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Manual Lymphatic Drainage (MLD)

Manual Lymph drainage (MLD), is a technique developed by the Vodders (Dr. Emil Vodder and his wife, Estrid) in 1936 in Paris for treatment of swollen lymph nodes.

Lymphatic diseases, especially lymphedema, represent a serious problem in the health community.

MLD is a light, skin-stretching massage that helps promote the movement of lymphatic fluid out of the swollen limb. It should not be confused with a traditional massage. MLD is specifically focused on the lymph vessels to help the flow of lymphatic fluid. Therapy is applied to your unaffected areas first, making it possible for the fluid to move out of the affected area, or “decongest” the region. MLD helps open the remaining functioning lymph collectors and move protein and fluid into them, as well as to help speed up lymph fluid flow through the lymphatics.

MLD is intended to stimulate lymph nodes and increase rhythmic contractions of the lymphatics to enhance their activity so that stagnant lymphatic fluid can be rerouted.

MLD is composed of four main strokes: stationary circles, scoop technique, pump technique, and rotary technique.

MLD Is effective both as a preventative treatment and as a post-operative rehabilitation treatment, and has optimal results when it is combined with the other elements of CDT (Complete Decongestive Therapy).  MLD also increases blood flow in deep and superficial veins.

Other than lymphedema, MLD may be useful in conditions such as post-traumatic and post-surgical edema, and palliative care.

There are various techniques for MLD including the Vodder, Földi, Leduc or Casley-Smith methods.

Often, MLD is recommended as a component of the treatment plan known as Complete Decongestive Therapy (CDT), although it may be used in combination with other treatments.

It often takes many hours of training in MLD, combined with years of hands-on experience, for a lymphedema therapist to become truly skilled.


  • Primary or secondary lymphedema
  • Lipedema
  • Phlebo-lymphostatic edema
  • Postoperative edema
  • Posttraumatic edema 
  • Chronic venous insufficiency
  • Palliative care: Provision of comfort and pain relief when other physical therapies are no longer appropriate
  • This technique may be used as a complement in therapies for patients with stress. 
  • May be effective for reducing intracranial pressure in severe cerebral diseases.


  • Decompensated cardiac insufficiency
  • Untreated Congestive heart failure (CHF - cardiac edema)
  • Acute inflammation caused by pathogenic germs (bacteria, fungi, viruses). The germs could be spread by the manual lymph drainage, with resulting blood poisoning (sepsis).
  • Acute renal failure
  • Acute deep venous thrombosis (DVT)   
  • Malignant lymphedema caused by active cancer
  • Renal dysfunction