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Have you ever heard of Manual Lymphatic Drainage (MLD)?


Hello, and thank you for checking out my first blog post! Today I’m going to answer the questions I get asked the most regarding Manual Lymphatic Drainage (MLD). If you’ve ever wondered what it is, what it’s like, and if it would be good for you, then this blog post is for you. Or maybe you’re just interested in learning more about your lymphatic system, either way I hope you find it informative. In addition to my massage therapy education, I also have my bachelor’s degree with a double major in Community Health Education and Aging Services. I have taken many fascinating classes on how and why our bodies do what they do, and I absolutely love learning about the human body and how it all works. OK, enough about me…let’s get started!

What is lymph?

The more appropriate question is what WAS lymph. Approximately one-sixth of the human body consists of interstitium — this gelatinous substance is the glue that keeps our cells together. Without it, our cells would be loose and unable to form tissues. I often tell my clients to imagine a bowl of jello with grapes suspended in it, the jello is your interstitium and the grapes are your cells.

This ‘jello’ is mostly made of water (96%) but also contains proteins, minerals, lipids, cellular debris/waste, white blood cells, and other substances that may or may not be present like certain hormones, gases, microbes, toxins, etc. Once interstitial fluid enters your lymphatic system it’s called lymph fluid, and when it enters your circulatory system it becomes part of your blood.

What is the lymphatic system?

Unlike the circulatory system that pumps blood out through your arteries, diffuses through your capillaries and returns to your heart via your venous system in a continuous loop – your lymphatic system is a one-way highway. It begins at the lymphatic capillaries where the lymph fluid is absorbed, it then moves the fluid into deeper vessels that transport it through the surrounding lymph nodes for a security check, and eventually it merges with the circulatory system where the lymph fluid joins the bloodstream above your collar bones at the base of the neck. The lymphatic system transports up to a gallon of lymph fluid from the interstitium to the bloodstream every 24 hours!

What does the lymphatic system do?

· Takes the trash out – it collects and recycles excess fluid and all its components (like cellular debris, etc.) cleaning out the “jello” so the “grapes” can maintain optimal functioning.

· Recycles proteins – up to 100 grams per day!

· Helps regulate fluid volume and pressure within your tissues.

· Transports white blood cells, hormones and other substances throughout the body.

· Provides immune surveillance by recognizing and responding to foreign cells, microbes, viruses, and cancer cells.

· Absorbs and carries fat and fat-soluble vitamins from the small intestines to the blood stream.

Why is MLD so light?

For clients who are used to getting regular therapeutic massage, they often wonder if MLD is even doing anything because it’s so light. Many of us share the no pain no gain mentality and feel like there needs to be a certain level of pressure to really accomplish anything. There is definitely a time and place for pressure, but MLD is not one.

Lymphatic capillaries are the diameter of a hair and extremely fragile. These delicate vessels reside just under the skin which is why MLD must be very light. Running along every lymphatic capillary are these tiny “trapdoors”. Each trapdoor has an anchoring filament coming off of it that attaches to surrounding tissues. When those anchoring filaments are pulled on the trapdoors open, creating a vacuum that pulls the surrounding fluid into the vessel. Many things can stretch these anchoring filaments – muscle contraction, breathing, movement, gravity, external compression and (drumroll please) …MLD!

MLD techniques are gentle, slow and rhythmic ­— designed to stretch the skin and open the trapdoors.

What causes swelling?

When we get an injury (whether accidental or surgical) our bodies immediately send out chemical alarms to “send in the medics”. These alarms not only signal the immune response, but they also cause the blood capillaries to become more permeable (or leaky) so the “medics” can enter the interstitial space and arrive at the injury site. This inflammatory response is super important because it’s what controls infection, clots your blood, and brings in oxygen and other nutrients like protein necessary for tissue repair. But with all that good stuff comes excess swelling that can cause pain, stiffness and a heavy sensation.

Other things that cause swelling usually have to do with a sluggish or damaged lymphatic system, or a leaky circulatory system – radiation, lymph node removal, being sedentary, chronic inflammation like with arthritis, histamine reactions (bug bite for example), damage to veins in legs, pregnancy, certain medications, or an underlying disease like congestive heart failure, kidney disease or cirrhosis of the liver. Not a complete list but it goes to show that MANY things can cause swelling. Often times my clients have unexplained swelling so it’s always good to rule out anything serious with your doctor before receiving treatment.

What can MLD treat?

MLD is most commonly used to treat excessive swelling that can occur from the above-mentioned causes. Other things MLD can help support are chronic pain, sinus problems, tinnitus, diabetic neuropathy, fibromyalgia, chronic fatigue syndrome, rheumatoid arthritis, scleroderma, and Lyme disease. In addition to stimulating the lymphatic system, MLD also stimulates the parasympathetic nervous system which is the part of your nervous system that relaxes you after a stressful situation and induces a sense of calm. Because of this I’ve used MLD to relieve pain in stage 4 cancer clients, hospice patients, and even those who have been in severe auto accidents and are in such pain they can’t receive anything more than a very gentle treatment.

How many sessions will I need?

This question ALWAYS comes up...but it’s a tricky one to answer. In an ideal world someone would come in to get a treatment every day or other day for a few treatments to really get on top of swelling and then reassess what is further needed. That said, it really depends on the client’s availability, cash-flow, condition being treated, and what they do on their own time – like wearing compression, elevation and icing. In most cases I think clients need to commit to three sessions and it’s best if the first two are close together, like within the same week. The first session always feels like the warm-up, and by the second treatment things really start moving along.

What should I do after my treatment?

Drink extra water to help flush out any waste products the treatment stirred up. Wear compressions if you’re being treated for swelling, this will help keep the fluid that was moved out from coming back. Use gravity if possible, like if your ankle is swollen put your foot up above your heart and throw some ice on it. And relax. Many people sleep really well after having MLD.

Whew! That was a long one! If you read this whole post, my hope is that you learned something new! My hope is to take what can be confusing information and make it fun and easy to understand so any feedback is appreciated. Thank you and please leave any comments or questions below.

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