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What Is Manual Lymph Drainage Massage?

Lymphatic System

Manual lymph drainage is a type of lymphatic massage developed by Danish doctor Emil Hans Vodder. The purpose of lymphatic massage is to assist the movement of lymph fluid.

About the Lymphatic System

Lymph fluid starts out as interstitial fluid in the spaces between connective tissues. When the interstitial fluid enters the lymphatic capillaries, it's then called lymph. Lymph capillaries come together to form lymphatic vessels, which move lymph into and out of lymph nodes and eventually back into the bloodstream.

The lymphatic system is an important part of the body's immune function. The lymph absorbs excess fluid, trapped proteins, dying cells, toxins, and foreign substances from the spaces around the cells. Lymph also carries vitamins, hormones, and plasma proteins needed by cells as building blocks of life. This process regulates the body's fluid volume and pressure and helps maintain the integrity of connective tissue.

Lymph does not circulate in the same way that blood circulates. Instead, body movement encourages the flow of lymph fluid through the body. Lymphatic massage is a way to stimulate lymph flow.

The massage therapist uses slow, gentle, and specific strokes to move the skin in the direction of the lymph flow. The rhythmical motion stimulates the lymphatic vessels, encouraging the flow of fluid. 

Benefits of Lymphatic Massage

A primary benefit of manual lymph drainage is to help reduce the buildup of fluid (swelling) in the body. MLD and LDT are often used for lymphedema, an excess collection of lymph fluid that can occur after surgery (it's especially common after breast cancer surgery) or with some medical conditions or injuries

Other possible uses for lymphatic massage include impaired flow of blood through the veins, ulcerations and other skin conditions, circulatory problems, injuries that cause swelling, and burns.

Because the lymphatic flow moves pathogens to the lymph nodes where they are removed from the body, lymphatic massage may also benefit the immune system by improving helping those pathogens move more quickly out of the body.

Plus, the massage may help lower blood pressure, reduce stress and improve sleeping patterns.

Types of Lymphatic Massage

The two main types of lymphatic massage are Manual Lymphatic Drainage (MLD®) and Lymph Drainage Therapy (LDT).

Vodder's MLD technique is taught at the Dr. Vodder School International in 40-hour segments ranging from basic training to advanced courses. Students can become Vodder-Certified Therapists by completing 160 hours of training and passing a certification exam. For more information, see the Compendium of Dr. Vodder's Manual Lymph Drainage.

Building on the work of Vodder, Bruno Chikly, MD, DO, developed Lymph Drainage Therapy (LDT). The technique is taught at the Chikily Health Institute. The Chikily Health Institute offers two levels of certification in MLD. The level 1 certification is 140 hours of training, and the level 2 certification is an additional 170 hours of training.

According to the Upledger Institute, MLD and LDT are similar, but LDT is more specific and efficient. Also, Dr. Chikly teaches how to identify and manually feel the specific rhythm, quality, direction and depth of the lymph flow.


Bruno Chikly and Sue Welfley, "Lymphedema," Massage Therapy Journal, Fall 2001.

Bruno Chikly, Lymph Drainage Therapy: An Effective Complement to Breast Care 

Kalyani Premkumar, Edema and Lymphedema: Are They Different? Implications for Bodyworkers 

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