Manual Lymphatic Drainage (MLD) for Lymphoedema Management

Treat yourself to a session of the best Manual Lymphatic Drainage and discover its benefits.

For lymphoedema management, Manual Lymphatic Drainage (MLD) is a specialised, gentle, rhythmic soft tissue technique that is precise in nature and induces mechanical and neural effects on both lymph vessels and blood capillaries. The gentle shearing forces applied around the initial lymph vessels, without enough pressure to compress them even slightly, leads to maximal opening of initial lymph plexus and directs the pre-lymph fluid towards the vessel. The sympatholytic effect (reduction of sympathetic activity) of MLD helps to dilate the pre capillary sphincter, allowing more blood to flow without causing corresponding increase in blood pressure. The sympatheticolysis also dilates the lymph vessels, increasing their lymph carrying capacity, while the shearing force applied at the tissue helps to increase the stretch- contraction reflex mediated lymphatic pumping. The overall effect is increased lymph removal from the tissues interstitium, reducing metabolic waste products, decreasing protein load which further reduces the filtrate escaping the capillary. The increased capillary flow will result in increased oxygen and nutrient being delivered to the tissue enhancing tissue health and healing.

At Perth Lymphoedema Clinic, our certified therapist uses MLD as a cornerstone treatment to reduce swelling, decongest and improve the quality of life for those living with primary and secondary lymphoedema. The therapist is trained and certified in Dr. Vodder’s method of MLD, arguably the best form of clinical grade lymphatic drainage. The MLD technique in each case may vary to suit individual conditions. Oedema after lymph node removal (secondary lymphoedema) will require “re- routing” of stagnant protein rich fluid towards healthy lymph node stations and back into the circulatory system. On the other hand, oedema where the lymphatic system is healthy but simply overwhelmed by the increased fluid overload, like in phlebo- lymphoedema, the drainage is directed to the correspondent lymph node station which lies in the same lymphatic territory. This requires a suitably qualified and skilled lymphoedema practitioner. Your therapist at Perth Lymphoedema Clinic is suitably qualified and is accredited by Australasian lymphology Association -peak body in Australia and New Zealand.

Full body diagram showing lymphatic drainage territories and flow directions used in manual lymphatic drainage therapy
Lymphatic Territories - Anterior View

Please find a study here showing the effectiveness of MLD in the treatment of lymphoedema.

Pressure Matters

In clinical and self-care settings, the question of how much pressure to apply has become a hot topic. The answer is no one -size-fits-all. The amount of pressure required is determined by the individual patient needs, tissue response and stage of lymphoedema, level of fibrosis etc. In the early stages, lighter pressures are sufficient to encourage fluid movement towards open areas of drainage, while in more advanced stages, where tissues have undergone fibrotic change, therapists will apply firmer pressure for sustained periods to soften the fibrous tissues. By assessing and adjusting MLD pressures according to the patient’s condition, therapists were able to tailor their technique to provide more effective treatment and avoid complications, such as lymphatic vessel collapse from excessive pressure.

See the picture below to understand the basic anatomy of the lymphatic system of the skin.

Diagram showing layers of the lymphatic system in the skin including lymph capillaries, pre collector, collector and muscle fascia
Lymphatic System of the Skin

Customised Treatment Approach

This adaptability underscores the need for a personalised clinical approach rather than a one-size-fits-all protocol. At Perth Lymphoedema Clinic, your therapist assesses your condition and customise the treatment techniques to suit your individual needs for an effective outcome. We also use adjunctive therapeutic devices such as Sequential Intermittent Pneumatic Compression (SIPC) therapy, Electrostatic Oscillation Therapy (EOT), oedema kinesio taping, Low Level Laser Therapy aka photo biomodulation , pain management and range of other soft tissue therapies depending upon the unique nature of each presentation. For example, if person is presented with restricted shoulder movements and “axillary cording” your therapist may use various soft tissue techniques such as myofascial release technique, joint mobilisation etc to address the problem right away to reverse the condition and to facilitate the joint range of motion thereby facilitate the lymphatic drainage.

MLD is most effective when used as part of Combined Decongestive Therapy (CDT). To ensure the fluid we move during MLD doesn’t return to the limb, we integrate the following,

Compression Therapy (multilayer compression bandaging or two-layer bandaging system, compression wraps, compression garments etc).

