Manual lymphatic drainage
Encyclopedia
Manual lymphatic drainage (MLD) is a type of gentle massage
Massage
Massage is the manipulation of superficial and deeper layers of muscle and connective tissue to enhance function, aid in the healing process, and promote relaxation and well-being. The word comes from the French massage "friction of kneading", or from Arabic massa meaning "to touch, feel or handle"...

 which is intended by proponents to encourage the natural circulation of the lymph
Lymph
Lymph is considered a part of the interstitial fluid, the fluid which lies in the interstices of all body tissues. Interstitial fluid becomes lymph when it enters a lymph capillary...

 through the body
Body
With regard to living things, a body is the physical body of an individual. "Body" often is used in connection with appearance, health issues and death...

. The lymph system depends on intrinsic contractions of the smooth muscle cells in the walls of lymph vessels (peristalsis
Peristalsis
Peristalsis is a radially symmetrical contraction and relaxation of muscles which propagates in a wave down the muscular tube, in an anterograde fashion. In humans, peristalsis is found in the contraction of smooth muscles to propel contents through the digestive tract. Earthworms use a similar...

) and the movement of skeletal muscles to propel lymph through the vessels to lymph nodes and then beyond the lymph nodes 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) and rhythmic circular movements to stimulate lymph flow.

History

Manual Lymphatic Drainage was pioneered by Dr. Emil Vodder
Emil Vodder
Dr. Emil Vodder and his wife Dr. Estrid Vodder pioneered the specialty of medicine called "lymphology". While working on the French Riviera treating patients with chronic colds, they noticed these patients had swollen lymph nodes...

 in the 1930s for the treatment of chronic sinusitis
Sinusitis
Sinusitis is inflammation of the paranasal sinuses, which may be due to infection, allergy, or autoimmune issues. Most cases are due to a viral infection and resolve over the course of 10 days...

 and other immune disorders. While working on the French Riviera
French Riviera
The Côte d'Azur, pronounced , often known in English as the French Riviera , is the Mediterranean coastline of the southeast corner of France, also including the sovereign state of Monaco...

 treating patients with chronic colds, Dr Emil Vodder and his wife Dr. Estrid Vodder noticed these patients had swollen lymph nodes. In the 1930s it was considered taboo to tamper with the lymphatic system
Lymphatic system
The lymphoid system is the part of the immune system comprising a network of conduits called lymphatic vessels that carry a clear fluid called lymph unidirectionally toward the heart. Lymphoid tissue is found in many organs, particularly the lymph nodes, and in the lymphoid follicles associated...

 due to the medical profession's poor understanding of this system. The Vodders were not deterred by this, and in 1932 began to study the lymph system, and developed careful hand movements to cause lymph movement. In 1936 after four years of research they introduced this technique in Paris France.

Recognition

It is now recognized as a primary tool in lymphedema
Lymphedema
Lymphedema , also known as lymphatic obstruction, is a condition of localized fluid retention and tissue swelling caused by a compromised lymphatic system....

management. Therapists can today receive certification through special classes conducted by various organizations specializing in MLD. Scientific studies show mixed results regarding the efficacy of the method in treating lymphedema and further studies are needed. In several unique studies on animals has MLDT (Manual lymphatic drainage treatment) been shown to increase lymph uptake and thoracic duct flow, but the same evidence has not yet been shown for human subjects.
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