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Writer's pictureJan Douglass

Applied MLD, it's more than just lymphoedema

Updated: Jun 29

When we think about lymphoedema care, it is natural that we will consider volume reduction as a high priority.

a woman with arms behind her back
A frozen shoulder can significantly reduce the effectiveness of standard lymphoedema therapy.

Likewise our clients commonly anticipate that the treatment will be solely focused on addressing issues with the lymphoedema itself.


However, leaders in lymphoedema management such as Vodder and Foeldi have always advocated for a more comprehensive approach, considering the system as a whole and addressing co-morbidities that can impact on lymphoedema management.


clocks
Image by Jon Tyson on Unsplash

This approach emphasises the necessity of viewing lymphoedema as a systemic issue and treating the entire body, While this approach offers promising results, it can be challenging to uphold in a busy clinical setting where time is limited, and clients present with complex medical histories.


In Applied MLD the therapists adopts a holistic perspective and considers the interconnectedness of various bodily systems, but that doesn't mean doing whole body MLD.


Applied MLD offers whole body therapy.


woman with compression sleeves
Image by Vin Stratton on Unsplash

Treating the whole body means looking for and treating other sources of inflammation which may be exacerbating the lymphoedema or preventing some aspects of best practice.


This could be any condition which causes pain or inflammation including skeletal muscular issues preventing free movement, which will not only adversely affect the lymphoedema, but also hinder essential activities such as exercise and garment donning or doffing.


When lymphoedema is present, co-existing inflammatory and skeletal muscular issues should be addressed lymphatically, and using Applied MLD protects the lymphedema affected areas and supports the system generally.


When inflammation reduces and movement increases, lymphoedema treatments become more effective.


female torso posterior view

Releasing a frozen shoulder makes it much easier to apply effective CDT in arm lymphoedema, and reducing piriformis pain will certainly help with management of leg lymphoedema. While our substantive professions usually offer deep tissue techniques for this, these may be painful and not appropriate in lymphoedema.


So how do you treat a frozen shoulder on an untreated lymphedema arm without causing pain and risking a worsening of the oedema?



Most lymphedema training programs don’t teach MLD for musculoskeletal conditions.


scapular mobilisation
Scapular mobilisation using Applied MLD

The Dr Vodder Certificate in Applied MLD teaches the application of Dr Vodder's MLD to almost every conceivable acute or chronic inflammatory condition. When used in conjunction with best practice lymphoedema management, Applied MLD is the best way to treat all those co-morbidities that are preventing you from achieving the best possible result for your client.

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lecturer

Like all things Vodder, the effectiveness of the techniques are in the precision manipulation of the soft tissues, careful application of MLD drainage techniques to targeted structures, and most importantly working without pain! These innate qualities within the techniques give us a safe and effective way to address musculoskeletal issues for our lymphoedema clients.


Prior to 2020, graduates of the Dr Vodder Lymphoedema training program, including me, learned these treatments in the middle of a massive and overwhelming course on lymphedema management.


Back in the clinic and faced with advanced lymphoedema, other co-morbidities can get pushed aside to the detriment of both therapist and client. I feel like crying when I hear experienced therapists say they have forgotten how to use these special techniques, because I know that taking the time to apply a whole body approach is vital to achieving the best possible clinical outcomes.


Applied MLD is unique to the Dr Vodder School


MLD soldiers technique

Using MLD to address all potential co-morbidities offers highly effective techniques to treat a huge number of pathologies and has become recognised for its value in multiple clinical settings and conditions.


Treatment protocols encompass skeletal-muscle, neural and digestive system pathologies, not to mention the obvious and major effects on lymphatic function and immune interactions.

neon sign
Image by Austin Chan on Unsplash

Using case-based clinical reasoning scenarios during the training ensures that everyone leaves the classroom with a comprehensive understanding on how to transfer the techniques into clinical practice and use them with existing clientele, whether they be lymphoedema clients or a more general client population.



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