Dr. Vodder’s Manual Lymph Drainage (MLD)— Indications
Manual Lymph Drainage is indicated for a variety of conditions as it both affects and acts upon the diverse physiological functions of the human body. It is an alternative or key supplement to the many forms of physical therapies available today.
1) Extensive lymphedemas of the limbs head the list of conditions. These may be primary or secondary lymphedemas, such as those which form after mastectomy combined with the removal of axillary lymph nodes, or after radiation injury of the axillary or inguinal lymph nodes, iliac or lumbar lymphatic pathways. Although MLD rarely achieves complete removal of edemas in such cases, it greatly improves the patient’s general condition by reducing their size. Combining MLD, compression bandaging and remedial exercises will optimize edema reduction. Medication containing benzopyrone may help clear plasma proteins from the interstitial space, whereas diuretics result in only a short-term outflow of edema fluid. The fluid thus cleared will re-accumulate immediately as the plasma proteins that remain in the tissue once again begin to draw fluid to the edematous area. Moreover, this tends to encourage the formation of fibrosis, whereby highly fibrotic edemas which have been pre-treated with diuretics become very difficult to drain.
2) Another major group of indications is that of traumatic injuries: hematomas, distortions, muscle fiber tears, as well as the choice of therapy following dislocations of joints.
2a) Hematoma and post-fracture treatment provide numerous applications for Manual Lymph Drainage. In hematomas MLD should start as early as possible once the bleeding has stopped, i.e. before hematomas have formed a barrier of fibrin and leukocytes. Even large hematomas can be drained away with a few but extended treatment sessions.
2b) MLD’s pain relieving effect can be put to use when treating distortions and dislocations. In such cases hematoma therapy will be combined with isometric exercises. Active exercises and elastic bandaging supplement the treatment program.
2c) MLD greatly reduces the duration of treatment for torn muscle fibers. CRPS – Complex regional pain syndrome
3) Hematoma in fractures can be treated before the split cast is put on, as well as for the time period in which it is needed, thus enabling patients to receive a full cast soon. MLD treatment of hematomas greatly helps prevent the development of post-fracture complications. MLD may also be used pre- and post-operatively when fractures are managed by surgical intervention.
4) CRPS – (complex regional pain syndrome) in all its stages is a major indication for Manual Lymph Drainage. Its also called RSD (Reflex Sympathetic Dystrophy). Alongside edema removal, MLD’s analgesic effect plays a significant role. This enables patients to begin with passive and active remedial exercises relatively soon. Acute burn injury
5) Scar therapy is another major application. HUTZSCHENREUTER has demonstrated in a study that MLD improves wound healing and optimizes the scarring process. Damaged lymph drainage routes can be restored in existing scars. If post-surgical scars interrupt the lymphatic pathways and local edemas form, they can be drained away, while MLD scar treatment reconnects the interrupted drainage routes. MLD also has a salutary effect on large scars, such as those caused by burns. Hyperkeratotic scars cease their itching, the deep reddening of the scar area pales and the scar tissue softens. Frequently MLD makes surgical corrections of scars unnecessary. However, much time must be spent on scar therapy. A particularly good area of indication for MLD is cosmetic surgery aftercare. patient with a stroke
6) MLD is also indicated for treatment of many kinds of rheumatic disorders. If this involves subacute inflammatory conditions, the usual regime for treating chronic inflammation applies: the MLD therapist begins with short therapy sessions which are gradually extended. If there are no acute reactions, the therapist may move on to full-length sessions. Conditions that respond well to MLD are all types of rheumatoid arthritis. Since MLD alleviates pain and removes edema, it helps improve patients’ mobility.
7) Various soft-tissue rheumatic disorders (such as tendinitis, tendoperiostitis, tendovaginitis, bursitis, periarthritis, periarthrosis, carpal tunnel syndrome) respond well to MLD but need comparatively long individual courses of treatment.
8) In dentistry MLD is frequently part of an effective and successful combination therapy for correcting jaw positions or following tooth extraction and operations.
9) MLD treatment cycles also provide good therapy results for chronic inflammations (such as chronic cold, chronic tonsillitis, chronic sinusitis, chronic bronchitis).
10) Experience has shown that MLD can also be successfully included in the treatment of pathological conditions associated with local edema in the brain region (stroke, craniocerebral trauma). There are no lymphatic vessels within the skull. The lymphatic load produced there is drained via the Virchov-Robin spaces in the vessel walls and via the arachnoid sheaths along the olfactory and optic nerves to the lymphatic vessels of neck and face. Intrabuccal drainage encourages and supports cerebral decongestion. This has a favorable effect on cerebral concussion, apoplexy, headache, migraine and Meniere’s syndrome. Conditions associated with local edema in the bulbus, spinal marrow or along peripheral nerves also show distinct signs of improvement as a result of MLD therapy. acne patient
11) Proven dermatological applications for MLD include acne and rosacea.
12) MLD is used to drain away edematous changes in post-thrombotic syndrome and to heal ulcera cruris of various origins (venous, arterial, diabetic).
13) There are a number of other indications based on more recent experience with MLD, such as: mastodynia, so-called “cellulite”, fibromyalgia, scleroderma. As shown by a study conducted at the EVK hospital in Dusseldorf, MLD helps in cases of postpartum milk-stasis. One or two treatment sessions suffice to induce lactogenesis. Hence doctors at this hospital have stopped prescribing the medication previously used. Healthy individuals will also benefit from Dr. Vodder’s Manual Lymph Drainage. Women have long appreciated its salutary effect on swollen legs and its pro