Lymphoedema causes fluid to collect in the body’s tissues. It often leads to swelling in the arms or legs, and can follow surgery, trauma or cancer treatment. This swelling can become painful, restrict movement and affect daily life.
Many people with lymphoedema explore different ways to manage their condition. One common option is manual lymphatic drainage (MLD)—a gentle massage that helps move fluid through the lymphatic system. But does it really work? And when should it be used?
As part of a complete lymphoedema treatment plan, MLD has shown benefits for some people. In this article, we unpack how it works, where it fits in treatment, and what results to expect.
What Is Manual Lymphatic Drainage?
Manual lymphatic drainage is a technique where a trained therapist uses light, rhythmic strokes on the skin. These movements follow the flow of lymphatic vessels and aim to redirect fluid away from swollen areas. Unlike traditional massage, it doesn’t focus on muscles or deep tissue.
MLD is used to help clear blockages in the lymphatic system. When lymph fluid isn’t draining properly, it collects under the skin and causes swelling. By encouraging better flow, MLD reduces pressure, eases tightness and supports healing.
A key part of understanding its value is knowing the common causes and stages of lymphoedema, since early intervention often leads to better outcomes.
MLD is safe, calming and often used with compression therapy, exercise and skincare. It’s not painful and doesn’t rely on machines. That makes it a natural, hands-on tool to support recovery and symptom control.
How MLD Supports Fluid Movement
The lymphatic system is responsible for clearing waste and extra fluid from the body. When this system is slow or damaged, swelling happens. Manual lymphatic drainage helps stimulate flow through nearby lymph nodes and vessels, which may still be working normally.
Therapists use a sequence of movements that gently stretch the skin. These are repeated and controlled, starting at the neck and moving toward the swollen area. Over time, the fluid is guided to parts of the body where it can drain more effectively.
Beyond swelling reduction, MLD helps by:
- Easing heaviness in limbs
- Soothing sore or tight skin
- Reducing risk of skin infections
- Supporting natural immune function
These effects make it a good choice in early and moderate stages. When used consistently, it can also prevent long-term complications such as thickened tissue or loss of mobility.
A better view of how to plan treatment depends on understanding how lymphoedema changes over time, as it can worsen without support.
When Manual Lymphatic Drainage Is Most Helpful
MLD is most effective when started early—before the swelling becomes hard or widespread. It’s often recommended soon after surgery, especially in cases where lymph nodes have been removed, like after cancer treatment.
Therapists assess the severity and stage before beginning. For mild swelling, MLD can slow progression and reduce the need for more intense therapy. In moderate cases, it becomes part of ongoing maintenance. In more severe stages, it’s often used for comfort and softening hardened tissue.
Consider a patient who starts noticing swelling after long flights or intense physical activity. Early use of MLD may help limit that build-up and return the limb to its baseline size. Waiting too long could lead to permanent tissue changes.
Its role becomes clearer when you compare it with other top treatment options for lymphoedema, which often work best when combined with MLD in a complete care plan.
What Research Tells Us About Its Effectiveness
Several studies support the use of manual lymphatic drainage in managing lymphoedema. Clinical trials have shown it can reduce limb volume, ease discomfort and improve function when used alongside compression and physical therapy.
A review published in the Journal of Lymphology found that MLD reduced swelling in breast cancer survivors. In another study, women with upper limb lymphoedema saw greater reductions when MLD was added to standard bandaging therapy.
The science shows consistent results when MLD is used as part of a broader approach. It works best when sessions are regular and tailored to the individual. Patients who attend weekly treatments over several months report better control of swelling and fewer flare-ups.
The evidence also highlights that results take time. While a single session may offer short-term relief, long-term success requires planning and follow-through.
The Importance of Skilled Therapists
Only certified therapists trained in lymphatic care should perform MLD. They understand lymphatic anatomy and how to safely move fluid around the body. In Australia, many are registered through the Australasian Lymphology Association.
These therapists design treatment plans based on the stage of lymphoedema and overall health. They track swelling, measure limb volume and may adjust the massage method if the condition changes. Safety is a key focus—especially for patients with cancer history or other medical conditions.
A skilled therapist can also teach safe techniques for home care. For those unable to attend weekly sessions, this support helps keep symptoms stable between visits.
Without proper training, MLD could make symptoms worse or push fluid in the wrong direction. That’s why expertise matters.
How MLD Fits into a Broader Plan
Manual lymphatic drainage doesn’t stand alone. It works alongside other tools used to manage lymphoedema. A complete treatment plan often includes:
- Compression garments to maintain fluid balance
- Exercise to activate muscle pumps and boost drainage
- Skin care to lower infection risk
- Education on triggers and self-management
MLD adds value by softening tissue and clearing fluid before compression is applied. It also prepares the skin and tissues for physical activity.
