Life of Lymph

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From puffy eyes, to swollen feet: How this woman's gentle touch can instantly drain the pain of swollen limbs


Anne Schreiber is a trained physiotherapist who can bring instant relief

From puffy eyes in the morning to swollen feet and ankles, they are the everyday problems that can be uncomfortable and unsightly. Known medically as oedema, the symptoms are caused by too much water in the body’s tissues, leading to inflammation, but in most cases the swelling is temporary.

The body naturally processes the extra fluid, which is then passed out via the kidneys.

However, for some, there is no return to normality. It is distressing, painful and often disfiguring as limbs can expand to four or five times their normal size.

This condition, lymphoedema, affects 100,000 Britons. It occurs when the lymph system – a network of vessels and glands that circulate fluid around the body and form part of the immune system – is damaged by infection or injury.

Fortunately, there is relief in the form of a treatment that is simple, safe and painless, yet incredibly effective. Manual lymphatic drainage (MLD) is a highly specialised form of massage carried out by a trained physiotherapist.

Because lymph vessels are situated just under the surface of the skin, it is possible to stimulate them by means of gentle hand movements that direct the flow of fluid away from the swollen area into a part of the lymphatic system that is functioning properly.

Although not a cure, if used alongside the other cornerstones of treatment – compression bandages, exercise and skin care – MLD can reduce it to manageable proportions and bring huge relief.

To see how effective it is, we spent a day with MLD therapist Anne Schreiber at her clinic in Milborne Port, Dorset, observing how she treated a variety of lymphoedema patients.

Each session lasts between 60 and 90 minutes, and the instant results were remarkable .  .  .

9am Jo’s left arm

The first patient, yoga teacher Jo Waldon, 53, arrives. After discovering a lump in her left breast in 2000, Jo had a lumpectomy and five lymph nodes under her arm removed. Then, in 2004, her left arm swelled.

‘It was very heavy and tight and it was difficult to put on clothes,’ she says.

Jo was referred by her GP to Anne in 2007 and she has MLD twice a month. Even to the untrained eye, MLD looks very different from ordinary massage. There is no firm kneading, pushing or pummelling. Instead, the therapist’s fingers move lightly over the surface of the body, starting at the neck – the ‘M25 of the lymphatic system’, as Anne describes it. ‘It’s similar to a bottle – you have to empty the neck first to drain the fluid out.’


Anne, left, treats Jo Waldon's arm twice a month after she was referred to her by a GP

From there the therapist’s hands move down the body to the armpits, chest and abdomen, and then on to the problem area. Jo removes a compression bandage from her left arm, which looks almost twice the size of the right, and lies on  the bed.

Anne starts by treating Jo’s unaffected right chest and arm in order to clear it and make room so that the excess fluid from the swollen arm can move into the healthy area. She then moves across Jo’s upper chest, lightly touching the skin, clearing the passageways for the fluid to move from left to right. Judging by Jo’s expression, it is clearly very relaxing. Finally, Anne moves on to the swollen arm and hand. After treatment, they are visibly smaller and Jo is thrilled.

10.30am  Helen’s left leg

Anne’s next patient is Helen Lickerish, 47, an interior designer, who also comes to the clinic twice a month. When she was 32 and with a two-year-old son, she was  diagnosed with cervical cancer. She had a hysterectomy with the removal of lymph nodes surrounding the womb.

Seven years later, she noticed her left leg and foot swelling up. ‘It became horrible, really swollen and heavy. It affected my movement and balance,’ Helen says.

When she first visited Anne, Helen’s left leg was 50 per cent larger than her right. Anne bandages Helen’s leg before starting the treatment to encourage the movement of the fluid.

She starts by massaging her from the neck down to stimulate the lymphatic flow and its reabsorption. For the final 30 minutes, Anne works on the front and back of Helen’s leg. At the end of the session, Anne takes her measurements and notes that there is now only a 20 per cent difference between Helen’s left and right leg size.

