Two widely used techniques in physiotherapy are MLD (Manual Lymphatic Drainage) and MFR (Myofascial Release). Both techniques have their own benefits, ways of application, indications, contraindications, and effects on the human body.
Although myofascial release and lymphatic drainage manually complement the effects of each other, and in some conditions might be used as each other’s substitutes; or in combination, there are still major differences between both techniques. People often confuse the two techniques because of the overlapping effects and benefits.
Techniques used in Myofascial Release and Manual Lymphatic Drainage
Myofascial Release (MFR) deals with any tightness in the fascia which is a connective tissue covering the muscles, nerves, and blood vessels.
Fascia tightness can give you pain and limit your movement during functional activities.
The MFR technique releases the tightness in the fascia and gives you relief from the symptoms as it restores normal movements and alleviates your pain.
Manual Lymphatic Drainage (MLD) deals with the lymphatic system which is a network of vessels and nodes for the removal of toxic waste from your body.
Many chronic conditions like cancers come with lymphatic system disorders including the accumulation of lymph or swelling of the lymph nodes.
MLD technique promotes the flow of the accumulated lymph fluid by applying a gentle rhythmic massage that stimulates the lymphatic system.
How are the Techniques Performed?
As we know fascia and muscle are the targets for the myofascial release and the lymphatic system is the target for the manual lymphatic drainage technique.
Considering the different targets for both techniques the method of application of both massages also differ.
Myofascial Release (MFR)
Here is the step-by-step process of MFR:
- Locate the area of fascial restriction. This can feel tight, tender, or rigid compared to surrounding tissues.
- Apply sustained, gentle pressure to the area. The pressure should be light to moderate – just enough to engage the fascia without causing discomfort.
- Wait for the fascia to respond. This can take several minutes.
- As the fascia releases, move in the direction of the release to encourage further relaxation.
Manual Lymphatic Drainage (MLD)
And here’s the step-by-step process of MLD:
- Start with slow, gentle strokes on the neck, where many lymph nodes are located.
- Move towards the lymph nodes in the armpits or groin, following the natural flow of the lymphatic system.
- Use light, rhythmic, pumping movements, focusing on the skin rather than the underlying tissues.
- Continue the process, encouraging the movement of lymph fluid toward the lymph nodes.
No special tools are required for MFR as the therapist used their own hands to apply the pressure and massage the fascia. In some cases, the therapist might use a foam roller or a massage ball to work on the fascia.
The same goes for MLD, the therapist applies gentle massaging force with their own hands and in some cases, soft brushes or a paddle wood massaging tool can be used for MLD.
Ease of Application and Side Effects
To apply MFR a therapist must have expert knowledge about the anatomy of the muscles and fascia along with the skills to understand the right amount of pressure applied on an accurate point.
For a person receiving an MFR massage, the tender point might hurt slightly at the start because of the pressure applied.
MLD also requires expert skills but is comparatively easier to apply than MFR because it is a very gentle and smooth massage type with fewer side effects or discomfort for the client.
To person MLD a therapist must know about the lymphatic system, the location of the lymph nodes, and the correct direction of hand movement while applying massage.
Benefits of Myofascial Release Vs Manual Lymphatic Drainage
|Myofascial Release||Manual Lymphatic Drainage|
|– Alleviates chronic pain |
– Improves mobility and flexibility
– Reduces inflammation
– Aids in recovery from sports injuries
– Enhances posture and physical functioning
|– Reduces swelling and edema |
– Enhances the immune system
– Aids in detoxification Promotes healing, especially post-surgical healing
– Helps with relaxation and stress relief
When to Go for Manual Lymphatic Drainage Vs Myofascial Release
Conditions where MLD is preferred over MFR
Lymphedema is characterized by the accumulation of lymph fluid in the body due to any damage to the lymphatic system. The fluid builds up in the body and swelling of the arms and legs occurs.
