Manual lymphatic drainage (MLD) is a treatment method that stimulates the body’s lymphatic system and thus helps to reduce swelling. It can support or improve physiological lymph transport, mobilize excess fluid from the tissues and loosen hardened tissues. Since 1973, manual lymph drainage has been part of the health insurance companies’ service catalog and the costs incurred are covered.
The lymphatic system regulates the body’s water balance, removes dietary fats and is involved in the immune system. Disorders of the lymphatic system can be caused by certain underlying diseases or traumas. Then the body needs help to get rid of the swelling.
With gentle pressure and the right technique, the physiotherapist can help. Lymphatic drainage is completely painless for the patient and the patient is passive, except for some breathing exercises. The lymphatic drainage technique is performed relatively slowly, as the physiotherapist achieves the best results when he adapts to the working speed of the lymphatic system.
Lymphatic fluid is not liquid, like water, but rather an inert mass and must be transported accordingly slowly. The lymph fluid contains metabolic products, cell debris, hormones and fats that have been absorbed from the small intestine. Every day, our body produces about 2 liters of lymph, which must be transported by the lymph vessel system.
First of all, the tissue fluid is absorbed from the tissue by the lymph capillaries into the lymph vessel system. The lymph capillaries are so to speak “entrances” from the tissue (interstitium) into the lymph vessel system. The lymph capillaries begin like thin branches of a tree root in the tissue and then connect to larger lymph channels.
In the course of these lymph channels there are always lymph nodes that can be compared to a filter. Metabolic products and cell debris are removed here. In the lymph nodes are the cells, the so-called lymphocytes, which are responsible for activating the immune system when needed.
If foreign bodies such as pathogenic viruses or bacteria are registered in the lymph nodes, the work begins there. This is also the reason why the lymph nodes (especially in the neck) swell up when you have a cold or flu. All the lymph vessels of the lower extremity unite in the “lumbar cyst” to form a large lymphatic trunk, the “lactiferous duct”, which then runs through the diaphragm and then connects to another large lymph trunk containing the lymph fluid of the left arm, finally ending in the left vein angle.
The lymphatic fluid of the right half of the upper body flows into the right vein angle. The lymph is thus absorbed throughout the body by small lymph capillaries, which unite to form larger lymph vessels and transport the lymph upwards to the venous angle against gravity. The venous angle is located to the right and left behind the clavicles.
To ensure that the lymph fluid can be transported against gravity at all, the lymph vessels contain valves that prevent backflow. The lymph vessels also have smooth muscles that are controlled by the autonomous nervous system. Therefore they contract for us unconsciously in their own rhythm. In a healthy lymph vessel system, all lymph that accumulates can be removed. If lymph can no longer be transported away, this is called oedema.
