Lymphedema Massage & Treatment

What is Manual Lymph Drainage (MLD)/Complete Decongestive Therapy (CDT)?


What can you expect during the initial consultation?

During the initial visit we will conduct a thorough medical history and physical evaluation of the lymphedema.  We spend time with the patient discussing the lymph system and its functions. We discuss the components of Complete Decongestive Therapy and come up with a treatment plan for the physician’s approval.  We demonstrate self massage techniques and talk about precautions and life style changes which will limit risk to the limb.  We give the patient materials to take home and review.  Upon receiving a prescription and/or approval of the treatment plan from the physician we determine a schedule for treatments.

What is a typical session like?
A typical session takes about an hour.  It will incorporate any or all of the following steps:

    1. Manual Lymph Drainage (MLD): a light manual technique which stimulates the superficial lymph vessels and enhances lymph drainage. It is gentle, light, slow and rhythmic and very relaxing and pleasant.
    2. Compression bandaging:  short stretch bandages are applied after MLD to prevent return of fluid to the limb.  In addition, bandages help break down fibrosis and soften the skin.  During the initial phase of treatment, bandages should be worn 23 out of 24 hours.  With proper application they should not be painful.
    3. Exercises which utilize the muscle pump to enhance lymph drainage through the limb against the resistance of compression.
    4. Education in skin care to prevent infection, cellulitis and dermatological changes.  Education also includes review of self massage and self bandaging techniques.  Our objective is to help the patient learn to manage the condition with a great degree of self-sufficiency. 
    5. Maintenance phase:  We are available to address any changes in condition, answer questions for doctors and patients and assist in the maintenance of volume reduction and optimal compliance with the program.

Duration of treatment varies, but the usual protocol is to begin with an intensive phase designed to quickly reduce edema. This stage usually lasts about 2 to 3 weeks at 4 to 5 visits per week. The next step is using a compression sleeve. The maintenance phase is usually follow up visits every 3 to 6 months or as needed by the individual. At all stages of treatment communication between doctor, therapist and patient is important.