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MLD for Pain and Stress

Updated: Feb 25, 2022

Intuitively, we all know that relaxing therapies can reduce #stress and relieve #pain. So it's not surprising that #MLD has a profound effect on stress, and that clients frequently report a complete resolution of painful conditions.

There's good scientific basis for the results we see with #Dr_Vodders_MLD and some published studies are summarised at the end of this report. The main blog will provide a simplified description of the effects of Vodder's MLD on the sympathetic nervous system and the mechanisms that relieve pain.

despite the psycho-emotional nature of modern stress, the body still prepares us to flee or fight

The physiology of MLD

When I teach MLD we talk a lot about the way the body responds to stress. We're all familiar with the symptoms, sweaty palms, knotted stomachs, hypervigilance. These symptoms tell us that despite our desk-bound lifestyles, and the psycho-emotional nature of modern stress, the body still prepares us to flee or fight.

energy and blood are directed towards muscles and brain

Blood is directed towards muscles and brain and away from skin and other non-essential systems such as digestion. Inflammation and immune activities are inhibited.

If you are fleeing for your life then injury has to wait for safety before healing can begin.

Persistently high level of stress are a major contributor to lifestyle diseases and the growth of the 'wellness' industry is an indication that we are becoming more aware of stress as an underlying contributor to poor health.

Professor P. Hutzschenreuter, Ulm University, Germany.
Prof. Dr. Paul Hutzschenreuter conducted many experiments on Dr Vodder's method and found that after only 5 minutes of commencing #MLD there is a significant reduction in sympathetic activity in both patient and therapist.

As I transitioned my clinic from conventional massage to MLD, clients frequently and spontaneously reported that they had relaxed well with massage, but MLD was another level of 'deep'.

Prof H. described this as the 'sympatholytic' effect.

Although the term has now become more widely used the original research was on the very precise movements of Vodder's MLD and should not be used as evidence for the effects of other forms of lymphatic drainage.

The body needs periods of calmness and rest for good digestion and tissue repair
This sympatholytic effect means the parasympathetic system can become more active and 'housekeeping' functions such as digestion, immunity and tissue repair can proceed.

Hutzschenreuter measured the effects of MLD on digestive smooth muscle by recording borborygmus sounds (digestive sounds) which increase in both the patient and therapist during MLD.

This reduction in stress after MLD contributes to a reduction in the perception of pain, but doing MLD also has two other, much more direct effects on pain.

Gate Mechanism is strongly activated by the light touch mechanoreceptors in the skin - Meissner's Corpuscles. These light touch nerve ending can 'close the gate' on some of the pain messages travelling up to the brain.

By rhythmically and repeatedly stimulating the Meissner's corpuscles, #MLD closes the gate and reduces the perception of pain.

But that's not all, the increased activity in the lymph vessels - which are literally vacuuming cleaning the loose connective tissue - draws inflammatory mediators out of the tissues.

Modified from Brakenhielm, E., & Alitalo, K. (2019). Cardiac lymphatics in health and disease. Nature Reviews Cardiology, 16(1), 56-68. doi:10.1038/s41569-018-0087-8

These small chemicals are firing the nociceptor (pain signalling nerve) in the first place, so reducing the load of pain causing chemicals has a pain relieving effect at the source. Since #MLD has simultaneously reduced sympathetic inhibition of immune functions, tissue healing can progress unimpeded.

I've heard some amazing stories from clients and therapists about the effects of MLD in chronic pain conditions where other modalities have failed to bring relief.

To find a properly trained MLD therapist visit the Vodder School website and enter your location.

To find a recognised training program in Australia, New Zealand or SEAsia visit

For a brief review of some of the published literature on the effects of Vodder MLD continue reading below...

Shim, J.-M., Yeun, Y.-R., Kim, H.-Y., & Kim, S.-J. (2017). Effects of manual lymph drainage for abdomen on the brain activity of subjects with psychological stress. Journal of Physical Therapy Science, 29(3), 491-494.

Purpose The present study investigated the effects of manual lymph drainage for abdomen on electroencephalography in subjects with psychological stress. Subjects and Methods Twenty-eight subjects were randomly allocated to undergo a 20-min session of either manual lymph drainage or abdominal massage on a bed. Results Analysis of electroencephalograms from the manual lymph drainage group showed a significant increase in relaxation, manifested as an increase in average absolute, relative alpha activity and a decrease in relative gamma activity. Conclusion Our results suggest that the application of manual lymph drainage from the abdomen provides acute neural effects that increase relaxation in subjects with psychological stress.

