The Lymphatic System is the second circulatory system otherwise known as the body’s waste disposal system. It has a vital role in the body by regulating the immune system which protects the body against infection and the development of diseases such as cancer. It is responsible for the destruction and elimination of the metabolic wastes, excess water, toxins, bacteria, large protein molecules and foreign substances from the connective tissue. If the pathways become congested, blocked or damaged then fluid and toxins can build up and eventually cell pathology may begin. Cellular oxygenation and nourishment is reduced, as is waste elimination. Toxins eventually penetrate the cells and may created the symptoms of chronic disease.

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Lymph vessels in the skin

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 tissue. The amount applied stroking a newborn’s head.

In the resting phase of the stroke the pressure is released, which supports the absorption of lymph fluid into lymph vessels. To achieve the maximum effect with each technique, the working phase with every stroke should last about one second and should be repeated five to seven times.

The overall goal of MLD in the treatment of lymphoedema is to re-route the flow of stagnated lymphatic fluid around blocked areas into more centrally located healthy lymphatic vessels, which eventually drain into the nervous system.

What is MLD

MLD (Manual Lymphaic Drainage) is used primarily to promote the optimal functioning of the lymphatic system as a whole and is both preventative and remedial. It relaxes the sympathetic nervous system reduces pain and enhances the immune system and general well being.

During the transportation process the lymph is cleaned and filtered as it passes through the lymph nodes. It has powerful cleansing, pain relieving and immunological effects. Lymph drainage can enhance recovery from surgery and a wide range of medical and non medical conditions, by removing toxins and wastes, thus increasing cellular oxygenation and nourishment and boosting immunity.

MLD is a non invasive deeply relaxing specialized therapy specifically designed for the lymphatic system. It is a gentle rhythmical flowing treatment in which the skin is stretched in the direction of lymph flow.

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Upper extremity lymphoedema

In the case of upper extremity lymphoedema caused by breast cancer surgery, it is necessary to re-route the flow of stagnated lymph in the subcutaneous tissues of the arm around the blocked axially area towards and into the axially lymph nodes on the opposite side and the inguinal lymph nodes on the same side the surgery was performed. These groups of lymph nodes represent the drainage areas for the stagnant lymph fluid located in the affected upper extremity and need to be manipulated prior to initiating the treatment of the arm itself.

Preventing re-accumulation of the fluid

In order to prevent reaccumulation of the fluid evacuated from the extremity, it is necessary that the MLD treatment is followed up with compression, which depending on the stage of treatment, is applied either with specialized padded bandages or compression garments. Manual lymph drainage presents a unique opportunity for health care professionals to specialize and opens the door to treat and manipulate a variety of conditions associated with dysfunctions of the lymphatic system. However, the unique techniques of manual lymph drainage deviate considerably from traditional manual techniques and therefore require specialized training.

Lower extremity lymphoedema

In the case of lower extremity lymphoedema the stagnated lymphatic fluid is generally re-routed around the blocked inguinal (groin) area towards and into the inguinal lymph nodes of the opposite side and the axillary lymph nodes on the same side of the blockage.

As with lymphoedema affecting the upper extremity, these groups of lymph nodes represent the drainage area for the stagnated lymph fluid and need to be manipulated prior to starting treatment of the leg.

The manipulation of these drainage areas with MLD strokes creates a “suction effect” in the healthy lymph vessels located in the drainage areas, which enables accumulated lymph fluid to move from a region with insufficient lymphatic drainage into an area with normal lymphatic drainage, and eventually back into the venous system.

Following this preparation, the extremity itself is treated in segments; the proximal (upper) aspect of the affected extremity is decongested prior to expanding the treatment to the more distal (lower) aspect of the arm or leg. This segmented approach ensures that lymph vessels located in more proximal areas of the extremity are properly prepared to handle incoming lymphatic fluid from areas located more distally.