Table 8 Manual lymphatic drainage (MLD) protocol administered to the head, neck, and thorax for 15 minutes, while in the head-down tilt position
Type of MLD treatment | Anatomic region | Description | No. of times performeda |
|---|---|---|---|
Central decongestion and priming of the system | Venous angle | • Stimulated supraclavicular nodes/venous angle by hooking fingers bilaterally over clavicle using fingertips/pads | 10 |
Neck | • Stimulated neck by bilaterally stretching forward and distal toward venous angle | 10 | |
Abdominal | |||
Umbilicus/ abdominal area | • Performed thoracic duct/diaphragmatic breathing by teaching subject how to belly breathe and resist diaphragmatic breathing | 5 | |
Cisterna chyli | • Deep abdominal technique over superior to umbilicus/below xiphoid; coordinated with diaphragmatic breathing, resisted a little more with each exhalation (if the aortic pulse was felt, held at that level for remaining cycles) | 5 | |
Iliac nodes and lumbar trunks | • Found iliac crest, moved medially to soft area, and provided wave-like motion toward umbilicus, right and left side | 5 | |
Axillary nodes | • Stimulated the axillary nodes ○ Right and left cephalic vasorum | 10 5 | |
Short neck treatment | Neck/shoulder | • Effleurage starting at the sternal notch following the clavicle to acromion process performed on both sides | 3 |
• Modified stationary circles in the supraclavicular fossa, stimulating the venous angle | 5 | ||
• Stationary circles on the lateral cervical triangle bilaterally | 5 | ||
• Stationary circles over the shoulder collectors on two locations on each side of the neck ○ First position closer to the neck, moving fluid away from neck toward axillary nodes ○ Second position distal over the acromion processes, deviating towards axillary nodes | 5 5 | ||
• Stationary circles pre- and retroauricular lymph nodes bilaterally | 5 | ||
• Reworked bilateral lateral cervical triangle bilaterally | 5 | ||
• Stationary circles submandibular area | 5 | ||
• Reworked bilateral lateral cervical triangle bilaterally | 5 | ||
• Stationary circles over axillary lymph nodes, each side ○ Right and left cephalic vaso vasorum | 5 5 | ||
• Reworked bilateral shoulder collectors in 2 locations (2D) | 5 | ||
Facial MLD | Face | • Effleurage in 3 pathways ○ Lips to mandible ○ Nose to mandible ○ Forehead to in front of ear | 5 5 5 |
• Stationary circles on submandibular lymph nodes, both sides | 5 | ||
• Stationary circles on the lateral cervical triangle on both sides | 5 | ||
• Alternating stationary circles on face with fingertips over the edge of the mandible on each side of subject’s mouth, hands parallel to sagittal watershed | 5 | ||
• Alternating stationary circles on face with hands moving slightly distal (away from neck) with fingertips pointing to edge of lips | 5 | ||
• Stationary circles on submandibular lymph nodes, | 5 | ||
• Stationary circles over the lateral cervical triangle on both sides | 5 | ||
• Alternating stationary circles on the bridge of the nose | 5 | ||
• Alternating stationary circles over cheeks | 5 | ||
• Alternating stationary circles with fingers pointing to edge of lips | 5 | ||
• Alternating stationary circles with fingertips over the edge of mandible | 5 | ||
• Stationary circles over the submandibular lymph nodes | 5 | ||
• Stationary circles on the lateral cervical triangle on both sides | 5 | ||
• Alternating stationary circles over upper and lower eyelids (if subject was not wearing contacts, otherwise needed to treat upper, then lower eyelids) | 5 | ||
• Alternating stationary circles to eyebrows medial to lateral | 5 | ||
• Forehead alternating stationary circles from midforehead to ears | 5 | ||
• Crown alternating stationary circles to ears | 5 | ||
• Stimulated pre- and retroauricular lymph nodes bilaterally | 5 | ||
• Stationary circles over the lateral cervical triangle on each side | 5 | ||
• Final effleurage on both sides of face | 5 | ||
Venous angle | Venous angle | • Stimulated the nodes and connections between internal jugular and subclavian veins by gentle pumping technique behind the clavicles | 10 |