JD Comments This study compared MLD for the abdomen with abdominal massage in people who scored highly on a stress scale. The MLD group had more significant relaxing effects than the massage group. Whilst this only involved abdominal treatment (with proximal clearance of the neck in the MLD group) it does testify to the difference in the body's response to MLD compared to pressure massage.

Shim, J. M., & Kim, S. J. (2014). Effects of manual lymph drainage of the neck on EEG in subjects with psychological stress. J Phys Ther Sci, 26(1), 127-129. doi:10.1589/jpts.26.127

Purpose The present study investigated the effect of manual lymph drainage (MLD) of the neck on electroencephalography (EEG) in subjects with psychological stress. Methods Twenty-six subjects were randomly allocated to receive one 15-min session of either MLD or resting on a bed (control). Results Analysis of EEG in the MLD group showed a significant increase in relaxation, manifested as an increase in average absolute and relative delta and alpha activity. Conclusion It is suggested that MLD provides acute neural effects that increase relaxation in subjects with psychological stress.

JD Comments This study also measured normals with high stress scores. The treatment in the intervention groupm was confined to the neck and compared to no treatment. Which really isn't a fair comparison because the people in the control group had no therapist attention. Never-the-less results add to the existing evidence in reduction of sympathetic activity during Vodder's MLD.

Kim, S.-J., Kwon, O.-Y., & Yi, C.-H. (2009). Effects of Manual Lymph Drainage on Cardiac Autonomic Tone in Healthy Subjects. International Journal of Neuroscience, 119(8), 1105-1117. doi:10.1080/00207450902834884

Abstract This study was designed to investigate the effects of manual lymph drainage on the cardiac autonomic tone. Thirty-two healthy male subjects were randomly assigned to manual lymph drainage (MLD) (experimental) and rest (control) groups. Electrocardiogram (ECG) parameters were recorded with bipolar electrocardiography using standard limb lead positions. The pressure-pain threshold (PPT) was quantitatively measured using an algometer. Heart rate variability differed significantly between the experimental and control groups (p < 0.05), but the PPT in the upper trapezius muscle did not (p > 0.05). These findings indicate that the application of MLD was effective in reducing the activity of the sympathetic nervous system.

JD Comments This study used a pressure test in the trapezius muscle of young men to determine change on stress levels induced by mental tests. Again, the control group had a lack of therapist contact but evidence for the sympatholytic effect of MLD is demonstrated.

Clemens, K. E., Jaspers, B., Klaschik, E., & Nieland, P. (2010). Evaluation of the clinical effectiveness of physiotherapeutic management of lymphoedema in palliative care patients. Japanese Journal of Clinical Oncology, 40(11), 1068-1072. doi:

OBJECTIVE: Lymphoedema is a common sequela of cancer or its treatment that affects lymph node drainage. The physiotherapist, as member of the multiprofessional team in palliative care, is one of the keys to successful rehabilitation and management of patients with cancer and non-malignant motoneuron disease such as amyotrophic lateral sclerosis and palliative care needs. The aim of the study was to evaluate the frequency and effect of manual lymphatic drainage in palliative care patients with lymphoedema in a far advanced stage of their disease. METHODS: Retrospective study (reflexive control design) of data of the 208 patients admitted to our palliative care unit from January 2007 to December 2007. Demographic and disease-related data (diagnosis, symptoms, Karnofsky performance status and effect of manual lymphatic drainage interventions) were documented and compared. STATISTICS: mean +/- SD, median; Wilcoxon's test. RESULTS: Of the 208 patients, 90 who reported symptom load due to lymphoedema were included; 67 (74.4%) had pain, 23 (25.6%) dyspnoea due to progredient trunk oedema. Mean age 65.5 +/- 13.0 years; 33 (36.7%) male; Karnofsky index 50% (30-80%), mean length of stay 15.6 +/- 8.0 days. The mean number of physiotherapeutic treatment interventions was 7.0 +/- 5.8. Manual lymphatic drainage was well tolerated in 83 (92.2%) patients; 63 of 67 (94.0%) patients showed a clinically relevant improvement in pain, and 17 of 23 (73.9%) in dyspnoea. CONCLUSIONS: The majority of the patients showed a clinical improvement in the intensity of symptoms after manual lymphatic drainage.

JD Comments This was a retrospective study on a facility using MLD and shows that #palliative patients receiving #VoddersMLD had valuable reduction in pain and #breathlessness


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