Manual Lymph Drainage (MLD)

Manual Lymphatic Drainage [MLD] is a unique, gentle type of skin massage technique that promotes lymph to drain out of a limb into an area that drains normally. It is mainly used for Lymphedema

In addition to improving lymphatic circulation, MLD also increases blood flow in deep and superficial veins.

There are  various techniques for MLD including the Vodder, Földi, Leduc or Casley-Smith methods.  The most appropriate techniques, optimal frequency and indications for MLD, as well as the benefits of treatment, all remain to be clarified, but the different methods have several aspects in common:

  • Usually performed with the patient in the lying position, unless for lymphoedema of the head and neck
  • Starts and ends with deep diaphragmatic breathing
  • The unaffected lymph nodes and region of the body are treated first
  • Moves proximal to distal to drain the affected areas
  • Slow and rhythmical movements
  • Uses gentle pressure


  • Primary or secondary (link to Lymphedema page)
  • 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


Absolute Contraindication:

  • Decompensated cardiac insufficiency
  • Cardiac edema
  • Congestive heart failure
  • 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

Condition stated above must not be treated with manual lymph drainage.

Relative Contraindication:

  • Malignant lymphedema caused by active cancer