Chapter 21 Manual Lymphatic Drainage
OVERVIEW.
Manual lymphatic drainage (MLD) is a gentle manual technique that involves mild, suprafacially applied mechanical stretches of the lymphatic collectors’ walls to enhance activity in intact lymph vessels, improve lymph circulation, and treat lymphedema.1,2 MLD is viewed as one component in a comprehensive approach to address lymphedema.1 It is important to note that MDL does not involve kneading—it is not viewed as massage.3
SUMMARY: CONTRAINDICATIONS AND PRECAUTIONS.
Three sources cite a total of 29 concerns for MLD. The greatest proportion of concerns is contained under the procedural category (almost 30%) and they relate to force level and correct technique. Other prominent categories where MLD presents a concern are patients with circulatory, digestive, and endocrine problems. These latter concerns are generally local and depend on where the technique is applied (e.g., the neck area in carotid sinus hypersensitivity or thyroid conditions).
CONTRAINDICATIONS AND PRECAUTIONS
A00-B99 CERTAIN INFECTIONS AND PARASITIC DISEASES
E00-E90 ENDOCRINE, NUTRITIONAL, AND METABOLIC DISEASES
I00-I99 DISEASES OF THE CIRCULATORY SYSTEM
J00-J99 DISEASES OF THE RESPIRATORY SYSTEM
K00-K93 DISEASES OF THE DIGESTIVE SYSTEM
N00-N99 DISEASES OF THE GENITOURINARY SYSTEM
1 Lasinski B. The lymphatic system. In Goodman CC, Boissonnault WG, Fuller KS, editors: Pathology: implications for the physical therapist, ed 2, Philadelphia: Saunders, 2003.
2 Benjamin PJ, Tappan FM. Handbook of healing massage techniques: classic, holistic, and emerging methods, ed 4. Upper Saddle River (NJ): Pearson Prentice Hall, 2005.
3 Foldi M. Massage and damage to lymphatics [editorial]. Lymphology. 1995;28:1-3.
4 Kelly DG. A primer on lymphedema. Upper Saddle River (NJ): Pearson Prentice Hall, 2002.
5 Tachi J, Amino N, Nyaik K, et al. Massage therapy on neck: a contributing factor for destructive thyrotoxicosis. Thyrology. 1990;2(1):25-27.
6 Goodman CC, Snyder TEK. The endocrine and metabolic systems. In Goodman CC, Boissonnault WG, Fuller KS, editors: Pathology: implications for the physical therapist, ed 2, Philadelphia: Saunders, 2003.
7 Goodman CC. The cardiovascular system. In Goodman CC, Boissonnault WG, Fuller KS, editors: Pathology: implications for the physical therapist, ed 2, Philadelphia: Saunders, 2003.
8 Strasberg B, Sagie A, Erdman S, et al. Carotid sinus hypersensitivity and the carotid sinus syndrome. Prog Cardiovasc Dis. 1989;31(5):379-391.
9 Goodman CC. The gastrointestinal system. In Goodman CC, Boissonnault WG, Fuller KS, editors: Pathology: implications for the physical therapist, ed 2, Philadelphia: Saunders, 2003.
10 MacDonald G. Cancer, radiation, and massage: the benefits and cautions. Massage Bodywork. 2001;16(4):7. 12,16
11 Eliska O, Eliskova M. Are peripheral lymphatics damaged by high pressure manual massage? Lymphology. 1995;28(1):1-3.
