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Questions about the anatomy & physiology, and the efficacy of approaches to lymph drainage

I'm trying to understand the physiology of facilitating lymph drainage. I know of at least two approaches, the Vodder Method & Bruno Chikly's method. I've taken a couple of Bruno's workshops. He focuses more on wellness using very gentle touch. I understand the Vodder Method is what's used more in oncology settings and is also gentle.

Sometimes I read therapists that write about Swedish, Ayurvedic & other massage modalities moving lymph, but if the technique is not specific -- following drainage patterns from downstream, working upstream, and using the type of engagement as taught by either Vodder or Chikly approach -- and the pressure is not gentle, then I'm skeptical that lymph will drain. So, are claims that "massage will facilitate lymph drainage" -- without using specific techniques -- false?

Since the pumping effect of muscle contractions is often cited as another way to move lymph, does it matter if the movement is active, or will passive movement move lymph?

How about electrical stimulation? By stimulating muscles, but not producing movement, it is not clear to me that e-stim is effective.

One question about anatomy: Bruno Chikly refers to lymphangions as structures within lymph collector vessels as mechanically moving lymph with one-way valves to prevent back flow. Is this anatomy & physiology accepted within the lymph drainage profession?

Other social media has tended to eclipse the ABMP groups, but I'm hoping that this thread might stir some interest. Thanks for your consideration.

Replies to This Discussion

Permalink Reply by Sharon Houlihan on June 8, 2014 at 5:05pm

I have taken 3 levels of Bruno Chikly's LDT classes, and also took the entire Dr. Vodder Lymphedema certification (CDT) program. The premise of both techniques are the same. Manual Lymph Drainage is a very light technique which works on the superficial lymphatics just below the skin. As one of my instructors used to say "it is a skin technique", meaning that unlike massage which glides over the skin and works on the muscles, MLD is a very specific, superficial, light technique which stretches the skin. Both Dr. Chikly & Dr. Vodder follow the the rules of Anatomy in that the direction of the stroke is one-way (toward the venous angle). Where they differ is that Chikly developed a technique called "Manual Lymphatic Mapping", in which he tries to find out where the Lymph wants to go and then sends it in that direction. Mapping is used primarily in treating Lymphedema patients.

Classic massage can help facilitate lymph drainage to some extent in a healthy body, but is contraindicated for use on people who are at risk for, or have established Lymphedema (such as cancer patients who have had lymph nodes removed).

Since the Lymphatic System does not have a central pump, other factors come into play in moving the fluid such as: muscle contractions, arterial pulsation, breathing, peristalsis. So, movement, whether passive or active is important for Lymph transport.

With regard to your question regarding lymphangions: they are a component of the Lymph Collectors (similar in construction to the venous veins), which aid in sending fluid through the system. The Collectors are the main transporting vessels of the Lymph System. A thorough knowledge of the Lymphatic & Cardiovascular system is necessary in order to do MLD well.

Both Dr. Chikly & Dr. Vodder have very specific protocols for both wellness & oncology patients. While different in execution, they have the same goal -- to increase transport capacity of the lymphatic system by sending it to the venous angle. No one should do this work without being properly trained. Dr. Chikly's book "Silent Waves" is an excellent book on the history, anatomy & physiology, and techniques of Lymphatic Drainage Therapy (LDT).

Permalink Reply by Jeff Sims on June 8, 2014 at 8:05pm

Thanks Sharon ~

Perhaps someone might help answer my specific questions. I'm trying to understand the physiology. Please see my initial posting, or let me know if my questions are unclear.

Thanks!