Medically Reviewed by Dr. Luis Alberto Vallejo
Manual Lymphatic Drainage is a technique of massage therapy that belongs to the field of Physical Therapy and therapeutic massage, which is performed in order to produce a displacement of the lymphatic fluid when the case always requires it based on a thorough study of the pathophysiopathology of the lymphatic system
To perform a manual lymphatic drainage really beneficial for the patient, it is necessary to know about the lymphatic system.
The Lymphatic System
The lymphatic system is responsible for draining excess plasma generated from cell exchange processes. In the same way, this system works as an excellent filter to trap bacteria and waste from the body, being therefore a very important component within the immune system.
The lymphatic system is composed of a system of branched tubes to which the interstitial fluids drain.
Consequently, from the tissues, the interstitial fluid passes into the thinner lymphatic vessels known as “lymphangions,” which join together to form increasingly thick vessels, which end in the general circulation through two bulky channels:
- The Thoracic canal, also known as Pecquet Cistern or the Quilo Reserve: Measures 40com long, is where MMII lymphatic vessels pour their contents. It is approximately at the level of L1-L2. It ascends along the left side of the thoracic vertebrae and ends at the left cephalic brachial trunk: internal jugular vein or subclavian.
- The Great Lymphatic Vein: Lymph on the right side of the head, neck, right arm and right side of the chest wall penetrates the right brachio-cephalic venous trunk through the Great Lymphatic Vein, which ends in the right subclavian vein.
Among the interstitial fluids we find:
- Eye fluid
- Intra Pleural Liquid
- Intra Peritoneal Liquid
- Intra Synovial Liquid
- Lymphatic Liquid
When this interstitial fluid penetrates into these tiny lymphatic vessels, it is called lymph.
Lymph is a colorless and viscous liquid, its composition is similar to blood plasma, but its movement is slower than that of blood. Its volume is 16% of the body, in a person of normal size and size.
Lymph is composed of water, proteins, fats, cell debris and lymphocytes.
The objectives of the lymph are:
- Feed the tissues
- Participate in body defense mechanisms
- It is part of all tissues except the nervous.
The lymph nodes or lymph nodes have a cornered shape and are located in the path of the lymphatic vessels, their mission is to filter the lymph, that is, they capture, trap, and destroy the invading pathological microorganisms.
They are also small deposits of lymph and lymphocyte generators.
The lymph nodes collaborate in the dilution or concentration of lymphatic proteins, their size is variable.
There are two types of lymph nodes:
Manual Lymphatic Drainage Indications
The cases in which manual lymphatic drainage can be used as part of the treatment with many, including:
– In type edemas:
- Lymphatic obstruction
- Post Traumatic and Post Surgical (for example in post mastectomized patients)
- Of rheumatic origin
- For venous stasis or post thrombotic
- Infectious post
- Post radiation
- By metastasis (Malignant Lymphedema)
- For burns
- Essential lymphedema (Molroy’s disease)
- Congenital lymphedema
– In aesthetics:
Manual lymphatic drainage is used in aesthetics to combat situations such as:
- Deep skin cleansing
- Bags under the eyes
- Hair loss
- Bust Cellulite
- Heavy legs
- Wrinkled hands
Contraindications of Manual Lymphatic Drainage
Contraindications of manual lymphatic drainage are contained in:
- Myocardial Infarction
- Angina pectoris
- Edema due to decompensated heart failure
- Malignant tumors
- Hypertension or severe hypertension
- Purulent or suppurating area
- Skin diseases
- Nephrotic Edema
- Acute Infections
- Phlebitis, thrombosis, thrombophlebitis
Application of Manual Lymphatic Drainage
The techniques should be performed in the following order:
- Ganglion aspirations
- Drainage or call maneuvers
- Ganglion aspirations
Objectives of the treatment:
- Increase the function of venous return and reduce capillary-venicular stasis
- Increase circulatory, venous and lymphatic speed
- Increase lymphatic capillary permeability and improve vascular atony
- Reduce edema
Practical Tips on Manual Lymphatic Drainage
- Slow pace of maneuvering
- Relaxed patient, it is recommended that after the person is relaxed, both knees and hips flex so that the straight abdominal muscles relax and the subject can breathe deeply, this will favor the lymphatic return due to the hydraulic work of the diaphragm and It will also improve venous return
- The times are: 20 min in the face, 30 min to 40 min in MMSS or MMII, a complete manual lymphatic drainage lasts about 2 hours
- It is not necessary to use sliding medium