Manual Lymphatic Drainage (MLD): Applications & Definition

The lymphatic system is finally getting some recognition. It has been a wild ride to have front row seats to learning about this system of the body as it simultaneously gains awareness and becomes a star of both social media and the beauty industry. It’s sudden boom has been empowering to many people who can now include the lymphatic system as part of their personal body literacy repertoire.

Lymphatic fluid is responsible for clearing out excess wastes, cellular debris (internal exfoliation), bacteria, and viruses. It also contains fatty acids and white blood cells. It’s presence is integral to the immune system. The lymphatic vessels are located in close proximity to the circulatory system, but do not have their own pump like the blood has the heart. Instead, lymph fluid moves as we move, pumped by our muscles, our diaphragm, and by Manual Lymphatic Drainage (MLD).

Manual Lymphatic Drainage is a technique that includes hand placements, pressure control, direction, and sequence. It mainly works with the vessels just underneath the skin and is incredibly gentle and rhythmic. There may be occasional deep techniques to stimulate the deeper lymphatic system of vessels and nodes. Your provider should do a thorough intake process with you and continuously give you resources and insights regarding your healing process. This might include exercise, garments, self-massage techniques, skin care, and breathing techniques.

The main use for MLD in the US is to drain swollen areas of the body due to lymphedema, a chronic swelling condition that a person can be born with or develop as an after-effect of lymphatic damage (we commonly see lymphedema in breast cancer patients after lumpectomy, mastectomy, radiation, or the combination of all of these). If you have lymphedema it is important to seek a Certified Lymphedema Therapist (CLT) for your treatment. A CLT is trained in Complete Decongestive Therapy and will be able to offer advanced sequencing and help you with compression wraps, garments, and more. This will likely be available through insurance, but if not you can find a CLT in private practice and pay out of pocket. One of the benefits to paying for a Licensed Massage Therapist (LMT) who is also a CLT is that your sessions will also be incredibly relaxing. At Queen of Cups, no matter what my clients main concern is, the foundation of every session is relaxation. Our bodies heal while relaxed, so it is my priority that you feel safe, cozy, and comfortable.

Another popular and effective use of MLD is for post-plastic surgery care. Liposuction, tummy tucks, and face-lifts in particular are traumatic to the lymphatic system and swelling becomes a medium-term part of the recovery process. While acute inflammation is a key part of the healing process, chronic inflammation and lymphatic stagnation lead to a hardening called fibrosis. Though I do recommend a CLT for this work, it is not necessary. You can find an LMT who is well trained in MLD and post-operative techniques (scar release and fibrosis techniques).

Aesthetic use of MLD has rapidly gained popularity in the US in the last few years. I use MLD in all of my face massage sessions relieving puffy areas can create an immediate change in the appearance of the face. But there are long-term benefits as well. Chronic puffiness (think around the eyes and ears) stretches the skin and encourages stagnation. While puffiness in the face can actually look good in the short term because fine lines and wrinkles are being filled out, once it does drain there can be more sag to the skin because it has been stretched out for so long. Chronic stagnation can lead to pain, allergies, skin flare-ups, and brain fog. For this type of session you can seek an LMT/CLT who offers this type of session but again, it is not necessary. Both LMT’s and Aestheticians can be trained in Manual Lymphatic Drainage and can include MLD in face massage/facial sessions. LMT’s can offer full body MLD sessions.

  • During no part of you MLD session should you feel pain.
  • During no part of your MLD session should you have liquid pushed out of incisions. The only time this is appropriate treatment is for seromas, fluid filled pockets that have enveloped themselves with tissue and no longer have access to the lymphatic system. Seroma drainage is outside of the scope of practice for LMT’s and should only be preformed by a surgeon or nurse.

If you experience either of these it is absolutely ok to stop your session and seek a different provider.

It is so important to research your provider before booking a session. MLD is an incredible and effective modality when properly executed. Because of its rapid growth there is also a lot of misinformation that can be confusing and misleading. The right provider for you will continuously educate you, be a part of your journey, ask you questions, and never stop learning.

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