Lymph drainage massage Davie (LDM), a gentle, rhythmic style of massage that mimics the action of the lymphatic system, uses precise rhythm and pressure to open the initial lymphatics and stimulate lymph vessel contraction to reduce edema. Edema is an unusual accumulation of fluid in soft tissues that can be temporary and mild, or serious, as in chronic lymphedema. Lymph massage strokes do not slide over the skin, but press gently into the skin, moving it without increasing blood circulation or reaching the depth of muscle tissue.’
In the late 19th century, Alexander von Winiwater of Austria developed specialized massage and compression treatments for lymphedema disease. In the 1930s, Emil Vodder, a Danish physiotherapist, and his wife developed a method of massaging the lymph nodes of patients with colds. In 1963, Dr. Johannes Asdonk learned the Vodder massage method and subsequently established a school in Germany with the Vodder’s as instructors. Eventually, the Vodder’s moved to Austria to open their own school. Dr. Asdonk founded the German Society of Lymphology in 1976 with Kuhnke, Foldi, and others. Since then, manual lymph drainage has been further developed by Leduc, and later by Foldi and Casley-Smith. These scientists developed comprehensive decongestive therapy (CDT), a combination of LDM, bandaging, exercise, and skincare that is more effective in the treatment of lymphedema disease than massage alone.
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UNDERSTANDING LYMPH DRAINAGE MASSAGE
LDM uses external massage strokes to move fluids out of body tissues and into the lymphatic system. LDM mimics the lymphatic system, employing repetitive strokes at a precise speed, rhythm, and pressure. LDM stimulates the immune system because it helps move stagnant tissue fluid out of tissues and into the lymphatic vessels, where his transported through the lymph nodes and purified by lymphocytes. When performing LDM, the therapist moves the client’s skin in different directions: lengthwise, horizontally, and diagonally. These movements, which stretch the microfilaments just below the skin that control the openings to the initial lymphatics (the start of the lymph vessels which allow entrance of fluid into the lymphatic system), allow interstitial fluid to enter the lymphatic system while stimulating the lymph vessels to contract .° Interstitial fluid is the solution that bathes and surrounds the body’s cells. Fluids are propelled forward through the lymph vessels and away from tissue areas where fluid has pooled. LDM stimulates the lymphatic vessels to contract more frequently. It also appears to make natural contractions more regular. In addition to improving fluid flow, LDM is very relaxing. The method’s slow, gentle, repetitive movements reduce the body’s “fight-or-flight response” to stress (a function of the sympathetic nervous system) and stimulate the body’s parasympathetic reaction. The fight-or-flight reaction causes the body to tense and to produce hormones and chemicals for defense. This reaction also depresses the immune system while stressing many-body systems, including the cardiovascular system. Over time, such stress can cause physical damage. LDM helps to put the body into a parasympathetic state, which slows the heart rate and breathing, relaxes muscles, and allows organs to resume normal functioning.
Although other massage styles, like Swedish massage, can move tissue fluids, they lack the specificity that is the basis of successful lymph work. LDM is very light, gentle, and strictly paced. It does not use long strokes, heavy pressure, or rapid movements such as percussion. LDM is not painful.
Dr. Vodder focused on using lymph drainage massage to enhance the immune system of relatively healthy people, establishing the importance of LDM in a wellness setting. The focus of the scientists who followed Vodder has been on the treatment of lymphedema disease. So, LDM is important in two areas: enhancing lymph circulation and immunity and maintaining health on the one hand, and the treatment of chronic edema, lymphedema disease, on the other hand. Working with LDM in the wellness setting is different from working with LDM in a clinical setting. Working in wellness care would not require every client to be medically supervised.
In the wellness setting, LDM is used to enhance lymph circulation and the distribution of leukocytes throughout the body, which enhances the immune system. It is used to reduce pain and edema, and improve the appearance and health of the skin. LDM is deeply relaxing and can be used when massaging clients with high-stress levels. Because LDM is so relaxing, it is a useful technique for body-mind work. LDM can be combined with sports massage, deep tissue massage, and body treatment in cases of disease or injury. It helps to speed the healing of injuries, and reduce scar tissue, so it is beneficial for sports injuries.
In a clinical setting, LDM is used after cosmetic surgery to reduce swelling, speed healing, and reduce the development of scar tissue. It is used in the treatment of lymphedema disease, which is chronic obstructive edema that can develop after surgery, injury, or radiation treatment. It is part of comprehensive decongestive therapy, along with non-elastic bandages, compression garments, exercise, and skincare. Bandaging and exercise for lymphedema disease are not covered in this text; instead, the focus is solely on lymph drainage massage.
Lymph drainage helps to reduce scar tissue. Scar tissue responds slowly to massage and repeated sessions are required to obtain visible results. Progress is faster if LDM is combined with connective tissue massages, such as skin rolling or cross-fiber friction. LDM helps speed the healing of injuries by stimulating microcirculation, which assists in the removal of cellular debris from the site of the injury. As the lymphatic system removes toxins and damaged cells, increased blood flow brings nutrients and fibers that will be used to repair injured tissues. Massaging as soon as safe after an injury minimizes the amount of scar tissue that forms, and improves tissue structure. Even old scars can benefit from LDM, which can help scars to become softer, smoother, and more flexible. Progress is slow, however, so it is a good idea to teach clients to self-treat daily. A combination of connective tissue massages, such as deep-tissue massage or myofascial release with LDM, produces the best results.
Something for massage therapists and estheticians to understand is that there is a difference between the techniques we use, the results that we believe can be attributed to those techniques, and our beliefs about why we get those results. Scientific research has shown that some of the things we used to believe about the effects of lymph drainage massage aren’t true and have validated other beliefs. Rather than continuing to repeat traditional ideas about the effects of LDM, we should stay informed about current scientific research so that we can be accurate when speaking about our work to our clients.
How can massage therapists, estheticians, and other caregivers stay informed about scientific progress in the field of lymph drainage massage? Subscribe to professional journals such as “Lymphology; use online resources to research answers to your client’s questions and continue to take classes in lymph drainage massage. Attend conferences where you can talk with other professionals, sharing information and experiences.