As a Massage therapist and practitioner of manual lymphatic drainage for 15 years, I can say it is a highly specialized technique that can be used to address many injuries and pathologies. Once you understand the full depth of manual lymphatic drainage and how it will benefit you may want to try this technique as addition to your health and wellness routine. MLD not only used in case of lymph related illnesses but often used for cellulite treatments too.

What is Manual Lymphatic Drainage (MLD)?

According to The Royal Marsden

Lymphatic drainage

Lymphatic drainage is sometimes termed 'massage' because it involves hand movements on the skin but it is very different from therapeutic or aromatherapy massage which can cause friction to the skin and increase the blood supply. This, in turn, causes more lymph to be produced.

There are two types of lymphatic drainage which may be used to treat lymphoedema – manual lymphatic drainage (MLD) and simple lymphatic drainage (SLD). Lymphatic draining techniques provide regular stimulation of the lymph vessels under the skin. It encourages them to work harder and find new pathways to drain away the lymph using a milking or syphoning effect to move lymph away from the swollen area. Treatment with MLD or SLD may be particularly helpful if you have swelling of your face, neck upper arm, thigh, breast, trunk or genitals.

Manual lymphatic drainage

Manual lymph drainage (MLD) is a very special type of massage designed to stimulate the lymphatic system. The hand movements and sequences are adapted for each person. It must be carried out by a qualified practitioner. Ask your lymphoedema specialist if you might benefit from MLD.

Not like other massage techniques it is start by the central collecting ducts and works towards the peripheries. If your therapist starts with your feet and works towards your heart that is NOT a manual lymph drainage!

Anatomy of the Lymphatic System:

The lymphatic circulation often called the “secondary” circulation of the body. Some might argue of this as the lymphatic “circulation” isn’t a closed system as our blood circulation but the both are closely related and connected. Our blood flow system is a closed circle and the blood running it doesn’t leave the blood vessels at any point except in case of injury. The exchange of gasses, nutrition and other material happens in the Capillaries, the smallest blood vessels in the body.

On another hand the lymphatic system isn’t closed, it starts from smallest vessels called Lymphatic capillaries. The lymph capillaries begin in the tissue spaces as blind-ended sacs, if you like you can picture them like the fingers of a glove. These capillaries merge to form lymphatic vessels. Small lymphatic vessels join to form larger tributaries. Those called lymphatic trunks and drain large regions. Lymphatic trunks merge until the lymph enters the two lymphatic ducts. The two ducts collect lymph from different sized areas. The right lymphatic duct drains lymph from the upper right quadrant of the body. The thoracic duct drains all the rest.

Just like our veins, the lymphatic tributaries have thin walls and have valves to prevent backflow of lymphatic fluid. There is no actual pumping organ in the lymphatic system like the heart in the cardiovascular system. The lymph moves through the vessels because of the skeletal muscle action, respiratory movement, and contraction of smooth muscle in vessel walls.

The lymphatic system other parts are the lymphatic organs (Lymph Nodes, Tonsils, Spleen, Thymus)

The lymphatic systems most known organs are the lymph nodes. They are like the army guard post on the road, they are filters. They spread out to the body but in larger numbers where the body might have open for invaders or pathogens, including the throat, armpits, chest, abdomen and groin. Organised in chains or groups and imbedded in fatty tissue and lie close to veins and arteries.

Lymph nodes have a wide range of functions but are generally associated with body defence. Bacteria (or their products) are forced to flow through the lymph nodes, filtered by the nodes picked up by cells called macrophages, or those that flow into the lymph. There, white blood cells called lymphocytes can attack and kill the bacteria. Viruses and cancer cells are also trapped and destroyed in the lymph nodes.


The spleen is located in the left side of your tummy, just under the diaphragm. This is the largest lymphatic organs. It has many as it filters and monitors our blood. It contains a range of cells, including macrophages. It also produces and stores a range of white blood cells (part of our defence) and removing microbes. The spleen also part of our blood reproduction as it disintegrates old or damaged red blood cells. It also acts as a blood storage and can also help in increasing blood volume quickly if someone loses a lot of blood.

Did you know you can live normal life without your spleen? If its damaged in an accident and surgically removed most function can be overtaken by the liver and you can survive. Of course, it is better to have one.


The thymus is inside the ribcage, just behind the breastbone. It filters and monitors our blood content. It produces cells T-lymphocytes or T-cells circulate around the body. These cells can remember previous infections and part of the adaptive immune system. Their tasks include directly killing infected host cells, activating other immune cells, producing cytokines and regulating the immune response.

If our lymphatic system not working properly, fluid builds in the tissues and causes swelling. This is called lymphedema. Other lymphatic system problems can include infections, blockage, and cancer.

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