For someone dealing with mild lymphoedema, this combined approach keeps swelling under control and helps avoid complications. In more advanced stages, it may offer comfort and symptom relief.
Challenges and Considerations
Despite its benefits, MLD has some limits. Sessions need to be frequent for best results, especially early in treatment. Without ongoing care, the swelling can return quickly. It may not be suitable for people with active infections, heart failure or kidney issues.
Access is another challenge. Not all regions have qualified therapists. Costs can add up, and not all private health funds offer rebates without a specialist referral.
To overcome these issues, therapists often teach basic drainage techniques for home use. With training and care, this can be a safe way to manage mild symptoms between appointments.
Case Study: Anna’s Story
Anna, 48, was treated for cervical cancer and had lymph nodes removed during surgery. A few weeks later, she noticed swelling in her legs. Her doctor referred her to a lymphoedema therapist. She started manual lymphatic drainage twice a week.
Within a month, Anna saw noticeable changes. Her legs felt lighter, the swelling reduced, and she was able to return to work without discomfort. She was also fitted for compression stockings and followed a daily stretching routine.
Anna’s case shows how MLD works best when it’s started early and supported by other treatments. It helped her take control of her recovery and avoid long-term complications.
FAQs
1. Can manual lymphatic drainage be done at home?
Yes, but only if your therapist shows you how. Self-MLD is useful between sessions when done correctly. The technique involves gentle skin movements in a specific order, starting near the neck and working outward. Pressure should feel like stretching the skin, not rubbing or pressing into muscle. Done wrong, self-MLD could move fluid into blocked areas or increase swelling. That’s why training is key. A therapist will guide you based on your specific case—some may advise daily sessions while others recommend less frequent use. If swelling increases or pain occurs during home treatments, stop and get a professional review. Home MLD can be effective, but safety comes first.
2. How often should I have MLD sessions?
The number of sessions depends on how severe your lymphoedema is. In early stages, you might start with two to three appointments each week. As swelling reduces, that may drop to once a week or fortnightly. Some people need ongoing care to keep symptoms under control, while others only use MLD during flare-ups. Your therapist will monitor progress and adjust your schedule. Factors like daily activity, surgery history, and how your body responds to treatment will also affect frequency. Long-term, many people use a mix of clinic visits and home care to manage their condition. Consistency and planning are what lead to results.
3. Does MLD hurt or feel uncomfortable?
No. It’s known for being one of the most relaxing treatments available. Manual lymphatic drainage uses slow, light strokes and gentle skin movements. The technique is calming and should never cause pain. Most people describe the feeling as soothing. Some even fall asleep during the session. If discomfort or tightness happens, speak with your therapist. It could mean the technique needs adjusting or that another health issue is present. After treatment, you may feel lighter or notice a softening in swollen areas. Some people feel tired afterward as the body processes the fluid, but this fades quickly.
4. Are there people who should avoid MLD?
Yes, certain health conditions mean MLD may not be safe. If you have congestive heart failure, blood clots, active cancer, untreated infections or kidney problems, you need medical clearance before starting. In these cases, moving fluid could add strain to organs or spread infection. A proper health check ensures MLD is used safely. Always tell your therapist about your full medical history before starting. If needed, they may adjust the treatment or delay it until it’s safe. In pregnancy, MLD can be safe in some cases, but always check with your doctor first.
5. Does MLD offer long-term results for lymphoedema?
Yes, when used consistently and as part of a full treatment plan. Manual lymphatic drainage helps maintain fluid balance, reduces swelling and improves comfort. While it doesn’t cure lymphoedema, it does prevent flare-ups and support daily function. Over time, people find a rhythm with MLD, using it more often during high-risk times like travel or illness. Combined with compression, exercise and proper skincare, it becomes a long-term strategy that supports quality of life. For many, it’s a key part of managing symptoms and keeping the condition from worsening.
Take Charge of Swelling Before It Takes Charge of You
Manual lymphatic drainage gives people with lymphoedema a hands-on way to feel lighter, move easier and live with less pain. It’s not a quick fix, but with the right plan, it works.
If swelling has become part of your daily life, there’s a safe, supported path forward. The sooner you start, the better your outcomes.
Book a personalised care plan with the team at Melbourne Hand Therapy and take the first step toward a more comfortable future.
Please call us today (03) 9000 0557 or leave an enquiry and we will get back to you as soon as possible.
