One of the things I love about teaching MLD is the ability to combine the hard science behind the Vodder techniques, with my years of clinical observation and resolution of my own lymphoedema. I have watched people heal faster after surgery, recovery better from traumatic injury, and enjoy significant pain and symptom relief in so many different chronic diseases.
I can explain the scientific basis of the effects of MLD, the specific tissue or system effects achieved by individual techniques, and the expected response in both target structures and any systemic effects. These are my top 10 facts and observations.
This effect underlies so many of the other events that occur during and after MLD, and it was one of the fundamental effects that Prof. Heutzschenreuter showed in his early experiments on MLD. What I love most is that he noted the reduction in sympathetic tonus very quickly after the MLD treatment began (< 5 minutes), and that it had occurred in the therapist as well. Heutzschenreuter was the first to use the term sympath[ic]olysis in describing the effects of MLD. Read other posts on Sympatholysis.
2: Increased lymph formation, and reduced capillary filtrate
There are mechanical and neural events occurring in both the lymph vessels and the capillary during MLD. The shearing forces applied around the initial lymph vessels, without enough pressure to compress them even slightly, conveys maximal movement along the anchoring filaments to the endothelial cells at the initial lymph plexus, and directs the pre-lymph toward the vessel. Sympatholysis dilates the pre-capillary sphincter and blood flow through the capillary is increased without a corresponding increase in blood pressure. This 12% increase in the velocity of the blood (another event measured by Heutzschenreuter), results in a slightly reduced filtration pressure, effectively reducing the volume of fluid entering the connective tissue bath. Sympatholysis also dilates the lymph collectors increasing their capacity, while the shearing forces created in the tissues help to increase stretch-receptor-reflex mediated lymphatic pumping. Increased lymph removal from the tissues reduces overall protein load which further reduces the total filtrate escaping the capillary. Read a previous post on this.
3: Improved digestion
Sympatholysis takes most of the credit here too, but the gentle abdominal treatment taught in Level 1 is directed toward activating neural reflexes between the skin and the bowel, more so than lymphatics. These light techniques apply no mechanical pressure to the gut and are tolerated well by people with diverticulitis, ulcerative colitis and irritable bowel syndromes. Heutzschenreiter had his measuring equipment out on this one too, detecting a significant increase in borborygmus sounds soon after MLD began, and once again, in both therapist and receiver. I have had people with serious constipation stop me half way though the treatment and rush out to the loo, it has worked so quickly. Therapists in the training courses also soon spot the movement described as 'weight reduction technique' which refers to the improvement that most people experience in nutrient absorption, and the flow on effect this has on appetite.
4: Thixotropic tissue change
All connective tissue is thixotropic, a fascinating property that allows for more or less free fluid to move around and between tissue structures and which determines tissue stiffness or compressibility. In the loose connective tissue thixotropic changes protect the cells from potential dehydration or flooding, and have a protective function in tissue repair and recovery. MLD changes the thixotropic state in congested tissues, an observation made by the Vodder's as they developed their very precise way of moving the skin almost 90 years ago.
5: Regrowth of lymph vessels though a healing scar
There is a window of opportunity that is only open in the first 3 - 5 months after a soft tissue injury or surgery, where the cut lymph vessels can grow back through the healing scar. Loading them increases the likelihood that cross scar connections will be re-established, and there is evidence from work on dogs that performing MLD prior to a surgical wound improves new vessel growth, even if MLD is not applied after the procedure. Unfortunately in our reactive health system I was often presented with old tight, contracted scars and asked to do something about them. But for these scars it's too late for basic MLD, other more aggressive forms of tissue manipulation are needed and I love #PunchTape for this. There are two previous posts on the effect of frequent and early MLD in my Mum's recovery from total knee replacement.
6: Analgesic effects
Did you learn about Gate mechanism in your undergraduate training? Where mechano- and thermo-receptors under the skin can block some of the pain messages arriving in the spinal cord from being transmitted to the brain? Well, it may not surprise you to find out that some of the most powerful gate effects come from Meissner's Corpuscles which respond most strongly to light touch and repeated movement of the skin. But the pain relieving effects of MLD go beyond this mechanical closing of the gate. There's sympatholysis again, which is also known to reduce the perception of pain, and increased lymphatic activity 'vacuums' out the inflammatory mediators in the tissues responsible for the nociceptor stimulus in the first place. I observed this so many times in the clinic, sometimes people would be pain free after only one session! Even when it took more than one session, it was often hard to believe the profoundly pain relieving effects that some people experienced, but I did grow to accept it. Read more on MLD for stress and pain.
7: Reduction of cerebral oedema
Studies show that intraoral MLD immediately reduces cerebral pressure in traumatic brain injury. I treated a dear fiend after and minor stroke and was surprised at how long it took for the oedema to clear completely, even though she'd had almost no symptoms. I've assisted a client to swallow and talk again after a two massive strokes, but intra-orals are probably one of the most underused MLD treatments generally. I hope this will change now that so much research is going on into brain drainage, highlighting the vital role of the lymphatics in clearing pre-lymph from the brain. We need more research on how MLD could be used in treatment or prevention of several neurological conditions such as Alzheimer's. Read more about brain drainage.
8: Resolution of trigger points
I've been writing and teaching on how MLD resolves trigger points, for a long time. Without pain for either the client or the therapists, without stress on anyone's thumbs or the need for needles, and with a potentially permanent effect. But I'm still frequently met with scepticism about this one, that is until people actually experience it for themselves, either as the therapist or the client. It's really all to do with simply tracking down the smallest tiny pockets of inflammation in any muscle or fascia tissue, and then very precisely draining it away. The revised Level 2 Course, which confers the Certificate in Applied MLD, teaches this treatment.
9 : Respiratory treatments
Another under-estimated and under-used benefit of MLD. I hope that many people with long-COVID will find their way to an Applied MLD therapist for intensive in costal work. MLD was originally developed among people suffering chronic lung diseases, but lymphoedema has draw the attention away from these many non-lymphoedema treatments. Watch this space as we begin to hear reports on MLD in COVID-recovery.
10: MLD restores homeostasis
The synergistic effect of MLD within multiple organ systems has never been properly studied, but many times I have observed people who have 'tried everything, but nothing works' start to improve once they receive MLD. I just wish there were more of us around to raise the profile and the availability of Applied MLD for everyone who needs it.