One of the most important systems in the body is the lymphatic system, which acts as a delivery agent, waste removal team, and hospital all in one. When something in this system goes awry, the body can have a disruptive reaction called “lymphedema” where limbs swell up to multiple times their normal size. Manual Lymphatic Drainage is one of the best methods for treating this uncomfortable and often painful condition.
Before discussing the various ways Manual Lymphatic Drainage (MLD) can offer relief to those suffering from lymphedema, it’s essential to understand the lymphatic system and all the wonderful things it does for us. Without it, we’d be in really bad shape.
Your lymphatic system is like a handy moving crew, making sure everything gets to the right place.The lymphatic system is the circulatory system’s silent sidekick, or a handy moving crew, making sure everything gets to the right place. While blood pulses through your body delivering oxygen and nutrients to your tissues and organs, the lymphatic system makes sure that the blood gets the oxygen that it needs, stays hydrated, and isn’t overloaded with too much protein or dead cells.
The lymphatic system is the courier between the blood and the surrounding tissues. This means that the lymph delivers fluid to the blood and delivers oxygen from the blood to other tissues. The lymphatic system also makes sure that any undesirable cells and particles get carted away from the blood and other tissues as soon as they are detected. With the assistance of white blood cells (which are produced, in part, by lymph nodes) and T and B cells (also produced within the lymphatic system), lymph removes dead cells, excess protein, excess salt and sugar, bacteria, and any other unwanted material from the blood and from the body.
Once the undesirable materials are taken out of the blood stream and surrounding tissues and absorbed Lymph nodes, located in the trunk of the body. Image from the National Cancer Institute. into the lymph, they are carted off to cleaning stations, also known as lymph nodes. There are approximately 700 of these in your body. You’ve probably felt them before – when you get sick, lymph nodes might swell up as they produce extra antibodies and fight off antigens.
The lymphatic system is our body’s protector. The lymph that flows upwards through the body parallel to the capillaries picks up unwanted material and deposits it with the lymph nodes, which filter out these toxins. GALT (gut associated lymphatic tissue) makes sure that the food we put in our body doesn’t poison us. Your spleen, your thymus, and your tonsils act as large lymph nodes, filtering out undesired tissue. The interstitial fluid that flows downwards through the lymphatic vessels keeps your tissues and your blood cells hydrated, allowing them to deliver oxygen and nutrients to your entire body.
When you get sick, your lymph nodes go into overtime, activating white blood cells, sending out T cells and B cells, and fighting off whatever bad stuff you might have encountered. Your overworked lymph nodes might start to swell because of overcrowding. This is normal.
When your lymph nodes are damaged, they can become blocked or backed up, and this can also cause swelling. Unlike when you are sick or lightly injured, this swelling does not easily go away on its own.
When your lymph nodes are damaged you experience swelling as a result, this is called lymphedema. The swelling associated with lymphedema occurs because backed-up lymph contains excess protein that was meant to be flushed out but, due to the blockage, was not. Protein attracts fluid, and excess fluid causes swelling. Because the lymph continues to accumulate, more protein gathers in the area, thus attracting more fluid and causing further swelling.
Along with the protein and fluid, the blocked up lymph might be holding onto some pretty nasty stuff, like bacteria and dead cells that haven’t been cleaned up properly. Altogether, this creates a very uncomfortable situation for your body.
Swelling associated with lymphedema is different from normal swelling associated with the healing process, or edema. For example, if you trip and twist your ankle, you might notice it swells a bit in the following days. This is edema. Extra lymph has been summoned to the area by the lymph nodes, which are working hard to produce the right healing materials (white blood cells) to get you all better. Over time, the edema will go away as your ankle heals.
On the other hand, lymphedema does not go away. But it can be controlled.
One of the best methods for controlling lymphedema is manual lymphatic drainage, which is a gentle massage-like practice that encourages stagnant lymph to flow. MLD targets your superficial lymphatic vessels, which are located below the skin but above the fascia. With gentle, circular motions, manual lymphatic drainage aims to stimulate blocked lymph vessels. Often, during breast cancer treatments, axillary lymph nodes near the breast are damaged or removed. Image from the National Cancer Institute.
Even if the target area happens to be below the fascia – for example, if the problem lymph nodes are closer to your organs – stimulating surface vessels should help push surface lymphatic fluids onward and jostle the stuck areas below.
MLD can be used as treatment for a variety of ailments, but is best recognized for the way it has been used to treat lymphedema in breast cancer survivors. According to the Course Manual for the Academy of Lymphatic Studies, over 70% of women with breast cancer choose a conventional treatment such as a lumpectomy, radiation, or surgery. Often, these treatments will result in the full or partial removal of the axillary, or underarm, lymph nodes. Of these women, approximately 15-20% of them will develop lymphedema.
A variety of studies have shown that using MLD as treatment of lymphedema, often in conjunction with other methods such as complete decongestive physiotherapy, has the potential to reduce swelling both in the short and long term. Many patients who have used manual lymphatic drainage therapy have reported that feelings of discomfort and heaviness decreased significantly after MLD treatment.
MLD can provide benefits to those without lymphedema, as well. Ongoing research has shown that MLD can reduce healing time for those recovering from surgeries, including cosmetic surgery; can provide relief for those with fibromyalgia, and can be incorporated into sports medicine and rehabilitation. MLD is also beneficial to those with immunodeficiencies, or those who are prone to colds and sinus infections.
Manual lymphatic drainage disrupts blockages in the lymphatic system and encourages the system to work efficiently, allowing your immune system to function at peak performance. Thus, MLD is useful for reducing healing time, diminishing bruises, decreasing swelling, and relieving pain.
Note that MLD is not a massage, but it can be practiced by trained massage therapists and other bodyworkers. MLD differs from massage in that massage aims to reach the muscles and encourage blood flow, while MLD targets the area right above the fascia where superficial lymphatic vessels can be found. Stimulating this area causes lymph to flow throughout the whole body.
As with all treatments, MLD may not be right for everyone. If you are prone to skin irritations or have sensitive injuries, do not get MLD. Check with your doctor before seeking manual lymphatic drainage as treatment.