Manual Lymphatic Drainage

Professional manual lymphatic drainage reduces swelling and prevents fluid retention, creating lighter legs and arms. Modifies lymphoedema, improves mobility and quality of life. Relieves post-operative inflammation and bruising.5,7-9

 lymphatic system 2

What is it?

We offer high quality treatments and expert guidance for patients with primary lymphoedema (malformation of lymphatic system) and secondary lymphoedema (damage to lymphatic system).1-4 Boosts the immune system through detoxification and decongestation. Prevents risk of lymphoedema, reduces swelling and recovers skin texture, improves circulation and promotes disease management.



Pre and Post Surgery Gently alleviates swelling and bruising while accelerating the body’s organic healing processes, promotes tissue regeneration and reduces scar tissue.

Detoxification Stimulates the body’s one-way lymphatic drainage system, as a non-invasive waste removal to cleanse toxins and purify.

Boost Immunity Promotes health by increasing natural defence mechanisms. Resolving symptoms of chronic fatigue syndrome, fibromyalgia and glandular fever.

Pregnancy and Hormones  Reduces swollen ankles safely and removes excess fluid, while helping hormonal balance. Also useful for menstrual pain, menopause bloating and hot flushes.

Lipoedema  Helps alleviate abnormal deposits of adipose (fatty) tissue, accompanied by an accumulation of fluid that causes pain and discomfort.

Lipoedema is predominately bilaterally in the lower limbs, causing enlargement and sensitivity. The feet are classically not affected. CHHC Patients can be professionally measured and  prescribed appropriate compression hosiery following Manual Lymphatic Drainage MLD treatment.

MLD reduces symptoms of  Haematoma, Scars and  Burns also aids in  pain relief. Additional MLD encourages a deeply relaxing and calming effect on the nervous system, helping to gently relieve stress and tension.8-13


Treatment Time + Approach:

Following a complete assessment and detailed history, patients will be physically examined and measurements taken. Patients will be asked to remove their outer garments, and comfortably position themselves on the couch. The gentle and rhythmic massage treatment makes direct contact with the skin, working from the trunk outwards (proximal to distal) and lasts between 30 minutes to 2 hours, depending on the areas being covered. An intensive course may be 3 to 5 times a week, lasting for 3 to 4 weeks. MLD may be repeated every 4-6 weeks, then 6 monthly, after which patients should be reviewed yearly.5,7-9



There are several well-recognised forms of Manual Lymphatic Drainage (MLD): Vodder (1930s), Földi (1960s), Leduc (1960s) and Casley-Smith (1970s). All originate from Vodder, with a great deal of research over the years, more recently Fluoroscopy Guided Manual Lymphatic Drainage (FG-MLD/Fill and Flush Method) has provided evidence based results (2017).1,3

All incorporate the four cornerstones of lymphoedema treatment:

  • Manual Lymphatic Drainage (MLD) – a dry, rhythmic and light massage, aimed at initial lymph system, specifically designed to stimulate lymphatic flow through methodological stretching of the skin.
  • External Compression – helps prevent re-accumulation of fluid and improves shape. Elastic graduated compression garments must be prescribed by a specialist therapist for correct compression and sizing.
  • Skin Care – keeps the skin in good condition, reduces the risk of infection.
  • Exercise – regular, gentle exercise is essential to maximise lymph drainage, and will keep the body supple and the weight within healthy limits. Treatment will incorporate breathing exercises, as directed by your therapist.5,6,7


Recognised Bodies + References:

MLD UK requires proof of recognised training, insurance and continuous professional development to maintain highest standards of care. Lymphatic Therapists must be able to fully assess and recognise contra-indications and medical implications before application.


1       Chartered Society of Physiotherapy (2012) Lymphoedema: 121103)

2        Moffatt CJ, Franks PJ, Doherty DC, Williams AF, Badger C, Jeffs E, Bosanquet N and Mortimer PS (2003) Lymphoedema: an underestimated health problem. Quarterly Journal of Medicine: An International Journal of Medicine. 2003;96(10):731-8.
3        Mortimer P and Easton G (2012) Chronic oedema and lymphoedema: (accessed 121103)
4        National Institute for Health and Clinical Excellence (2009) Advanced breast cancer: diagnosis and treatment (CG81): (accessed 121103)
5        Oremus M, Dayes I, Walker K and Raina P (2012) Systematic review: conservative treatments for secondary lymphedema, BioMed Central Cancer 2012, 12:6 doi:10.1186/1471-2407-12-6.
6        Egan B, Gage H, Hood J, Poole K, McDowell C, Maguire G and Storey L (2012) Availability of complementary and alternative medicine for people with cancer in the British National Health Service: Results of a national survey. Complementary Therapies in Clinical Practice 2012; 18, (2): 75-80.
7        Macmillan Cancer Support (2012) Manual Lymphatic Drainage 121103)
8        Damstra R and Kaandorp C (2007) Multidisciplinary guidelines for early diagnosis and management. Journal of Lymphoedema, 2007;2(1):57-65.
9        Morgan PA, Franks PJ and Moffatt CJ (2005) Health-related quality of life with lymphoedema: a review of the literature. International Wound Journal, 2005 Mar;2(1):47-62.
10      Stout NL, Pfalzer LA, Springer B, Levy E, McGarvey CL, Danoff JV, Gerber LH and Soballe PW (2012) Breast Cancer-Related Lymphedema: comparing direct costs of a prospective surveillance model and a traditional model of care. Physical Therapy, 92(1):152-163.
11       Box RC, Reul-Hirche HM, Bullock-Saxton JE and Furnival CM (2002) Physiotherapy after breast cancer surgery: results of a randomised controlled study to minimise lymphoedema. Breast Cancer Research and Treatment Journal. Sep;75(1):51-64.
12      Devoogdt N, Christiaens M-R, Geraerts I, Truijen S, Smeets A, Leunen K, Neven P and Van Kampen M (2011) Effect of manual lymph drainage in addition to guidelines and exercise therapy on arm lymphoedema related to breast cancer: randomised controlled trial BMJ 2011;343:d5326.
13      Chang SB, Askew RL, Xing Y, et al. Prospective assessment of postoperative complications and associated costs following inguinal lymph node dissection (ILND) in melanoma patients. Ann Surg Oncol. 2010 Oct;17(10):2764-72.







Fluoroscopy Guided MLD (FG-MLD/’Fill and Flush‘ technique)