top of page

Manual lymphatic Drainage

Updated: Feb 21, 2019

Sarah Millard

Massage Therapist

What did your mirror have to offer this morning? If it was bags under the eyes and a host of new wrinkles, it might be time for a lymphatic drainage treatment. Give your skin a treat for spring. Read on to find out about the benefits of lymphatic drainage.

What is Manual Lymphatic Drainage (MLD)?

When you intervene and encourage the fluid to drain properly, it’s known as manual lymphatic drainage. You can jazz up your whole system with a treatment, whether or not you have fluid retention. It can be a stand-alone procedure, or it can be incorporated into a massage treatment. You can even do it yourself and I encourage all my clients to do so with take home instructions on self massage.

What is The Lymphatic System?

The lymphatic system is the secondary system of circulation in the body with a very complex set of tasks. The major tasks are cleaning and nourishing the cells. Sounds simple enough, but without it, we wouldn’t survive long. The lymphatic system is a sort of go-between from the blood circulation to the individual cells. Lymph is a clear fluid containing nutrients and oxygen similar to blood but without the red and white corpuscles. It comes from the general circulation and is deposited around the cells to keep them nourished. The cells are able to discard waste and toxic materials into this fluid. The lymphatic vessels pick up this waste and any excess fluid from around cells and transport it, via the lymph nodes which filter it, back into the general circulation. It’s a one-way shuttle, so lymph should only ever flow in one direction – away from the cells and towards the heart.

Reasons for Poor Lymphatic Flow

Poor lifestyle choices are the commonest causes of an inefficient lymphatic system, though they are certainly not the only ones.

· Lack of exercise - lymphatic fluid needs muscle power to push it round the body

· Poor diet – may increase congestion and produce more waste for the lymph to pick up and dispose of

· Pollutants – environmental and dietary

· Surgery and trauma

· Pregnancy

Aims and therapeutic benefit of MLD therapy

The aim of the MLD therapist is to restore equilibrium in the tissues and ensure that 'that which enters equals that which departs'. If the body is not in this state of equilibrium, and there is too much fluid in the tissues, they become soft and 'boggy' to the touch. If excess fluid is present it can interfere with cell nutrition – oxygen and nutrients will take longer to pass through the tissues and get from the bloodstream to the cells through the interstitial fluid. This will also mean that waste products from cell metabolism will take longer to move from cells to the transport system, which will remove them from the body. If the lymphatic system is functioning well, we feel well. There are many reasons for the Lymphatic system to be sluggish and not functioning well, leaving fluid static in the tissues. Pollution, toxins, poor nutrition, mucous formation, overload from previous viral or bacterial infections etc – these are all things that can give rise to cellular stagnation.

Major Benefits of Lymphatic Drainage

Every part of the body is influenced by the lymphatic system, because no matter what the purpose of the cells, they all need nourishing and cleaning. It’s important in immunity, inflammation and healing in general, so an efficient lymphatic system is going to help in many areas. Lymphatic drainage is a way to achieve that efficiency.

· Skin care: For a clearer complexion and to lessen the appearance of fine lines and wrinkles in facial tissue, as well as reducing puffiness around the eyes. Old scar tissue can be reduced while the appearance of new scars can be minimized. It’s commonly used before and after cosmetic surgery.

· Detox: At the end of winter, or after a period of high stress, the body will really benefit from lymphatic drainage, to reduce the sluggishness brought on by too many starchy, high fat foods and too little exercise.

· Headache and allergy sufferers: Most headaches including sinusitis have a component of congestion that responds well to lymphatic drainage. Once tissue is decongested, blocked fluid and blood flow improve, reducing pain and discomfort.

· Promote healing: After surgery or injury, the tissue may be swollen and sore. Lymphatic drainage is a gentle treatment that will help drain the tissue, reduce inflammation and improve healing.

· Pregnancy and after: There is often fluid retention in pregnant women and lymphatic drainage can improve comfort especially in legs and feet. Breast feeding will be enhanced by this treatment, especially when there are problems with blocked ducts and sore tight breasts.

· Reduce swelling: After long periods of immobility such as air travel or lessened mobility, fluid tends to stagnate in the tissue making it puffy and tender. Conditions such as arthritis often have joints that are congested with fluid. All of these respond well when fluid is reduced with lymphatic drainage.