For the purpose of management of oedema, the treatment can be divided into two phases, an initial intensive phase and a maintenance phase. During intensive phase patient undergoes serial bandaging (traditional multilayer bandaging or two layer system) along with MLD, self MLD and skin care regimes to achieve maximum possible swelling reduction. It is during this phase of the management your therapist will educate you about lymphoedema, its potential complications and self-care strategies such as skin care, self-lymphatic drainage etc. This phase can usually last for 2- 4 weeks depending upon the severity of the condition. At the end of this phase the therapist will measure and prescribe the patient with appropriate compression garments to contain the oedema. At Perth Lymphoedema clinic we use internationally recognised STRIDE algorithm to guide us prescribe the right type of garments, we work with reputed garment brands and source directly from them. Once maximum possible volumetric reduction of oedema is achieved the treatment enters onto the less intense maintenance phase where the focus will be maintaining the gain achieved during the initial phase. This is primarily achieved through the compression garment and self-care strategies (skin care, exercise, self-lymphatic drainage etc). This is a less intense, patient led phase of the treatment.

Periodic review of the condition by the clinician is an integral part of the lymphoedema management. Your clinician will advise you about the time frame depending upon the cause and presentation of your condition.

Key Benefits of the Specialised MLD

Manual Lymph Drainage (MLD), is well known for its benefits in managing lymphoedema, but mounting evidence suggests it may also help address broader issues, from skeletal muscular aches and pains to brain health

  • Pain relief
  • General wellness and immune support
  • Stress reduction and relaxation
  • Pre and post workout, pre and post sporting event: reduce muscle soreness (DOMS) delayed onset muscle soreness, swelling, clear the metabolic waste faster, recover faster.
  • Sports injuries: aids in faster recovery and function.
  • Improves quality of sleep thereby improves mental clarity, feel refreshed.
  • Scar and fibrosis tissue management-post surgical or post trauma.
  • Repetitive strain injury - tennis elbow, golfer’s elbow, tendinitis.
  • Frozen shoulder, capsulitis and bursitis of shoulder, baker’s cyst.
  • Musculoskeletal pain in following areas: Shoulder, neck, back, hip and foot and more.
  • Chronic sinusitis.
  • Eye injuries, bruises, facial bruises.
  • Trigeminal neuralgia pain.
  • Chronic regional pain syndrome
  • Fibromyalgia
  • Cervicogenic headache.
  • Post covid 19 related cough, breathlessness, fatigue and mental fogginess
  • Chronic constipation.
  • Any inflammatory condition without infection can be benefited from MLD

MLD as a Non-Drug Therapy for Healthy Ageing

Persistent low-grade inflammation is now recognised as a major driver of age-related decline and MLD helps reduce inflammatory load in the body.

MLD is best known as a cornerstone of lymphoedema management where it has been shown to enhance lymphatic flow, reduce swelling, improve functional mobility, and quality of life. The very precise and specific movements of Dr Vodder’s MLD have been shown to increase lymphatic circulation and reduce systemic inflammation as a result. The ability to increase the blood circulation without increasing the capillary pressure helps to further enhance the tissue healing at a cellular level. The gentle, rhythmic, relaxed, reparative movement techniques of Dr. Vodder’s MLD method helps reduce the sympathetic nervous system tone, thereby indirectly enhancing the works of parasympathetic nerves, the system responsible for rest, sleep, repair and healing.

Several recent science discoveries suggests that its benefits may extend far beyond limb swelling:

  • Brain health: Experimental studies in Alzheimer’s models  show that stimulating lymphatic flow in the head and neck improves cognitive performance and reduces amyloid plaques along with tau proteins seen in some type of Alzheimer’s. (2)
  • https://www.nature.com/articles/s41392-025-02177-z
  • https://doi.org/10.1093/brain/awae329
  • Skeletal muscle pain & arthritis: Evidences suggest that various inflammatory mediators (eg.TNF, IL-1α/β,IL-6, Chemokines) are found to be in elevated level locally and systemically, in various musculoskeletal conditions. By reducing local inflammation and swelling, MLD can ease joint stiffness and pain. MLD is an excellent adjunct to support post-operative recovery after joint replacements where swelling is an issue.
  • Neuroinflammation and stroke: Enhanced lymphatic drainage may help clear metabolic waste molecules after brain injury, supporting neurological health and rehabilitation.
  • Respiratory health: MLD has been shown to improve breathing and reduce cough in long-COVID, and may assist breathing in COPD and post-pneumonia recovery.
  • Mental health & sleep: Patients receiving MLD report improvements in mood, appetite, and sleep. (2) These may be linked to systemic reductions in inflammation.

