Within the past decades a whole new form of post-surgical healing has emerged – Post Surgical Manual Lymphatic Drainage (PS-MLD). While there are many therapists trained to perform standard MLD for health and wellness purposes, they are not necessarily skilled in PS-MLD. To add to the confusion, there is a contingent of therapists who have created their own techniques to use post-surgically and those techniques completely oppose the long-studied, evidence-based, proven MLD techniques introduced by Dr. Vodder and others.
The Lymphatic System
Let’s take a brief look at the Lymphatic System and why it is important. A complex pathway of specialized capillaries, trunks, and nodes make up the Lymphatic System which rid the body of intercellular waste, fight off disease and viruses, and help maintain a balanced hydration level throughout the body. Along with being the primary immunity system, it is also a recycling system bringing protein snippets and unusable cellular debris back to the blood veins to be processed through the liver and kidneys and then excreted as urine or feces.
As a passive system, the lymphatic system has no central pump, like the heart, to move fluids. That task is left to certain trunk-type pathways where the pressure of muscles exerted against the skin (dermis) and other structures provide a decentralized pumping action which moves the fluid. This is the primary reason standard MLD for health and wellness is performed only at the skin level (superficial) and not “deep tissue.”
Along with a few key organs like the spleen and tonsils, the lymphatic system is peppered with approximately 650 nodes distributed around the body, often in clusters at a joint or transitional area of the body such as the knee or armpit. These nodes filter the lymphatic fluid and create cells to fight off disease.
The post-surgical twist to MLD
Therapists trained in standard MLD have only a basic knowledge of the lymphatic system. In most introductory classes the instructor emphasizes the teachings are for “uncomplicated” or “non-complex” clients only. This means students should do MLD only on a healthy people for health and wellness purposes. Without further training, these introductory students should refer-out patients with complex lymphedema, lipoedema, post-surgical issues, and other complexities not taught in class.
So, without delay, here are the 5-things you need to know BEFORE you schedule a PS-MLD session.
#1 You may receive Post-Surgical MLD treatments as soon as 3-days after surgery.
Doctors who know of PS-MLD and the benefits of such treatments will often suggest treatment by a well-trained PS-MLD therapist as soon as 3-days after surgery. However, some doctors suggest or even mandate patients wait from 2-6 weeks after surgery before receiving treatment. We believe this is too long to wait. During this waiting period, fibrosis and seromas can develop in the trauma area, and scar tissue can become immobile as soon as 3-4 days after surgery. Most often we find the doctors who mandate a long delay post-surgically have had clients report a bad experience with poorly trained MLD therapists or they are just not current on the latest studies and trends related to PS-MLD.
#2 Your MLD Therapist must have medical training
Medical training enhances the capabilities of the MLD therapist. The medical training should cover infection prevention, incision management and precautions, knowledge of scars and scar tissue, knowledge of fibrotic tissue development, seroma development and management of both, and knowledge of how the body heals naturally. In addition, a therapist without medical training will not be aware of bloodborne pathogens or wound care, and likely will not have methods to protect themselves and you from illness or infection. They may not be aware of CDC recommendations for sanitization, either.
#3 Pushing fluids and tissues out unhealed incisions is NOT PS-MLD
There is a contingent of “massage therapists” in various places in the United States and abroad who believe the best way to get lymphatic fluid out of your body is to reopen the incisions and push fluid out manually. First, this process is outside the scope of practice (100% illegal) for any massage therapist in any of the 50 United States. Unless the person performing this process is a nurse or similarly licensed healthcare worker in a clinic with biohazard bags, gloves, face shield, gowns, etc., they should not be doing this. If you are a surgery patient and someone wants to do this to you, just say “No!”
#4 YouTube videos are NOT an alternative to hands-on PS-MLD
While people love to share their stories and accomplishments, some things are better left to the trained professionals – and that is PS-MLD. YouTube videos often show a combination of techniques which are contrary to the healing process. A good example is stroking downward from the breasts to the lower belly – that is not a correct procedure. The lymphatic system changes direction in the mid-abdominal region, so two different strokes are needed in the belly area.
#5 PS-MLD does NOT use brushes, tools, cupping, bamboo sticks, rollers, or creams.
PS-MLD requires the use of hands, movement of the skin in particular directions, and gentle pressure toward the body. Any other technique, tool, cream, or even cupping, is not part of the PS-MLD process and should be avoided. If you have a therapist who is insistent on using creams, tool, cups or rollers, just say “No!” and tell them to use hands only. If they refuse, simply end the session and leave. There are some instances where cups and tools can be used during the healing process, but it is not for lymphatic drainage.
You Deserve a Better Healing
In all cases, a post-surgical lymphatic drainage session should be gentle, complete, and involve only minor pinching or a bruisy feeling while receiving treatment. PS-MLD is an excellent way to help promote the healing process and is appropriate for almost any surgery or procedure.
At RTPI, we treat clients who have had procedures such as lipo-360, mommy makeover, breast reduction or augmentation, Brazilian butt lifts, abdominoplasty, brachioplasty, facelifts, knee surgeries, hip replacements, shoulder surgeries, mastectomies and reconstruction, gender affirmation surgeries both top and bottom. We have hundreds of hours of training in oncology massage, lymphatic systems, manual lymphatic drainage, and wound care. We want to be your healing partner.
If you are planning surgery, consider booking with us when you confirm your procedure date – we can schedule up to 300-days in advance (BOOK NOW). If you just had a procedure, give us a call and we can get you started on your recovery plan!