What’s the Difference between a Lymphatic Massage and Manual Lymph Drainage?

Updated: Sep 27

Manual Lymphatic Drainage is a light-touch modality that is applied to reduce swelling of the face or body through specialized skills, techniques, and practices. Manual Lymphatic drainage has several different pathways that include working toward the cervical, inguinal, or axillary nodes. These sophisticated pathways become complicated when a client has an obstruction due to surgery, oncology treatment, birth defect or other physical trauma. (A high-quality CE course in lymphatic drainage will explain the different directions, pressures, and tissues that are manipulated and used in this highly specialized bodywork.)


Please note that Aline Health no longer offers this service


In Swedish massage, clients can request work almost anywhere they wish, in any order they wish, with a variety of pressures that can be changed from one appointment to the next. In manual lymphatic drainage, a specific order or routine is followed, with minimal pressure that cannot be altered without medical reasoning. Swedish Massage is generally provided in one direction—toward the heart—to increase overall cardiovascular circulation through venous return.


The Lymph system is a delicate network of capillaries resting just underneath the surface of the skin. It is a system of vessels that runs through your entire body with Lymph nodes that are strategically located throughout the system for optimal performance, and are clustered in areas like the neck, underarms, abdomen and behind the knee.




Primary and collateral Lymphatic system

An unhealthy lymphatic system can have a serious impact on your health. Poor lymph function is associated with fibromyalgia, multiple sclerosis, chronic fatigue syndrome, aches, and pains, bloating and poor digestion. Studies have shown that an unhealthy lymph system can contribute to cellulite, fat deposits and obesity as well.


Lymphedema and Lipedema – What is it and how is it treated?


Lymphedema is classified as either primary or secondary. Primary lymphedema is the result of lymphatic dysplasia meaning that it may be present at birth, but it more often develops later in life without an obvious cause. Secondary lymphedema is much more common and is the result of surgery and/or radiation therapy for cancer. Secondary lymphedema may also occur after injury, scarring, trauma, or infection of the lymphatic system. Lymphedema has important pathological and clinical consequences.


It is important to note that the lymphatic system not only carries lymph fluid it also carries metabolic waste, inflammatory agents, dead cell particles, large proteins, and fat molecules away from the interstitial areas. In layman’s terms, it is basically "the sewer system of the body".


Lymph fluid is a clear, colorless fluid originating in the tissue spaces as interstitial fluid. It is made up of various proteins, living and non-living particles, large fatty acids (protein), and fluid. In fact, the only difference between interstitial fluid and lymph fluid is where it is located. If it is in the interstitial space, it is called interstitial fluid; if it is in the lymphatic system, it is called lymph fluid.


Lipedema is a condition that mainly affects women and is characterized by a painful swelling in the legs, thighs, and buttocks and sometimes the arms. Lipedema usually occurs because of the abnormal accumulation of fat under the skin. Manual Lymph Drainage (MLD) can be very relaxing, can decrease pain, and stimulate lymphatic circulation. MLD is known to decrease capillary fragility in lipedema patients. Applying compression garments after MLD help keep the reduction effects.


MLD is a gentle manual technique to activate the lymphatic system, especially when the transport capacity of the lymph system is reduced because of prior surgery and/or radiation therapy. Because the Lymph system does not have a “pump” as does the circulatory system (the heart), it must be moved using certain hand techniques. These techniques are light, gentle skin-stretching movements in the direction of the lymph flow from areas of congestion to areas where there is better flow in the lymph vessels.


Manual Lymph Drainage (MLD)…

· Is intended to stimulate lymph nodes and increase rhythmic contractions of the lymphatics to enhance their activity so that stagnant lymphatic fluid can be rerouted.

  • Is effective both as a preventative treatment and as a postoperative rehabilitation treatment, and has optimal results when it is combined with the other elements of CDT (Complete Decongestive Therapy – bandaging and wrapping the affected areas).

  • MLD also increases blood flow in deep and superficial veins.

  • Other than lymphedema, MLD may be useful in conditions such as post-traumatic and post-surgical edema, and palliative care.


Indications for MLD

  • Primary or secondary lymphedema

  • Lipedema

  • Phlebo-lymphostatic edema

  • Postoperative edema

  • Posttraumatic edema

  • Chronic venous insufficiency

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

  • This technique may be used as a complement in therapies for patients with stress.

  • May be effective for reducing intracranial pressure in severe cerebral diseases.


Finding a certified therapist…

When looking for a therapist who can perform Manual Lymph Drainage you must make sure that they are certified. Anyone who has had only continuing education or watched videos for Manual Lymph Drainage and is not fully certified through a proper training program such as Vodder, Foldi, Klose or Norton for example, RUN AWAY! They could cause you more harm than good. Therapists that are properly trained and certified are qualified to work on you. They can explain in detail so you can understand what Lymphedema and Lipedema is and help you create a plan that will be for your benefit. Lymphedema and Lipedema are both manageable through Manual Lymph Drainage. Lymph brushing is also recommended to be done at home in between your sessions with a qualified MLD Therapist. There are several good videos on YouTube that one can watch.

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