Manual Lymphatic Drainage, usually called MLD, is a specialised, gentle massage technique designed to encourage the movement of lymph fluid around the body. The lymphatic system helps remove waste, excess fluid, and toxins from tissues, while also supporting the immune system. Unlike a normal massage, MLD uses light, rhythmic skin movements rather than deep pressure. The aim is to guide fluid away from swollen or congested areas and towards parts of the lymphatic system that are working well.

Different Schools of MLD

There are several recognised schools or methods of MLD. They all share the same goal of improving lymph flow, but they use slightly different movements, sequences, and treatment approaches.

• Vodder Method: Developed by Dr Emil Vodder and Estrid Vodder, this is one of the best-known MLD methods. It uses very light, precise, rhythmic movements to stimulate lymph flow.
• Földi Method: This approach is often used as part of Complete Decongestive Therapy. It combines MLD with compression, exercise, and skin care to help manage swelling.
• Casley-Smith Method: This method focuses on redirecting lymph fluid from affected areas into healthy drainage pathways. It may also include breathing techniques, compression, exercise, and self-management.
• Leduc Method: This school uses specific hand movements and treatment sequences to encourage lymph drainage, often based on the direction and condition of lymph flow.
• FG-MLD: Fluoroscopy-guided MLD uses imaging information to guide treatment more precisely, helping therapists understand how lymph is moving in an individual patient.

What MLD Is Used to Treat

MLD is most commonly used to treat lymphoedema, which is swelling caused by a build-up of lymph fluid. Lymphoedema can happen after cancer treatment, surgery, injury, infection, or because of problems with the lymphatic system. MLD may help reduce swelling, soften tissues, improve comfort and support the body’s natural drainage process.

MLD is also used to support recovery from post-surgical swelling, post-traumatic swelling, some forms of oedema, lipoedema, venous insufficiency and scar-related swelling. In some cases, it may be used as part of rehabilitation after cosmetic surgery, orthopaedic injury, burns or wound healing. It is often combined with other treatments such as compression garments, bandaging, exercise, breathing techniques and skin care.

MLD should be carried out by a trained therapist because the technique needs to be adapted to the person’s condition, medical history and treatment goals. It is gentle and relaxing, but it is still a clinical technique, especially when used for lymphoedema or post-surgical swelling.