Manual lymphatic drainage massage (MLD) is a technique developed by the Vodders (Dr. Emil Vodder and his wife Estrid) in Paris in 1936 to treat swollen lymph nodes. It treated Hay-fever originally, but we have taken today to a whole new level.

What is lymphatic drainage massage?

Lymphatic drainage massage has become a popular form of massage because of its potential health benefits. This specialised approach focuses on the lymphatic system, which is part of your immune system.

They designed this type of massage to help the body maintain blood circulation, body fluid balance, and immune functions. It is not meant to work muscles. The pressure is more superficial as your lymphatic system runs just underneath the surface of your skin.

Lymphatic diseases, especially lymphedema, are a serious problem in the health community.

Understanding the lymphatic system

The lymphatic system contains vessels and nodes with lymph, a mixture of protein, water, waste products, and elements of the immune system. Lymph nodes are throughout the body and filter out all these wastes/ toxins.

The largest nodes are in the neck, groin, and armpits. We pump these areas gently to clear them of congestion. They all work together to ensure that the “clean” lymph is transported back to the veins that carry blood to the heart.

MLD is a light massage that stretches the skin and promotes the movement of lymphatic fluid out of the swollen limb. Not to be confused with traditional massage, lymphatic drainage massage uses a lighter pressure and no oil. Manual lymphatic drainage massage focuses specifically on the lymphatic vessels to help the flow of lymph fluid through skin stretch. As an experienced massage therapist, we don’t follow a specific sequence. Instead, we use a variety of massage techniques, including stretching, compression, sliding and cupping.

Light rhythmic stretching movements stimulate the lymphatic system without pressing heavily on the vessel. They make the lymph fluid move easily through the nodes and tissues, ensuring that the fluid does not get trapped anywhere.

Therapy is first applied to unaffected areas, allowing fluid to leave the affected area or “decongest” the area. MLD helps open the remaining functioning lymph collectors and transport proteins and fluids into them, as well as speeds up the flow of lymph fluid through the lymphatic vessels.

Principles of lymphatic drainage massage

I stretch the skin in specific directions with hand movements to promote fluctuations in interstitial pressure without using oils. You will often see simple examples of dry brushing with a body brush. This isn’t what we do in lymphatic drainage massage.

Slow, repetitive movements which lift the skin upward also involve a rest period that allows the skin to return to its normal position. The pressure varies depending on the underlying tissue to promote lymphatic drainage.

We treat Fibrosis areas with deeper, firmer movements, often in a circular motion, in combination with compression garment therapy.

Lymphatic drainage massage begins centrally and proximally with treatments that usually start around the neck.

Healthy nodes

Functional and healthy lymph nodes are treated first, followed by the proximal and contralateral areas, and then the ipsilateral and lymphedema areas. The focus is on treating theWoman's legs being gently manipulated using MLD techniques during therapeutic oncology massage front and rear trunk in the early stages with upward motions before treating the swollen limb with upward strokes towards the upper arm or upper leg. Obviously, when we’re working with post surgery patients, including liposuction clients, then we do things slightly differently.

We combine the breathing techniques with pressure from the therapist’s hands, which promotes drainage of deep abdominal lymph nodes. We often combine the techniques of mobilisation and relaxation of the limbs with lymphatic draining.

We usually do deep breathing techniques known as diaphragmatic breathing at the beginning and end of a therapy session to open up deep lymphatic pathways. Not only is it relaxing, but it also encourages fluid movement towards the heart.

MLD – should stimulate lymph nodes and increase rhythmic contractions of the lymph vessels to increase their activity and thus be able to divert stagnant lymph fluid which often create lymphedema. Lymphatic drainage massages consist of four main strobes: stationary circuits, knife technology, pumping technology and rotation circulation techniques.

Benefits of Lymphatic Drainage Massages


We have used lymphatic drainage massage for people with lymphedema who experience swelling, usually in one leg or arms. Lymphoedema can be treated with tight compression bandages or stockings, but when we perform manual lymphatic drainage massage, it can help improve results.

Lymph fluid that has accumulated in soft tissues due to genetic disorders, injuries, infections, cancer treatments, or surgery caused inflammation.

Symptoms of lymphedema include:

lymphodoema after surgery massagePain Discoloration of the skin

Swelling of the tissues

Severity of the extremities

Weakness Hardening or thickening of the skin

Recurrent infections

Manual lymphatic drainage massage is effective as both a preventive and post-operative rehabilitation treatment, and achieves optimal results when combined with the other elements of complete decongestive therapy (CDT).

MLD also increases blood flow in deep and superficial veins.

Besides lymphedema, we can also use MLD in diseases such as post-traumatic and postoperative oedema and palliative care. For instance, if lymphedema occurs after a mastectomy that removes breast tissue to treat or prevent breast cancer, lymphatic drainage massage may help relieve mild-to-moderate symptoms after surgery. Even many years post-operative.

