Manual lymphatic drainage is an advanced massage therapy technique used in physiotherapy and aesthetics. Its purpose is the manual activation of the superficial lymphatic system in order to facilitate the drainage of interstitial fluid and lymph, stagnant for any pathological cause, to healthy lymphatic territories for normal evacuation into the venous stream. This prevents their stagnation or saturation by waste substances or harmful germs, as well as helping to drag the retained fluids into the circulatory system and blood.
Manual lymphatic drainage treatment is a technique that requires specialization and a deep knowledge of the anatomy and physiology of the lymphatic and venous systems by the therapist to achieve optimal treatment results.
What does it consist of?
Manual lymphatic drainage massages specific areas of the body following guidelines that allow it to fulfill its function. The massage should achieve a pleasant and relaxing effect through a slow and repetitive movement in the direction of the lymphatic ducts.
Benefits of manual lymphatic drainage
Drainage specifically stimulates the musculature of the lymphatic vessel walls and uses the lymphatic system itself to cleanse the body, reduce inflammation and strengthen the immune system.
This technique mobilizes and drains the proteins of the lymphatic edemas, which are not able to be drained by instrumental means (such as, for example, pressure therapy, which drains only the interstitial fluid). It also has an analgesic effect, regulates intestinal peristalsis and normalizes muscle tone.
Manual lymphatic drainage treatment
The manual lymphatic drainage technique consists of a series of manual maneuvers that are very gentle and generally painless for the patient. Each maneuver has three phases:
- Passive support phase
- Active thrust phase (pressure is applied in an increasing manner)
- Passive relaxation phase (the pressure is decreasingly eliminated and the skin returns to the initial position by itself).
This achieves a pumping action on the tissues so that the lymphatic vessels can mobilize and re-transport the lymph.
Slow, monotonous, harmonic, soft and rhythmic movements are applied. The rhythm of application should be slow and the pressure of the maneuvers should be minimal. It should not be performed abruptly.
The treatment is always started from proximal to distal to empty the collecting nodes that will collect the lymph.
In order to prevent the skin from slipping, lubricating products are not used. Even so, in some cases the use of moisturizing creams is allowed to improve the development of the technique and the dry and hypertrophic appearance of the skin.
Indications for manual lymphatic drainage
- Lymphedema
- Extensive lymphostatic edema:
- Secondary edema after mastectomy.
- Secondary edema due to interruption of lymphatic vessels.
- Primary edema.
- Fibrosclerotic edematous panniculosis.
- Edema of the head and/or face.
- Local edema of traumatic origin: hematomas, contusions, Sudeck’s dystrophy, dislocations and fractures.
- Post-surgical local edema and to accelerate healing: orthopedic, aesthetic operations, dental extractions.
- Articular rheumatic diseases (arthritis, arthrosis) and extra-articular (bursitis, capsulitis, periarthritis).
- Local edema of the central and peripheral nervous system: headaches, migraines, vertigo, paralysis, Down syndrome.
- Edemas due to circulatory disorders: varicose veins, tired legs (venous edema), venous ulcers or pressure ulcers.
- Edemas during pregnancy (prevention of stretch marks, unloading of legs).
- Lipedema: cellulite.
- Chronic inflammations of the respiratory system.
- ENT: chronic sinusitis, rhinitis, pharyngitis, tonsillitis.
- Digestive system: chronic constipation, heavy digestions.
- Edemas due to menstruation.
- Dermatology: acne, chronic eczema.
- Antistress: nerves, anxiety.
- Fibromyalgia.
Contraindications of manual lymphatic drainage
Absolute:
- Malignant tumors.
- Acute infections.
- Cardiac edema.
- Tortuous varicose veins and with relief.
- Phlebitis, deep vein thrombosis or thrombophlebitis in progress.
- Lymphodynamic edema: low blood protein (malnutrition).
Relative:
- Cancer already treated.
- Recent thrombosis, phlebitis or thrombophlebitis.
- Arterial hypotension.
- Acute inflammations: Rheumatism, nephritic colic, gout.
- Functional thyroid disorders.
- Autoimmune diseases (Lupus erythematosus, rheumatoid arthritis).
- Bronchial asthma.
- Disorders of the abdomen.
- Carotid sinus syndrome.
- Nevus (moles).