Manual Lymphatic Drainage: Exploring the History and Evidence Base

Anne Williams

Over 100 years ago, Winiwarter, a German surgeon, described the use of massage to ‘promote resorption’ of fluid from swollen tissues in people with lymphoedema (Winiwarter, 1892: 397). In the present day, manual lymph drainage (MLD), a type of massage, has become established as an integral part of lymphoedema treatment. However, the limited empirical evidence base and lack of consensus on the use and efficacy of MLD (Devoogdt et al, 2009) means there is a lack of clarity regarding the application of MLD for people with lymphoedema. Some lymphoedema practitioners may have limited knowledge of MLD. Those who have learned the techniques may have limited resources or support to continue using them.The current drive towards cost effectiveness also means that bodywork treatments such as MLD may be given low priority in the planning and resourcing of services.

This paper will provide a brief history and outline the main features and principles of MLD. It will discuss the evidence around the mechanisms through which MLD may exert its effect, and then overview the findings from studies that have examined the clinical and therapeutic efficacy of MLD. Finally, it will discuss some implications for clinical practice in lymphoedema treatment and care.

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