Manual lymphatic drainage (MLD)

Physiotherapy decongestive therapy

The Manual lymphatic drainage (MLD) belongs to the complex physical decongestive therapy of physiotherapy. It is used as a gentle type of massage so as to support the transport of lymph fluid along with its waste products from the body. This may be necessary when swelling occurs in the extremities, neck or face that does not subside on its own. In this case, special grip techniques are used to get the excess tissue fluid moving and back to the heart. The pressure in the tissue is relieved, which in turn leads to a reduction in pain.

The general benefit of manual lymphatic drainage has been scientifically proven and has been used successfully for many years in the treatment of patients with a wide range of complaints. It is considered a special form of therapy and may only be performed by therapists who have an additional certificate in manual lymphatic drainage. With us you can rely on professional treatment.

The Funktion of lymphatic drainage

Nutrients and oxygen travel from the heart via the blood vessels to the tissues, where they are needed for energy production, for example. From there, about 90 percent of the fluid flows back to the heart via the venous system. However, about 10 percent remains in the intercellular spaces and is transported away via the lymphatic system. The lymph fluid consists, among other things, of a mixture of lymphocytes (white blood cells), electrolytes and proteins. On its way toward the heart, it reaches the lymph nodes, where it is filtered by viruses and bacteria.

However, if there is a disturbance in this lymphatic system, the removal of the fluid can be prevented. It accumulates in the tissue, which leads to severe edema, pain and restricted movement. With the gentle grip techniques of manual lymph drainage, consisting of the rotating, scooping, pumping and circular grips, the specially trained therapists manage to support the removal of the lymph. This is increasingly transported back to the heart, which reduces the pressure on the tissue and the swelling decreases.

Indications and contraindications of manual lymphatic drainage

Manual lymphatic drainage is extremely versatile and can provide relief for patients with a wide variety of medical conditions:

Primary lymphedema

Primary lymphedema is a congenital weakness of the lymphatic vascular system in which the lymphatic fluid cannot be sufficiently removed. Instead, it is deposited in the tissue and swelling occurs, which can sometimes assume large proportions. The problem usually begins in distal areas of the body, such as the toes, from where it spreads. Women are particularly affected by primary lymphedema. Manual lymphatic drainage cannot cure this disorder completely. However, it can help to reduce the symptoms and thus significantly improve the patient's quality of life.

Secondary lymphedema 

In this type of lymphatic system, the problem develops only due to a specific cause. This can be, for example, radiation or lymph node removal after cancer. If, in the case of breast cancer, the tumor cells also affect the lymph nodes of the armpit, these often have to be removed as well. As a result, in many cases there is a disturbance in the removal of the lymph and thus swelling in the affected arm.

Extreme overweight also leads to secondary lymphedema sooner or later, as the fat cells can constrict the thin lymph vessels too much. It can also occur after an injury, if a bone fracture, soft tissue contusion or other tissue damage has occurred. The lymphatic vessels are also damaged and can no longer ensure the complete removal of the fluid. Secondary lymphedema can even occur after an operation if lymphatic vessels have been damaged.

After an operation or accident

After an accident or surgery, the affected area is swollen. Our physiotherapists are trained to decongest the affected area. When the swelling is practically massaged out of the affected area, it helps to significantly improve wound healing. The pressure caused by the lymphedema or water retention decreases. Lymphtape can also help relieve their pressure. We are your specialists for lymphatic drainage Zurich.

Migraine and trigeminal neuralgia

With the help of manual lymphatic drainage, recurrent, severe lymphatic Headache and treat trigeminal neuralgia. The drainage of lymphatic fluid in the neck, throat and head is stimulated and, as a result, pain relief is induced. Also the Trigger point therapy can work in combination here.

Pregnancy

Although this is not a medical condition, many pregnant women also suffer from swollen legs, which limits them in their daily lives. Manual lymphatic drainage then not only helps to reduce the swelling, but can also combat the development of varicose veins.
However, this therapy may only ever be used after consultation with a doctor. In addition, deep abdominal drainage must be avoided in order not to trigger premature labor and thus a premature birth.

Correct performance of manual lymphatic drainage

Basically, at the beginning of this treatment, care must be taken to ensure correct positioning. The affected, swollen area should be positioned higher than the heart to ensure better drainage. Furthermore, any constricting clothing must be removed so as not to restrict the transport of the lymph fluid. During manual lymphatic drainage, the skin is touched only with a very low pressure. The thin lymph vessels are located superficially under the skin and would quickly be constricted by too hard a grip.

Bandaging should be applied immediately after treatment to prevent the area from swelling again with tissue fluid. This can be done with specially fitted compression stockings for arms or legs. Ideally, however, compression is provided by wrapped bandages, as these can be better adjusted to the current circumference.

An excessive urge to urinate after Manual Lymphatic Drainage can be interpreted as a good sign. The lymph fluid has been set in motion and returned to the heart. From there it is subsequently excreted from the body through the kidneys and bladder. It is also recommended to drink sufficient amounts of water after the treatment to support the removal of the lymph with all its waste products.

However, there are also clinical pictures for which manual lymphatic drainage is not indicated. A distinction is made between relative and absolute contraindications. Relative contraindications include, among others:

• chronic inflammations
• Low blood pressure
• compensated heart failure
• Thyroid disorders
• Bronchial asthma
• Various skin diseases

In the case of these complaints, it must always be discussed with a doctor whether the benefit outweighs any possible harm and whether Manual Lymphatic Drainage is therefore permitted under certain circumstances.

However, absolute contraindications indicate that this form of therapy must not be performed under any circumstances, so as not to further worsen the current condition. These include:

• malignant tumors
• acute inflammations
• Fever
• acute, deep vein thrombosis of the leg
• decompensated heart failure
• Cardiac arrhythmias
• open skin wounds in the treatment area