Helen says: ‘I always notice the improvement. My left leg is definitely thinner and softer than before. It amazes me how something so gentle can be so effective.’

Anne doing the MLD massage on Haran's tennis ankle


12.30pm  Richard’s heart surgery scar

Retired theatre director Richard Black, 75, arrives. He seems frail. Richard suffers from heart and kidney failure and says he has MLD to help his circulation and ease pain caused by arthritis.

Although some Primary Care Trusts will provide funding for patients to receive MLD, not all do. Others fund only cancer-related lymphoedema, yet this accounts for just 25 per cent of cases. Richard gets his massage on the NHS. He had surgery after a heart attack aged 39 and has a large raised, painful scar on his chest. This scar contains large amounts of fluid, and MLD softens it by dispersing the build-up. He leaves in good spirits.

2.30pm  Haran’s tennis ankle

Haran Kunapalasingam, 33, is a mature student studying finance and business at Bournemouth University. He sprained his ankle playing tennis in 2000, causing it to swell for a while. He thought no more about it until 2008 when, after a series of long car journeys, the swelling returned. He first came to see Anne early in 2009, and after three sessions a week the swelling began to subside.

But Haran’s enthusiastic sessions at the gym have now made the swelling increase in size again, so he’s back. He looks healthy and fit but takes off his trousers to reveal a left leg that is twice the size of the right.

‘I can sit down for only an hour before  it gets uncomfortable,’ he says. ‘And sometimes I can’t get to lectures as it’s too swollen.’

Before treatment Anne measures Haran’s leg. Because of the dramatic increase in size, he will now have to return for sessions every day for a fortnight, and weekly after that. She gets to work, moving gradually down his leg to his swollen foot and toes. After the session, Haran has to squeeze his leg back into a compression garment. Anne cautions him not to overdo things, telling him to stick with the gentle exercises that she has shown him.


Equine Manual Lymphatic Drainage

Beauty treatment of the week: Manual Lymph Drainage detox treatment

24 January 2011 by Cosmo Team

This light touch massage assists the circulation of the body’s lymphatic system, helping to shift waste products from the cells and banish bloating. 


Like most people, we're trying everything to help us with our New Year body-boost and this beauty treatment is one that promises to help.

Manual Lymph Drainage has been bit of a beauty industry secret but now the merits of the treatment are being more widely recognised and it's being tactically incorporated into detox programmes.

The treatment is essentially a light touch massage that works to improve the ability of the body's lymphatic system and help cleanse you from the inside out. Although it doesn't feel like it's working wonders, the gentle movements performed by the specially trained practitioners are very specific and effective at increasing the rate of removal of waste products, toxins and excess fluid from the body's tissues.

It can be performed on the body to benefit bloating (by reducing water retention and aiding digestion) and shift cellulite, and on the face to promote clearer skin and reduce puffiness.

This super-relaxing treatment is tailored to your needs and is suitable post-surgery and during pregnancies. Just don't expect to have an invigorating massage experience as you'll feel short changed. This is specifically for boosting the circulation of the lymphatic system which at this time of year especially can be very sluggish meaning your body won't eliminate its waste efficiently.

After a session your digestive system will feel stimulated and it's important to drink plenty of water to help flush out the toxins.

It's recommended you combine a series of treatments with a detox diet for maximum benefits, or if you simply want to give your body a bit of a kick start a single treatment will help.

you can find a practitioner local to you at

Latest comments

16.05 | 17:31

Lumi is immensely knowledgeable and has really helped me so much with my lymphodema. Highly recommended for mld and Bowen. She is absolutely the best!

16.05 | 10:20

I have been seeing Lumi for a few months now for both MLD and Bowen technique massages and quite honestly I have never felt better! Lumi has been simply amazing, extremely knowledgeable, professional, very friendly and easy to talk to. I am very pleased w