Treating Other Health Conditions

Lymphatic drainage massage can help with various health problems. Some medical conditions may benefit more from massage than others. Studies have found that lymphatic drainage massage may be beneficial for:

Rheumatoid arthritis. If you have rheumatoid arthritis, you may experience poor lymph flow as the disease progresses. Along with swelling of the tissues, joint pain increases, joints lose their function, and the skin changes color.

Lymphatic drainage massage can help relieve these symptoms of late-stage rheumatoid arthritis.

Chronic venous insufficiency (CVI). Chronic venous insufficiency occurs when the valves or vein walls of the legs do not work properly. This allows blood to flow from the legs to the heart. Lymphatic drainage massage can help increase blood flow velocity in people with CVI.

Massage allows the femoral artery, the large artery of the thigh, to work better immediately after the session. It is not clear how long this effect lasts or whether the massage will relieve pain and swelling in the long term. Further research in this area would help to shed light on the effectiveness of this massage technique in CVI fibromyalgia. Lymphatic drainage massage can help people with fibromyalgia. This condition causes inflammation of the nerves in the skin, discoloration of the skin, and swelling of the tissues. They have shown massage to be better than connective tissue massage to treat depression, stiffness, and improve the quality of life of people with fibromyalgia.

Text us on 07757 946023 to book, appointments in Central London near Harley Street and Romford, Essex.


There are several techniques for MLD, including vodder, foeldi, leduc or casley smith methods.

MLD is often recommended as part of a treatment plan known as Complete Decongestive Therapy (CDT), although it may be used in combination with other treatments. Complete Decongestive Therapy (CDT) is a comprehensive and highly effective treatment approach for individuals dealing with lymphedema, a condition characterised by the accumulation of lymphatic fluid, often leading to swelling and discomfort. CDT encompasses a multi-faceted approach that includes manual lymphatic drainage, compression therapy, exercise, and skin care.

Manual lymphatic drainage, performed by trained therapists, encourages the lymphatic system’s natural flow, reducing swelling and promoting lymph fluid drainage. Compression therapy involves the use of special garments or bandages to maintain reduced swelling. In addition, tailored exercises and skin care routines are integrated to enhance the overall therapeutic benefits. CDT is a holistic and evidence-based approach that not only alleviates the symptoms of lymphedema but also empowers individuals to manage their condition effectively, improving their overall quality of life. We also use this approach with our post surgery patients who come for MLD.

It often takes many hours of training in MLD, combined with years of practical experience, for a lymphedema therapist to be truly qualified. We have been working on clients for around ten years now and work with referrals from Harley St and Knightsbridge cosmetic surgery clinics.

The most appropriate techniques, the frequency and optimal indications for MLD, and the benefits of treatment vary by client and their condition, but the different methods have several aspects in common

Normally performed with the patient in a lying position

Often begins and ends with deep diaphragmatic breathing

We treat the lymph nodes in specific regions first and then move proximally distally to drain affected areas with slow and rhythmic movements

Uses gentle pressure

There are four main stages of lymphedema, each of which acts on the body differently and can be classified by severity.

Duration of treatment varies depending on the stage of lymphedema the client has. For example, intensive treatment may last longer than 2 to 4 weeks and treatments less intensive methods may take months or years as part of your maintenance programme.

Different approaches

Vodder: we use different hand movements in the body depending on the part being treated. It also includes the treatment of fibrosis.

Foldi: based on the Vodder technique, this method focuses on thrust and relaxation. It helps to treat edema caused by “circulating strokes”.Casley-Smith: This method uses small, smooth effleurage movements with the side of the hand.

Leduc: includes special “call” (or attractive) and “resorption” movements that reflect how lymph absorbs first in the initial lymph nodes and then into larger lymph vessels.

We will mix some or all into your treatment based on what your body needs and how it best reacts. We will also often use Deep Oscillation or Cavitation to help speed up the way your body reacts and ultimately improve your results. You typically will book an hour’s appointment with us. To accelerate your healing process, you have the choice to incorporate optional supplements such as red light therapy in London or vitamin injections available in Romford and London.


Primary or secondary lymphedema

Phlebolymphostatic oedema edema

Posttraumatic edema including post surgery, including liposuction.

Chronic venous insufficiency

Palliative care: comfort and pain relief when other physical therapies are no longer appropriate

This technique can be used to supplement therapies for patients with stress as it stimulates the parasympathetic nervous system.

May reduce intracranial pressure in severe brain conditions.


General contraindications

Contraindication absolute: decompensated heart failure Untreated heart failure (CHF – cardiac edema) Acute inflammation caused by pathogenic germs (bacteria, fungi, viruses). The germs could spread through manual lymphatic drainage, causing blood poisoning (sepsis). Acute renal failure Acute deep vein thrombosis (DVT) The previous condition should not be treated with manual lymphatic drainage.

Text us on 07757 946023 to book, appointments in Central London near Harley Street and Romford, Essex.