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Activities for Daily Living

Lesson 2

Manual Lymphatic Drainage (MLD)
MLD is a method of stimulating movement of lymphatic fluid through the lymph vessels that are directly under the skin. A technique of light, gentle massage - MLD opens up collateral or additional pathways through which fluid can travel to meet a healthy lymph vessel and continue along its way to the kidneys. The initial lymph vessels are the smallest lymphatic vessels in the surface of the skin. They normally drain into larger vessels deep in the extremity. The therapist massages these lymph vessels to move fluid up the affected limb through the vessels in the surface of the skin. Fluid is gently pushed away from blocked areas and into the new collateral pathways that are created by the series of massages.

Compression Bandaging
Compression bandages augment and in some cases, replace the elasticity of skin. The bandages increase tissue pressure in the affected limb and prevent the return of lymph fluid to the area. The increased tissue pressure from the bandaging works with the skeletal muscles to pump additional fluid through collateral pathways created by the MLD. For example, if you hold your lower arm and open and close your fingers, you will feel an additional pressure from the muscles contracting beneath your grip. This can give you a sense of how the bandages help to squeeze out additional fluid.

Complete Decongestive Therapy (CDT)
CDT is a combination of MLD, compression bandaging and therapeutic exercises. When lymph pathways are compromised, MLD "opens up" and stimulates the lymphatic system to clear the limb of fluid. Applying compression bandages after and MLD treatment will help keep fluid from re-entering the affected area. Performing therapeutic exercises with the bandaged limb helps to move additional fluid out of the affected limb. CDT, the combination of these therapies, produces results that could not be accomplished with just one therapy alone.


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HOPE Lymphedema Treatment Center | 134C Eldridge Road | Sugar Land, TX 77478