· Relaxation: Because it is such a gentle treatment, it is one of the most relaxing. And the relaxation is enhanced as the cleansing and rejuvenating effects relieve stress.

Most people will notice improvements in their level of wellbeing after a treatment because lymphatic drainage has so many benefits.

Therapeutic Benefits of MLD

There are many other conditions, that benefit from the application of MLD, because of its propensity to move fluid, but MLD also has other properties that have great therapeutic value besides decongesting tissue.

Because it is a very light massage, utilizing repetitive and continuous hand movements, it has a calming effect on the autonomic nervous system which Vodder explains as "a change from a sympathetic state to a parasympathetic state" stressing the importance of the lightness of touch so as not to trigger a release of histamines in the tissue which would otherwise overstimulate. The effect is to induce a state of deep relaxation in the body allowing even the walls of vessels and bowels to be relaxed. For this reason, MLD is an excellent therapy for sufferers of hypertension.

MLD is also believed to have an analgesic effect based on the Gate Theory where nocireceptors (pain receptors) and mechanoreceptors (touch receptors) of the central nervous system share a synapse or pathway. A simplified explanation could be that the touch receptors are stimulated by the light, repetitive touch of MLD, these signals overtake or crowd out those sent by the pain receptors. MLD will also remove from cells the chemicals associated with the central nervous systems pain response. In practice, MLD does, indeed, have an analgesic effect.

Not yet proven but noted empirically and anecdotally, a logical consequence of MLD is in boosting the immune system. Lymph stagnation impedes the body's immunological response so speeding up the workings of the lymphatic system must promote it. Certainly, people who are receiving MLD on a regular basis, report that they no longer pick up colds and sore throats as frequently as they may have done before having the treatment.

Vodder quotes over 60 different ailments and conditions for which MLD is indicated – these include migraine and chronic headaches, common acne and acne rosacea, constipation, eczema, tinnitus, Ménière's, multiple sclerosis, rheumatoid and osteo arthritis, sinus congestion and chronic catarrh, tendonitis, repetitive strain injury, whiplash and other trauma to name a few. It can be used to improve scar tissue and to reduce bruising after surgery or injury. It is an excellent therapy for rejuvenation as a beauty treatment and can reduce puffiness and fine lines and wrinkles.

MLD is also an effective treatment for localized post-traumatic oedema after bruising, distortion, fracture, dislocation or surgical procedures and is a useful to complement mobilization by physical therapy.

There are some people who cannot have MLD, as there are some absolute contra-indications to treatment and some cases where caution is warranted. The MLD therapist takes a full medical history to determine suitability of the treatment before sessions can commence.

What to expect

Relaxation. Rejuvenation.

Compared to traditional massage, the pressure applied with manual lymph drainage is much lower in intensity. The goal of these techniques is to manipulate the lymphatic structures located in the subcutaneous tissues. In order to achieve the desired effect, the pressure in the working phase should be sufficient enough to stretch the subcutaneous tissues against the fascia (a structure separating the skin from the muscle layer) located underneath, but not to manipulate the underlying muscle tissue. The amount of pressure needed in MLD is sometimes described as the pressure applied stroking a newborn’s head.

Manual lymph drainage (MLD) is a gentle manual treatment technique based on four basic strokes, which were initially developed in the 1930’s by Dr. Emil Vodder, a PhD from Denmark. These basic strokes known as the “stationary circle”, “pump”, rotary” and “scoop” techniques are designed to manipulate lymph nodes and lymphatic vessels with the goal of increasing their activity and promote the flow of lymph.

Certain MLD strokes are designed to manipulate lymph vessels located in the subcutaneous tissues of larger body surfaces, such as the trunk, other techniques are better suited to be applied on contoured surfaces, such as the extremities.

Stationary circle: This technique consists of an oval-shaped stretching of the skin with the palmar surfaces of the fingers or the entire hand. Stationary circles can be applied with one hand, or bimanually and are used on the entire surface of the body, but mainly on lymph node groups (axilla and groin), the neck and the face.

Pump technique: The entire palm and the proximal (upper) phalanges are used to apply a circle-shaped pressure on the skin, operating within almost the full range of motion in the wrist. Pumps are primarily used to manipulate lymph vessels located in the extremities and can be applied with one hand or bimanually.