References

  1. World Health Organization. Ageing and Health Fact Sheet. 2024.
  2. Erickson RP, et al. Manual Lymph Drainage for Alzheimer’s Dementia: Editorial. Lymphology, 2025.
  3. Non-invasive modulation of meningeal lymphatics ameliorates ageing and Alzheimer’s disease-associated pathology and cognition in mice Nature communications. Vol. 15, Article No. 1453 (2024).
  4. Neurodegenerative fluid biomarkers are enriched in human cervical lymph nodes  Brain, Vol. 148, Issue 2, February 2025, Published: 21 October 2024.

Some of the animal model studies are promising which are cited as rationale for future human trials targeting lymphatic circulation for cognitive benefits and addressing neuro degenerative diseases. With healthy aging and longevity being a key area of interest for medical and research community, researches exploring the use of various pharmacological and non-pharmacological non-invasive physical modalities to influence lymphatic clearance is expected.

Why Choose our Perth Lymphoedema Specialist?

MLD for the clinical use requires a sophisticated understanding of the lymphatic system and a deep knowledge of various medical conditions.

  1. Certified Therapist: Our therapist is trained and certified in world renounced Dr. Vodder’s method of lymphatic drainage.
  2. Medical focus: We specialise in Primary and secondary Lymphoedema, Lipoedema and post-surgical / post cosmetic procedure oedema support including scar therapy. Another area of interest is pain relief using physical modalities and soft tissue therapies.
  3. Central Perth Location: Conveniently located in Canning Vale, corner South Street/ Bannister Road. Easy access from South Street, Leech Highway, Kwinana Freeway, Roe highway etc. Plenty of free parking right Infront of the clinic.
  4. Wheelchair Accessible Clinic: Accessible for patients with mobility challenges.
  5. Beautiful reception and waiting area: Spacious reception with friendly staff.

What to Expect During Your Appointment:

While referral from a medical specialist or GP is not mandatory to see the lymphoedema practitioner, it’s often recommended to obtain one as they contain crucial information.

  1. Comprehensive Assessment: Your therapist reviews your medical history and assess the oedema, measure limb volume as appropriate.
  2. Discussion of treatment plan: Assessment of your presentation will be followed my formulating a treatment plan in consultation with you.
  3. The treatment: while doing MLD you will be positioned comfortably while your therapist uses precise, light, directional pressure to “reroute” fluid to functioning lymph nodes.
  4. Home care plan: We provide guidance on skin care, self-lymphatic drainage (SLD). If necessary, prescription of compression garment.

Note: MLD is pleasant, painless therapy. Most Perth patients find the sessions deeply relaxing and notice a reduction in “tightness” immediately after treatment.

Frequently Asked Questions

Success Stories

For many of our clients, lymphoedema isn’t just about swelling—it’s about the loss of the small, everyday activities that make life meaningful. Whether it’s the ability to read a book comfortably or go for a morning walk along the Swan River, we understand that mobility means independence.

The Personalized Treatment Plan

Our Perth-based specialists developed a comprehensive management strategy tailored to each client’s specific needs:

  • Manual Lymphatic Drainage (MLD): Gentle, rhythmic massage techniques designed to stimulate lymphatic flow and reduce swelling.

  • Expert Compression Fitting: Selecting and fitting high-quality, medical-grade sleeves and stockings (as seen in the photos) to help maintain the results achieved through MLD.

  • Education & Self-Care: Empowering clients with the knowledge and skills needed to manage their condition effectively at home.

The Results

The transformation was about more than just numbers on a measuring tape. With consistent MLD sessions and the correct compression garments, our client reported:

  • A significant reduction in limb heaviness and discomfort.

  • Restored dexterity, allowing them to enjoy hobbies such as reading and gardening.

  • Increased confidence to remain active and mobile.

Elderly patient wearing compression sleeve on upper limb after lymphoedema treatment at Perth Lymphoedema Clinic
Patient wearing compression stocking on lower limb after lymphoedema treatment at Perth Lymphoedema Clinic

“ The team didn’t just treat my swelling; they gave me my lifestyle back. I feel lighter, more mobile, and finally in control of my condition. ”

Book your consultation today.

Don’t let swelling and pain limit your lifestyle. Experience the highest standard of lymphoedema therapy in Perth.

Location: 4/259 Bannister Road, Canning Vale, Perth, WA 6155.

Phone: 0435222573

Opening Hours: Wednesday to Saturday.

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