Manual Lymphatic Drainage (MLD)
Manual Lymphatic Drainage (MLD) alos sometimes known as Complete Decongestive Therapy (CDT) is the manual activation by a massage, lymphatic circulation by stimulating the automation of the vessels and lymph nodes, thus improving the evacuation of excess interstitial fluid. MLD is an excellent form of treatment.
Many clinics now incorporate the sequential gradient compression pump devices as part of the program. Not every patient that has MLD needs a pump, and not every patient receives a pump requires MLD.
The decision for a lymphedema patient to receive MLD maybe based on various factors.
- Physicians Orders
- Training and Experience of the Therapist
- Location of the Treatment Facility
- Insurance Coverage
- Commitment from the patient
- Severity of the Lymphedema
About Lymphatic Drainage
Lymph is a clear fluid that seeps from the capillary blood into the interstitial space or intercellular. Contains substances that can not be carried by the venous system as proteins and fats large, metabolic wastes, white blood urea, fibrinogen, foreign matter and bacteria.
The lymphatic system runs in our body as a network, parallel to the circulatory system, and carries the meaning of the venous circulation. First collects lymph from the tissues using extremely thin conduits called lymphatic capillaries, which penetrate into many tissues except the nervous, capillaries join to form larger vessels, lymph vessels, which carry lymph to lymph nodes, small responsible for debugging nodules of bacteria, which are destroyed and which absorbs some of its volume. Again through the lymphatic vessels draining lymph ends in a point located at the junction of the subclavian and jugular veins in the neck, where it joins the venous circulation, becoming part of the blood.
The lymphatic system has two main functions:
- Transports and drains large molecules which by their nature can not be recovered by the blood system.
- Production by lymph node cells and antibodies to defend the body.
In the lymph vessel walls exist valves, the segment between the two valve walls contain smooth muscle cells and thus are able to contract to pump mode unintentionally, acting as a "heart Lymph. " These valves also ensure that the runs of lymphatic circulation one direction. The linfangions can contract rhythmically at a rate of between 6 and 12 cycles per minute, helped mobilize the lymph of muscle contraction and breathing.
When excess fluid out into the interstitial space, it compresses preventing lymphatic capillaries can work, leading to an accumulation of fluid or edema which can be caused by several reasons:
- For a failure or malfunction lymphatic system is called lymphedema or lymphedema. It may be due to a malformation of the lymphatic system or be secondary to removal of lymph nodes (frequently in the surgical treatment of certain tumors), by radiotherapy or injury of a node.
At first there is a large edema aqueous protein concentration, but soft and palpable tenderness. The lymphatic system dysfunction is not able to collect this excess of proteins, which stimulate fibroblast proliferation and collagen fibers leading to fibrosis. At this stage the swelling is hard and cause a blockage node larger. If lymphedema can progress to cause cell death.
- For reasons beyond the proper functioning of the lymphatic system:
. Venous Edema or fleboedema: usually caused by venous insufficiency.
. Lipedema: fluid entrapment result of lymphatic vessels by excess adipose tissue.
. Edema of pregnancy: the compression exerted by the fetus on the lymphatic vessels and secretion of renin during pregnancy and progesterone (relax smooth muscle forming vessels).
. Traumatic: by surgery, contusion, sprain, fracture ...
. Premenstrual edema: by hormonal changes.
. Myxedema: by malfunction of the thyroid gland.
. Right heart failure
. Kidney problems
. Gastrointestinal disease, liver cirrhosis, malnutrition
By Manual Lymphatic Drainage (MLD) putting pressure on the skin in a very soft massage (less than 40 mmHg) combined with a rhythmic and slow flow or transport, stimulates rhythmic contraction of linfangión, favoring the lymph advance up to 40% faster. Similarly, to stimulate lymph node directly reduces the suffering slowing the flow of lymph passing through them. Techniques are also performed to facilitate the reabsorption of excess fluid and protein.
It should be noted that MLD is not comparable to acupressure, or a deep tissue massage one might receive for sore muscles. Properly applied MLD only drains interstitial fluid and proteins. If the MLD lymphedema is essential and not replaceable by other techniques, it should be accompanied by specific exercises that build on and maintain the draining effect. Lymphedema containment measures often include (bandages), night time compression garments, a home compression pump, and the patient doing scrupulous skin care.
Effects of MLD
- Improves circulation return
- Regenerates the lymphatic system
- With a calming, relaxing effect by acting on the autonomic nervous system
- Inhibits painful stimuli
- Regulates the tone of both smooth muscle and the striated
- Improves the immune defense system by the overproduction of lymphocytes
- Stimulates kidney function
- Phlebitis or thrombophlebitis
- Heart failure, increase the risk of cardiac load
- Acute infections, the risk of lymphatic spread
- Cancerous growths or tumors, currently is a relative contraindication. If action has been taken on the tumor by surgery, chemotherapy or radiotherapy is indicated DLM
- Carotid sinus syndrome
- Hyperthyroidism: avoid manipulation of the thyroid
- Asthma: there must be a symptom-free interval of at least two months