Rotary technique: This stroke is used on large body surface areas, such as the trunk. The entire surface of the hand and fingers are used in an elliptical movement during the working phase. Like the scoop technique, rotaries are applied dynamically, meaning the working hand moves over the surface of the treated body part in a continuous fashion. If applied bimanually, the techniques are alternating.

Scoop technique: Scoops are applied mainly on the lower parts of extremities and consist of a spiral-shaped movement. During the working phase, which can be applied with one or both hands, the palmar surface of the hand moves dynamically over the skin.

Case studies


Mrs C (42), a self-employed choreographer and teacher, was involved in a rear-end collision with her car being struck from behind at some speed resulting in a moderate whiplash injury. She was examined at casualty and X-rayed which confirmed no skeletal damage but soft tissue injury. She was told that her injury could take 'some months' to resolve, to see her GP for a referral to the local physiotherapy department and for analgesics. She was supplied with a soft collar and advised to refrain from driving, working etc. She presented with pain and stiffness and immobility of the neck and upper back, with some pain radiating down her arms on movement.

The first treatment took place about one week after the accident and initially she was treated in a sitting position, leaning forward with her arms resting on a couch and supported by pillows, as this was the only way for her to be comfortable. Stiffness of the whole upper body had set in by this time.

She received MLD to the neck and shoulders every day for about one week, reported some pain relief after the first session and showed a marked improvement after the first three days reporting much less pain and stiffness and improved mobility. Before the end of the first week she was able to lie face down on the couch. MLD was applied to her neck, shoulders and upper back at each session.

For the second week, sessions again took place every day with continuing improvements resulting in very little pain and greatly increased mobility and lack of stiffness. The following two weeks, sessions took place every other day with continuing improvements; at one point Mrs C reported that she felt fully recovered. Sessions were continued to the end of the week to ensure that there was no return of the problem.

In all, 21 sessions took place and effected a full recovery so that Mrs C was able to resume her work. She continues to have occasional MLD sessions she says 'to keep her in good working order' and was very pleased to have resolved her whiplash in a shorter time than originally thought. She never sought physiotherapy treatments.

Seborrhoeic Dermatitis of the Scalp

Mrs E (34) came for MLD because she had been diagnosed as suffering from this condition after she had developed weeping, itchy lumps on her scalp. She had been prescribed a topical cream, which appeared to be ineffective. She had been told that the condition could be exacerbated by stress and she had noted that it was prone to flaring up intermittently.

Treatment began at the neck as it always does with MLD. The first session was planned to take no longer than 20 minutes to see what sort of reaction might occur and ensure that it would not induce a flare-up; it consisted of work on the neck and face. When Mrs E returned a week later, there was a marked improvement with much less itchiness and weeping. At this second session, again the neck and face were treated but for 40 minutes. A third session was planned for the following week and again, there was a remarkable improvement with the lumps having almost completely resolved. Again, neck and face were worked on for 40 minutes. At the fourth and final session, the scalp area was clear enough to be worked on directly after the initial clearing of the neck; a forty-minute treatment took place.

Mrs E was so pleased with the results after the four sessions that she had another four but spaced a month apart with no return of the problematic itchy, weeping lumps on her scalp. She continues to be free of the original condition.

During Pregnancy

Mrs S (32) was 27 weeks pregnant with twins when she came for help with swollen feet and hands due to the pregnancy. She was getting symptoms of carpal tunnel syndrome (which can be a complication of pregnancy due to the extra fluid being carried) in both hands.

She had weekly sessions of MLD concentrating on clearing her pathways centrally and then her arms and legs, which helped to keep her comfortable and maintain her fluid balance preventing her feet and hands from becoming too swollen. The biggest difficulty for Mrs S was in getting into a comfortable position for the treatments.

Sessions were kept short or broken for comfort breaks so that she could be re-positioned with supporting pillows and bolsters. She was delivered of healthy boy/girl twins at 37 weeks. She continues to have occasional sessions for relaxation and recuperation.

Keep yourself looking and feeling in tip-top condition with a regular session.

30min spot treatment $45

(Perfect for single area treatment for allergy or post injury relief)

45min treatment $55

(Ideal for digestion aid, fluid retention)

60min treatment $65 Bulk session x 6 $335

(Full body for increased immunity)

90min treatment $85

(Full body inc. Focus on specific area. Ideal for pre-surgery or relaxation and post surgery/injury treatment)

270 views0 comments

Recent Posts

See All



bottom of page