MLD? Who needs it?
At Creative Chiro we offer a range of different treatments, tailored to each patient’s needs. But, the treatment that is probably least known about and generates the most questions is Manual Lymphatic Drainage (MLD). It is not surprising that people are curious about this particularly specialised technique, as it is not commonly available at most clinics.
In order to offer MLD, I needed to undertake specialist, accredited training. This involved a thorough understanding of the body’s lymphatic system and the ways in which MLD can help people suffering from related problems. I then received hands-on training in specific MLD massage techniques. These are very different to any other type of massage.
MLD treatment is used to address a condition called lymphoedema. This occurs when the body’s lymphatic system is not working as it should, causing swelling in the affected area, most usually the limbs.
It is a gentle and relaxing form of treatment. The techniques used are slow and light to touch, which helps stimulate movement of the fluid through the lymph vessels. The lymphatic system runs close to the surface of the skin, which is why the pressure is so light (a millimetre in depth).
Specific strokes are used, based on the principle that the movement will push the lymph fluid in the right direction and towards the correct nodes. For example, in the upper arm MLD would go towards the armpit. A slow rhythmic technique is used as we want the vessels to open and close in a way that mimics the normal function of the lymphatic system. If it is done too quickly, there is little time for the lymph fluid to be moved along the vessels.
How does the lymphatic system work?
The lymphatic system is a network of vessels, nodes and ducts, which are an essential part of the circulatory system.
The blood in our blood vessels is under constant pressure as it is moved around the body. This pushes nutrients and fluids into the body’s tissues to provide energy and oxygen to them. Once these have been absorbed, the remaining fluid drains back into the lymphatic system. This lymph fluid is then transported back around the body, passing through a series of ducts and nodes where it is checked for bacteria, infection, damaged cells and cancer before being returned to the blood stream.
The main functions of the lymphatic system are:
To work as a drainage system; collecting, filtering and returning fluid and plasma protein to the bloodstream.
To maintain fluid balance and prevent oedema (swelling).
To react to bacteria, triggering the body’s defence mechanisms.
To act as a defence system against infections, generating antibodies.
To absorb fats from our diet into the intestine.
To remove waste products.
To boost the immune system.
What happens when the lymphatic system is not working properly?
When part of the lymphatic system is not functioning well or has a blockage, it can cause the body’s tissues in the area to become swollen and uncomfortable. The swelling is caused when the lymph fluid collects in the soft tissues. If the swelling lasts a short period of time, it is called oedema and if it lasts longer, it is called lymphoedema. Symptoms include:
A persistent ache in the affected area
Restricted movement, especially in jointed areas such as the elbow or knee
Susceptibility to skin infection
Tightening and hardening of the skin
In addition, when the lymph fluid does not return to the bloodstream as it should, the imbalance can affect the body’s ability to maintain normal blood pressure.
If left untreated the skin can thicken and develop folds, creases and skin growths. Eventually the pressure caused by the swelling can cause the fluid to leak out through the skin itself.
Swollen lymph nodes are a sign that the body is fighting an infection. Persistently swollen lymph nodes in any part of the body may be a sign of a more serious issue, including cancer. Always see your GP if you notice this.
What can cause the lymphatic system to malfunction?
There are 2 types of lymphoedema:
Primary lymphoedema is a rare genetic condition where the lymphatic system has not developed properly or does not work at all.
Secondary lymphoedema is much more common and is the result of another condition or disease such as:
Surgery
Infection
Cancer
Radiation treatment for cancer
Removal of the lymph nodes (often as a result of cancer treatment)
Traumatic injury
How can MLD help?
Prior to treatment, it is important to establish the cause of the issue and whether MLD is suitable. For instance, MLD is not recommended if you are suffering from an infection. Swollen limbs can also be a sign of other underlying issues such as a heart problem. Therefore, you should always see your GP first for any unexplained oedema or lymphoedema.
During the first appointment, I do a consultation to assess the extent of the lymphoedema and ensure the patient’s comfort. For instance, some patients who are attending post-surgery may not be able to lie in certain positions, so the treatment will be adapted accordingly.
The treatment enables excess fluid, toxins and bacteria to move through the lymph vessels, which helps to reduce the swelling in the affected area.
Deep breathing, both during and after treatment, stimulates the pumping action of the lymphatic system, which moves the toxins into the bloodstream, so they can be detoxified in the liver.
MLD also helps to reduce the associated pain and relax the sympathetic nervous system; the network of nerves that activates the flight or fight response.
MLD is especially beneficial for people who suffer with lymphoedema in the arms and legs. It is also helpful for cancer patients, especially in cases where the lymph nodes have been removed.
MLD is recommended by health professionals, including the NHS, Cancer Research UK, Macmillan Cancer Support and the Lymphoedema Support Network.
When MLD is needed, it is generally advisable to book a number of treatments at intervals, to ensure availability. These may not all be needed and I will advise patients accordingly as the treatment plan progresses.
It is important to have a therapist fully trained and qualified to practice MLD, as it is not widely available to patients suffering from this often debilitating condition. For my patients who have booked MLD in advance of planned surgical procedures, I have found that it has been reassuring for them to have a planned pathway of care, which can be adjusted as recovery progresses.