue, Mild Depression, and Chronic Soft Tissue Pain: LDM will stimulate the immune system and “has an energizing effect on the body’s qi or vital energy.” (French, 43)
- Inactivity Edema: sitting for long periods either from work, traveling or inactivity due to medical reasons 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.” (French, 44)
- 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 fat cells is 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 it is normal to have them) but will improve the condition and appearance of the skin, reduces troublesome adhesions and scars, and increases the circulation of nutrients to tissues (the only way to remove excess fat cells and restructure the shape of the body is liposuction).
- Unhealthy Skin: unhealthy skin such as acne, rosacea, eczema caused by poor circulation responds to manual lymphatic drainage massage.
Contraindications for lymphatic drainage massage include:
- 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 patient and treating physician. In general when cancer is in remission and no longer being treated for cancer, MLD is generally considered safe.
- Wounds, Rashes, and Inflamed Skin Conditions: any skin that is contagious, infected, open, discharging fluid, or inflamed (red, hot, swollen, painful) are contraindicated for MLD or any kind of massage.
- Fever and Infections: signs that that client is ill and all forms of massage are prohibited.
- 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.
- Thyroid: MLD can aggravate hyperthyroidism.
- Blood Clots, Phlebitis, and Varicose Veins: blood clots and phlebitis are contraindicated for massage and varicose veins need to be massaged with caution with very light pressure.
French, Romana Moody. (2004) Milady’s Guide to Lymph Drainage Massage. Milady.