This condition often results when the lymphatic system can remove the toxins usually after cancer treatment. To stimulate the lymphatic system and help the fluid flow, MLD techniques are best used in such cases.
A systematic review suggests that manual lymphatic drainage could effectively reduce limb volume in patients with lymphedema, reducing discomfort and improving mobility.
Chronic Fatigue Syndrome
Chronic Fatigue syndrome is a condition characterized by extreme fatigue due to multiple reasons ranging from physical exhaustion to emotional depression. It is a constant feeling of being tired, dizzy, having body aches, and fever.
Myofascial release reduces the tension in the muscles and induces general relaxation. Manual lymphatic drainage technique also helps by providing detoxification effects.
If a person is seeking massage therapy for detoxification then MLD is the best option. By promoting lymphatic flow, MLD improves your immune functions and makes you feel relaxed.
Conditions when MFR is preferred over MLD
Mostly, chronic pain occurs due to tightness in the fascia. Releasing the tightness with massage and stretching thus reduces the incidence of chronic pain in people with fibromyalgia or migraine.
The sensitivity in patients with Chronic Low Back Pain (CLBP) can be reduced to a significant level using the myofascial release technique as seen in a research study.
Sports injuries that occur due to overuse of a muscle often include tightness of the fascia that restricts the movements and makes it hard for the athletes to play due to pain.
Myofascial release techniques are therefore widely used in sports for reconditioning, stretching, and alleviating fascia pain as MFR massage not only relaxes the muscles but also loosens the overlying fascia.
The use of MFR for improving range of motion and functional outcomes in athletes with musculoskeletal injuries is well reported in a paper published in the “International Journal of Sports Physical Therapy”.
Conditions when both MFR and MLD can be Used
Similar to lymphedema, fluid accumulation can occur after surgeries making your arms and legs swell. Adhesions and fascial restrictions are also common after surgeries because of the wound or scar formation.
Hence both MFR and MLD can be used after surgery to recover from the movement restrictions and adhesions as well as to reduce the swelling or post-surgical edema.
A systematic review suggests the positive effects of manual lymphatic drainage in reducing postoperative edema. Once the edema has reduced and in the later stages of recovery a person can benefit from MFR for restoring normal range of motion.
Fibromyalgia comes with widespread pain in the body that can be managed through MFR and MLD. MFR techniques are proven to improve pain, anxiety, sleep quality, and overall quality of life in patients with fibromyalgia.
MLD complements the effects of MFR by reducing inflammation and chronic pain in such cases.
Stress and Anxiety
Research studies show the effects of myofascial release therapy in decreasing anxiety levels in patients with fibromyalgia, similarly, MLD is also seen to improve the condition of postpartum women by reducing their stress and fatigue levels. These results can be generalized for other anxiety-related conditions as well.
MFR also tends to reduce the level of stress hormones as per some research, that’s why MFR not only relaxes your muscles but also makes you feel good. Thus a combination of MLD followed by MFR is preferred for optimum results.
Contraindications of MLD and MFR
Both techniques are generally safe when applied with care and precautions, however, some people might have injuries or disorders that could worsen after either MFR or MLD.
People with fractures, advanced stage of osteoporosis, skin conditions, bleeding disorders, and pregnant women should either not be treated with MFR or if necessary then treated with a healthcare provider’s consent.
Anyone with a malignant tumor, acute heart failure, acute inflammatory conditions, DVT (deep venous thrombosis), or severe kidney problems must avoid MLD.
Cost to get Manual Lymphatic Drainage and Myofascial Release
Both MFR and MLD typically fall within the same price range. A session can cost anywhere between $60-$110, depending on the therapist’s expertise and location. Prices may vary, so it’s best to check with local providers.
Myofascial Release and Manual Lymphatic Drainage are both valuable techniques in physical therapy, each with unique benefits, techniques, and considerations.
The choice between the two largely depends on individual health conditions, goals, and preferences. Always consult with a professional physiotherapist before starting either therapy.