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Manual Lymphatic Drainage Technique Certification

Approved for 8 Online Continuing Education Units/Credits (CEU's) for Pennsylvania Licensed Massage Therapists

Receive Your 8 CEU's Now

Approved for 8 Online CEU's for Pennsylvania Licensed Massage Therapists. Cost $100.00 / Certificates Awarded Upon Completion.

Please allow time for your purchase to process. We will contact you via email with instructions to access the online course as soon as your payment is complete. Please make sure your email address is correct. Thank you for your patience. 


Manual Lymph Drainage (MLD) is a gentle, light, rhythmic manual technique that has been used by massage therapists and other professionals since the early 1930s. There are several different manual techniques currently used in the massage and manual therapy fields that affect the lymph system. The most well known of these is the Dr. Vodder method of MLD, and it can have dramatic effects in the body if performed correctly. The Dr. Vodder method of MLD is a well-researched technique, and later in the chapter, references to current research are given. A Danish couple, Emil and Estrid Vodder, first developed and documented MLD in France in the 1930s. This was the first time that a systematic method of manually affecting the lymphatic system had been described, although others had mentioned the use of massage in treating swelling.1 The technique is now taught worldwide, primarily in Europe, North America, Australia, and Asia.

MLD has been developed for use in treating many different conditions including lymphedema (swelling), orthopedic conditions, sports injuries, dermatologic conditions, and stress. A thorough comprehension of the lymph vessel system enables an understanding of how MLD can affect various systems in the body. Beginning with the history of the development of MLD, this chapter describes the lymph vessel system and how MLD can affect it. The various strokes and techniques are described in detail, and then the effects of MLD are discussed. With this basic knowledge, the reader will be able to understand the effects of and indications for MLD.

Manual techniques to affect the lymph system have been described in the literature since the late 1800s. Von Winiwater1 described massage for swollen limbs as follows:

It is best to start with the manual treatment of those parts of the body which are in the immediate vicinity of the root of the swollen extremity. In order to influence lymphatics and veins, the extremity itself is treated only later on. Dependent upon what the aim of the treatment is: to crush or to divide hardened infiltrates, or to help reabsorption, or to move a stagnant tissue fluid centrally, various forms of massage can be used. Those masseurs who boast about all their force and proudly inflict bruises on their patients are of lesser help than a clever layman! After every massage treatment, passive movements of the swollen extremity should be performed methodically.

More specifics about the treatment of swelling are given later in the chapter, but it is of interest to note that in the 1800s massage techniques were already recognized as being effective for reducing swelling.

In the late 1800s and early 1900s various osteopathic techniques were described by Still and others to affect the lymphatic system, primarily through “pumping” movements over the lymph nodes and organ and spinal manipulations.2


Emil Vodder was born in 1896 in Copenhagen, Denmark. Dr. Vodder initially studied biology and then medicine in Brussels, Belgium. Due to illness, he was unable to complete his medical studies and was subsequently awarded a doctorate in philosophy in 1928 by the University of Brussels.

Dr. Vodder worked with his wife, Estrid Vodder, a trained naturopath, treating patients in Cannes, France, in a physical therapy institute from 1929 to 1933. During this time they studied what little was known about the lymph system using anatomic charts and medical texts that had little information about this important system. They were firm believers in treating the whole person. Partly through their studies and partly through intuition, they developed the techniques that are still used today to influence lymph flow in the body. The Vodders accumulated experience with patients, especially those with upper respiratory tract problems such as rhinitis and sinusitis. In 1933 they moved to Paris and continued their studies into the lymph system. They presented their techniques at a health conference in Paris in 1936, which was the first time the Dr. Vodder method of MLD was exposed to the world. Newspapers reported on lymph drainage as a revolutionary skin treatment. Dr. Vodder wrote an article on MLD for the Parisian journal Santé et Beauté pour Tous in 1936.34

The Vodders’ MLD treatment techniques consisted of gentle, rhythmic, circular motions that focused on moving fluid toward the lymph nodes. The Vodders found that they were able to reduce swelling and congestion of areas drained by these nodes. They later established the Dr. Vodder Center in their native Denmark, where they used these treatments.

In 1965 the Vodders met massage therapists Hildegard and Günther Wittlinger as well as a German physician, Dr. Asdonk. Together, they developed specialized Vodder techniques for use in medicine (Figure 7-1). Clinics were subsequently established in Austria and Germany.

FIGURE 7-1 ​Emil Vodder, Günther Wittlinger, and Estrid Vodder, 1984. (Courtesy Professor Hildegard Wittlinger.)

The technique was so successful in Germany in treating edema, especially lymphedema, that it was recognized by the national German medical insurance program and then prescribed by physicians. It has since become the most prescribed physical therapy technique in Germany. At a conference in Austria in 2013, it was reported that over 60,000 physical therapists have been trained in Dr. Vodder’s MLD techniques in Germany alone.5

Dr. and Mrs. Vodder legally designated Hildegard and Günther Wittlinger to be their successors and authorized them to teach and to train teachers in the original Dr. Vodder method of MLD. In 1971 the Wittlingers established the Dr. Vodder School and Clinic in Walchsee, Austria. It is an internationally recognized study center for this method. The Wittlingers have taught extensively in North America and have established the Dr. Vodder method as the premier lymphatic drainage technique. The Dr. Vodder method of MLD was first introduced to the United States by the Wittlingers in 1972 at a conference in New York and was introduced in Toronto, Canada, in 1982.

This chapter describes the Dr. Vodder method of MLD. An overview of the history of MLD is given, from the origination of this technique by Emil and Estrid Vodder in 1932 to the present day. The lymph vessel system has until recently been an underrecognized system of the body, often described as merely an adjunct to the blood vessel system. To help the reader understand the impact of MLD, the anatomy of the lymph vessel system is described in detail, from the initial lymph vessels in the interstitium of the skin to the major lymph ducts returning lymph into the main veins entering the heart. The importance to health maintenance, fluid balance, and fat deposition has been noted.

The various techniques of the Dr. Vodder method of MLD are described, and the effects of MLD on the nervous system, tissue drainage, and the smooth muscles of blood and lymph vessels are discussed. Therapeutic applications of MLD are outlined, including the treatment of lymphedema, the most widely known application for MLD. The major contraindications for MLD are included. The chapter finishes with an overview of the certification process required to become a Vodder-certified MLD therapist.

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Receive Your 8 CEU's Now

Approved for 8 Online CEU's for Pennsylvania Licensed Massage Therapists. Cost $100.00 / Certificates Awarded Upon Completion.

Please allow time for your purchase to process. We will contact you via email with instructions to access the online course as soon as your payment is complete. Please make sure your email address is correct. Thank you for your patience.