Last week I started our conversation about the lymphatic system. This week I am going to explain how supporting this system through Manual Lymphatic Drainage, or MLD, is impactful for both compromised and healthy systems. In this post I answer the most common questions I get asked about the lymphatic system and MLD.
So …. What is MLD, and how does it work?
MLD is a gentle, rhythmic massage technique designed to increase the movement of lymph and interstitial fluid. Actually it’s not traditional massage at all, even though it has some of the same effects. It’s more like a gentle skin stretch: imagine pulling along the body rather than pushing down into it. The pressure is incredibly light as the lymphatic vessels are just under the surface of the skin, superficial to the fascia layer that covers the muscular system. The lymphatic vessels contain a layer of smooth muscle that contracts in response to lymph volume, moving the lymph along the network. Performing MLD stimulates this muscle layer to contract, and the increased fluid uptake further increases lymphatic transport due to the increase of intra-lymphatic pressure. In healthy systems, MLD can help move the fluid along the pathways. In compromised systems, MLD can actually redirect the fluid around blocked areas or lymph nodes that are not functioning properly toward healthy lymph nodes. (This STILL blows my mind.)
What are the effects of MLD?
The general effects of MLD include increased lymph flow, an analgesic effect on the tissues and the redirection of fluid around blocked areas (if that is necessary). MLD is also incredibly soothing, because it activates the parasympathetic nervous system.
Is it just for lymphedema?
MLD is critical for people living with lymphedema, as it is part of their daily care regimen. Combined with compression garments and other self-care measures, MLD can keep the lymphedema contained and manageable. For those living with this condition, it is necessary to be treated by a Lymphedema Therapist first before being referred to an MLD Therapist. For more information on lymphedema, please visit The National Lymphedema Network. You can also check out a great blog written by a woman living with this condition – it is very informative and supportive (lymphielife.com). However, MLD can be used for other conditions as well. Here is a list of conditions that respond favorably to MLD:
Post-traumatic edema: MLD is very effective at reducing most types of swelling, so any type of sprains or injuries can be treated after the acute injury phase of 24-48 hours
Post-surgical edema: MLD is often prescribed post-surgery to reduce swelling and help prevent infection. It is very good for cosmetic surgery or dental surgery
Autoimmune disorders: MLD, performed conservatively, can help the symptoms of Fibromyalgia, Chronic Fatigue Syndrome, Rheumatoid Arthritis and others. Specifically, it can help promote restful sleep, decrease hypersensitivity, provide general detoxification and decongestion of tissues and reduce pain.
Migraines and sinus headaches: MLD can reduce the pain and hypersensitivity associated with these events and potentially reduce the frequency of reoccurrence.
Allergies: Perfect for Austinites! MLD can reduce inflammation and congestion in the sinus tissues, as well as support the body in its response to the allergens
Is MLD beneficial if I do not present with any of these conditions?
YES!!! MLD is an excellent yet under-utilized therapy for healthy systems. One of the main functions of the lymphatic system is immunological response. Given all of the toxins in our environment, the air we breathe, the food we eat, the water we drink, the vaccines and antibiotics that we have all been exposed to… a therapy that supports the immune system functioning should be a part of our maintenance regimen. As our bodies combat these foreign substances, MLD can help move along the metabolic waste produced. It can also help by manually moving pathogens along the lymphatic vessels into the lymph nodes, where they are inactivated by lymphocytes and macrophages. There is evidence to suggest that MLD may also free the connective tissues of larger pathogens by stretching and moving the skin. Immunoglobulins can also reach the sites where they are needed through increased movement of the lymph.
Systemic relaxation is a critical piece of any healing modality. Systemic relaxation refers specifically to the activation of the parasympathetic nervous system and the calming of the sympathetic response. The body cannot truly heal itself unless it is in the parasympathetic state. Multiple studies using an electroencephalogram (EEG) to measure brain activity reveal that MLD increases alpha brainwave activity, which is dominant in relaxed conditions. The same studies show a statistically significant decrease in beta and gamma activity, which are present during excitation and stress conditions.
There is evidence to suggest that proper lymph movement could potentially help our brains in another way. Research out of the University of Virginia Medical School recently discovered lymphatic vessels responsible for draining waste products out of the brain, or a pathway for immune cells to exit the central nervous system. This finding raises the question as to whether a disruption of this route may be involved in neurological disorders associated with immune system dysfunction, like Multiple Sclerosis and Alzheimer’s disease. In Alzheimer’s disease, for example, a protein called amyloid beta accumulates in the brain and damages cells. In laboratory studies using mice, mice with healthy vessels rapidly removed this protein from their brains, whereas mice with damaged lymphatic pathways in the brain experienced much slower removal of this protein. These studies are by no means conclusive and a causal relationship cannot be established. However, scientists speculate based on these findings that further research is necessary, as there may be a connection between the brain’s lymphatic system and neurological disorders. Even if no direct correlation has yet been proven, it is my belief that manually supporting the lymphatic system as a possible preventive measure is a good idea.
MLD is effective for a variety of different health conditions, but it can also be very useful as a maintenance tool. Given that our bodies are approximately two-thirds fluid, many of our systems involve proper circulation and transport of these fluids. MLD can be a gentle support in the proper functioning of these systems.
“Lymphatic Vessels Discovered in Central Nervous System”, Carol Torgan, PhD, National Institutes of Health, June 15, 2015 https://www.nih.gov/news-events/nih-research-matters/lymphatic-vessels-discovered-central-nervous-system
“Effects of Manual Lymph Drainage for Abdomen on the Brain Activity of Subjects with Psychological Stress”, Shim JM, Yeun YR, Kim HY, Kim SJ, Journal of Physical Therapy Sciences, March 2017 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5361017/
“Effects of Manual Lymph Drainage of the Neck on EEG in Subjects with Psychological Stress”, Jung-Myo Shim, MSc and Sung-Joong Kim, PT, PhD, Journal of Physical Therapy, February 2016 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3927024/
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