How does Dr Vodder's MLD affect small blood vessels?

Manual Lymph Drainage, developed by Emil and Estrid Vodder over 80 years ago, has gained recognition around the world for its effectiveness

Manual Lymph Drainage, developed by Emil and Estrid Vodder over 80 years ago, has

The Vodders & Wittlingers during a training break
The Vodders & Wittlingers during a training break

gained recognition around the world for its effectiveness in the treatment of lymphatic disorders.

What is less well know is the effect on small blood vessels which makes MLD


very effective in the treatment of vascular disorders such as rosacea, and in post-surgical tissue recovery.

In fact it was Aestheticians who first seized on MLD for its decongestive and beautifying effects on the skin of the face, and modern plastic surgeons frequently recommend peri-surgical MLD to achieve the best possible cosmetic outcomes.

The very light nature of MLD is part of the reason for these effects.

The application should not exceed 40 mmHg, which is about the same pressure applied by a little stack of 4 x $1 coins sitting on the skin.

MLD creates precision stretch and recoil forces in the skin and subcutaneous tissue without sliding
MLD creates precision stretch and recoil forces in the skin and subcutaneous tissue without sliding


The circular stretch and release forces that are applied obey the limits set by the collagen septa between the skin and underlying fascia, and the natural elasticity of the skin is harnessed for the recoil. As there are no strong compression forces or stress applied to the tissue, the repetitive movements have a very calming effect. This effect was measure by Professor Hutzschenreuter who conducted many experiments on Dr Vodder's method and found that 5 minutes after commencing #MLD there were significant reductions in sympathetic activity in both the patient and the therapist. You can read more on this at #TalkingLymph on MLD for Pain and Stress.

This 'sympathicolytic' effect as Hutzschenreuter called it - meaning to reduce the sympathetic activity in the body - is also responsible for the effect of MLD on the small blood vessels. When there is any tissue damage or inflammation, pressure inside the small blood vessels increases and the skin appears pink or flushed as can be seen in the before photo below.

One week after surgery, before (left) and 24 hrs after MLD (right). Treatment by M Gaynor.

The pre-capillary sphincter which controls blood flow into the capillary is relaxed under MLD and blood flow increases without any increase in capillary pressure (something else Hutzschenreuter investigated). In the before and after photos the inflammation and pinkness seen before MLD has reduced and the puffiness in the before photo is gone. granted these results are subtle, but we are talking about microscopically tiny blood vessels and structures, and we would need a special camera to see the result more clearly (our photos are not that great for these kinds of close-ups).

MLD usually has a superior effect on small vessels conditions like rosacea because of this effect on the capillaries. Other forms of massage, whilst generally relaxing, usually have the opposite effect on small blood vessels. When heavy compression, friction or deep tissue manipulations are performed, capillaries and small blood vessels are also compressed and even damaged and this increases capillary pressure and exacerbates existing inflammation.

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Jan Douglass
Jan Douglass

Jan has been practicing and educating in manual body therapies since 1986. Specialising in MLD and Lymph Taping, she became an Accredited Practical Instructor with the Dr Vodder School in 2002 and a certified Lymph Taping Instructor in 2017. Her diverse background includes eight years as the senior lymphoedema therapist at Flinders Medical Centre Breast Oncology Clinic, and trial coordinator at Flinders University. With a PhD in lymphatic dysfunction, Jan has consulted internationally for the Liverpool School of Tropical Medicine and co-founded the LKN Foundation Ltd in 2021 to support global lymphoedema management.

Read more articles by Jan

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