Sunday, July 1, 2012

What's the Difference Between Lymphatic Massage and Lymph Drainage Therapy(LDT)?

On a first session with a new client I typically give them what I refer to as the Lymph lecture. It is a simplistic description of how the lymph system works, why it is important and how it directly relates to pain, malaise and other illnesses.

When I first started doing this years ago, less than 1% had any working knowledge of the lymphatic system. I am happy to report that those numbers have been increasing. People who are educated on the lymph system are still a dismally small number but it is promising that, at least in my practice, t
his number is on a steady rise.
So what is the difference between Lymphatic Massage and Lymph Drainage Therapy (LDT)? My primary massage practice is in Salt Lake City, Utah and in this state most of the people trained in lymphatic work have been trained in a technique that calls itself Lymph Drainage Therapy (a therapy developed by French doctor Bruno Chikley.) This is an uber light technique that helps to move fluid with the slightest pressure (5 grams or the weight of a nickel.)

LDT is based on a premise that the lymph cells will rupture with more than 5 grams of pressure and regenerate within 24 hours. I don't believe this is true. In my experience, when someone has severe lymphedema it is possible to rupture the lymph cells with too much pressure but the amount of pressure it takes to burst these cells is variable based on multiple factors. It may be 5 grams but not necessarily.

Severe Lymphedema (Light Pressure)
There is always an optimum pressure and finding that requires the therapist to have a finally developed sense of touch and sensitivity to their client's body.

For healthy people 5 grams will not rupture the lymph cell. When someone is extremely ill or has the most severe form of lymphedema...the almost imperceptible touch of LDT can be quite healing and do wonders for an overtaxed parasympathetic system.

For anyone who is healthy, moderately ill or has the kind of lymphedema caused by a mastectomy or adolescent onset...Lymphatic Massage is often the more effective and satisfying choice.

Moderate Lymphedema (Variable Pressure)
In Lymphatic massage...the lymph fluid is still being drained and depending on the expertise of the therapist there is potential for a much bigger release of toxins than in LDT. For a very ill person...too many toxins released at the same time can send them into a downward spin that can be challenging to overcome.
However, in the moderately ill to healthy person, releasing as many toxins as possible is desirable.

I do occasionally use LDT when the circumstance is warranted...but in my experience Lymph Massage is typically by far more effective and satisfying.

For those of you that have had both the uber light LDT and Lymph Massage (usually not by the same therapist), how do you notice the difference?

This article should not be a substitute for professional medical care
copyright © 2010 Essential Stillpoint


  1. What is the best method for swelling caused by a mastectomy?

  2. Hi Ella,

    This is a more complicated question then you might have guessed. It really depends on your overall lymphatic health. The short answer is whatever form of lymph drainage you respond to is the best. Some people love the gentle quiet nature of MLD and others are more satisfied having the lymph moved in a more substantive way. As long as you work with someone who is knowledgeable and skilled in lymph work and who respects the swelling without using forceful pressure in those can try out different methods until you find something that is a good fit for you.

    Here is the longer answer:

    In our society the lymph system isn't usually noticed until it is in distress. My own theory (non medical opinion) about one possible etiology of cancer is that it may be traced back to some lymphatic blockage caused by muscle, joint or other tissue obstructions. If this takes place for long enough the body waste may fester in the trapped locations and turn into a multitude of illnesses including cancer. (Again important to stress that I am not a medical doctor and this is just my opinion.)

    With most of the mastectomies that I have worked with, many important lymph nodes have been removed which causes an already stressed lymphatic system to become inadequate and brings about the dangerous edema condition known as lymph edema. This typically presents as major swelling on the arm on the side of the body that the breast was removed (if just one it is more commonly the left) and often will spread to one or both legs and ankles.

    Any method of lymph work that enhances lymph drainage will help you. Because there are lymph nodes that have been removed you may need some manual help with this for the rest of your life. I will often find people who want this situation to go away and this is what motivates them to seek treatment. In the case of a mastectomy where critical lymph nodes have been removed the situation is not likely to resolve permanently.

    As I stated I am trained in the very light MLD and will use this on occasion (especially if someone is extremely ill) but mostly prefer my own unique blend of lymph massage and structural work. If you have a structural distortion such as internal rotation of the shoulder, an overly tight neck or pectoral muscle it most likely is pinching off the lymph flow. Having this worked in addition to lymph massage will often increase the functioning of the lymphatic exponentially.

    I hope this helps and wish you the best of luck. If you have additional questions please feel free to send me a personal message.

    1. A dear and loving friend send me this from NY through e-mail. Obesity has taken a toll on my legs. some swelling, burning, numbness & painful. I am 71 and don't let this hold me back in doing much that needs to be done in life. Still walk and work in garden..etc. Amelia

    2. Hi Amelia,

      I am so sorry to hear of your pain and discomfort. Have you been receiving care from your doctor? It is very important to learn the signs of cellulitus. Cellulitus is very deadly. If you haven't already I encourage you to go see your doctor and learn the signs and symptoms and to learn of any other treatments that may be useful.

      He/she may be able to prescribe compression stockings that might help to alleviate some of the swelling. may be good to find someone who is trained in lymph drainage in your area. Please realize that it is rarely about getting rid of this and more often about keeping the lymph moving so that it gives some relief and quite possibly may prevent something more serious from taking root.

      Take good care,

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