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Manual Lymphatic Drainage (MLD) Techniques

Manual Lymphatic Drainage Techniques

Almost all MLD techniques involve the resting and working phase. This means that during the working phase of the massage stroke the lymphatic structures found in the subcutaneous tissues are stretched promoting their activity (lymphangiomotoricity).  During this working phase of lymphatic stimuli and low intensity directional pressure applied by the therapist (during the working stroke), helps to initiate lymphatic fluid to move in the preferred direction, thereby helping to decrease the reduction of swelling.


There are different types of massage techniques involved in MLD that are designed to manipulate lymph vessels located in the subcutaneous tissues. These techniques may be best suited for large surface areas such as the trunk or contoured surface areas such as the extremities.

Manual Lymphatic Drainage Techniques

The Stationary Circle Method

comprises of an oval shaped stretching technique of the skin using the palmar surfaces of the fingers or hand. The therapist performs stationary circular techniques either with one hand or two hands which are applied mainly on the lymph node groups such as the axilla and groin and the neck and face as well as the whole surface of the body. 


The Pump Method 

is when the therapist uses the whole palm and proximal phalanges together with wrist motion to perform a low intensity circle shaped pressure on the skin. The Pump Method technique is aimed to manipulate lymph vessels situated in the extremities which can be applied either with one hand or two hands.


The Rotary Method 

technique is applied to large surface areas of the body such as the trunk. The therapist performs this technique with the whole of the hand and fingers dynamically in an elliptical movement. This is where one hand such as the working hand moves over the surface area being treated in a continuous manner during the working phase. This method can be performed with one hand or two hands.


The Scoop Method 

technique is generally performed on the lower extremities and comprises of a spiral shaped movement. This can be applied dynamically over the skin with one or two hands during the working phase using the palmar surface of the hand. The therapist facilitates this movement further by using wrist motion combined with forearm supination and pronation.


Unlike other classic types of massage MLD techniques aims to stimulate lymphatic structures situated in the subcutaneous tissues. To facilitate the effect, low intensity pressure is applied throughout the working phase to promote the subcutaneous tissues to stretch against the fascia (a structure that separates the skin from the muscle layer) situated underneath without stimulating the underlying muscle tissue.


During the resting phase the pressure of the stroke is released to encourage the absorption of lymph fluid into lymph vessels. To produce the optimum effect following each technique of the working phase every stroke must approximately last one second and then be repeated at least five to several times.

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