Jan Douglass, PhD
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.
Courses with Jan
Articles by Jan
The thoraco-abdominal pump, how important is it to the lymph system?
The 2019 #Nobel_Prize in #physiology was awarded to three scientists for their work on the effect of oxygen in #cellular_metabolism ... and the action of the diaphragm during breathing is essential for normal lymphatic and cardiovascular health.
Why does MLD have such a profound effect on the Autonomic Nervous System?
Almost 50 years ago Prof. Dr. Paul Hutzschenreuter measured the effect of Dr Vodder's MLD on the sympathetic nervous system, noting a significant reduction in sympathetic activity within 5 minutes of beginning the MLD treatment. He coined the term sympatholytic which is now commonly used in lymphology.
Does MLD improve volume reduction in lymphoedema management? And does the technique really matter?
A recent SR and MA on standard therapy (compression with or without exercise and skin-care), compared to standard therapy with MLD, concl
Is it really fibrosis? Or is it thixotropic tissue change?
I had an email recently from a therapist who described her client as having deep pitting oedema and heavy fibrosis. Technically this is not possible. If the tissue is truly fibrotic then it really doesn't pit much any more. But in many ways they look and feel the same. So what is the difference and how can you tell ...
Body contours, swollen lymph nodes and dehydration, 3 facts about the lymph system you may not know.
Why do the tendons stand out on the back of your hand? What makes lymph nodes swell during an infection? How does being dehydrated increase nocturnal micturation?
Critical appraisal skills - the missing link for Therapists
The demand for level 1 studies is largely driven by academic needs, rather than tangible, clinically relevant outcomes.
Applied MLD, more than just lymphoedema
Dr Vodder's Applied MLD can effectively treat many of the common co-morbidities that impact on lymphoedema treatment. Using safe, pain free methods to address musculoskeletal issues, autoimmune diseases, digestive and respiratory issues can reduce overall inflammation, increase mobility and contribute to better outcomes in Lymphoedema reduction and management.
Measuring clinically relevant outcomes
An easy - and free - way for therapists to assess clinical progress is to use an analogue scale.This can be a numeric scale such as the one developed in 1932 by Rensis Likert (1) to measure attitudes. Typically a 5- or 7-point ordinal scale, respondents rate the degree to which they agree or disagree with a statement. It is essentially a rating scale, usually presented as a score between 1 - 5 or 1 - 10, where the person selects the number to reflect the perceived quality of a product or servic
Stretching helps resolve acute inflammation and reduce pain.
Gentle stretching forces help resolve acute inflammation, and reduce pain and immune cell infiltrate. This has implications for those of us
Lymphoedema services in regional Australia
I just did a quick search on the National Lymphoedema Practitioner Register #NLPR to see where people affected by lymphoedema have access therapist services. As expected people with the necessary training and skills are clustered in the metro areas and Melbourne and Sydney have over 50 therapists within a 100km radius of each city centre. Brisbane is not far behind with 48 Perth has 31. Everywhere else you will struggle to find more than a handful of therapists and even major centres like Canber
Using ICG to image the effects of MLD
What ICG fluoroscopy can't tell us, is what is happening in the deep system, nor the systemic effects of MLD which were shown by Heutzschenr
COVID-recovery and the role of MLD
..driven by the body's exaggerated inflammatory response to the virus and could therefore benefit from MLD therapy. Primarily due to the lig
Update on my Mum's new knee
My Mum's knee surgery went really well, after 3-weeks of MLD and exercise she has recovered almost full flexion and extension.
Another disappointing SR that fails to tell us anything new 😖
Systematic reviews are an academic exercise to ‘systemically review’ the existing literature on a particular research question. They are ...
lymph-angiogenesis
Initial lymph vessels and interstitium should not be thought of as separate entities, rather as a continuum responding primarily to mechanical forces. lymph-angiogenesis
MLD and dementia, one OT's experience. by Delbar Mehta.
Understanding the role of the glymphatic system in neurodegenerative diseases opens up new avenues for therapeutic interventions and reinfor
Lymphatic therapy for exercise and injury recovery among athletes
The bulk of published research on lymphatic therapies are on oncology patients, and the majority of these are on breast cancer-related arm lymphoedema (BCRL). So it's always exciting to find publications on something completely different, such as this study on MLD for post exercise regeneration of the forearm muscles of mixed martial arts (MMA) athletes. Zebrowska and colleagues (1) divided 20 MMA athletes into 4 groups and measured blood flow in the cephalic vein, maximal forearm strength ...
Why Elastic Tape Is a Game Changer for Phase 2 Lymphoedema Management
Evidence for the effectiveness of elastic taping as an adjunct in Lymphatic Therapies is also growing, and the most recent Systematic Review (SR) on elastic taping in lymphoedema management supports our collective clinical observations, and confirms that lymph taping is a vital option for people who have trouble applying traditional compression therapies.
From Manila to Perth and Back
Adrian first became interested in lymphoedema management when his Grandmother suffered with swelling later in life. As a Physio, and appalle
Every little bit helps
Next time one of your clients tells you they don't have time to do their own self-treatment for lymphoedema - tell them it only takes 10 minutes! A recently published study conducted in Japan has shown that even 10-minutes a day can improve people's experience of their lymphedema (1). The program is based on the Japanese rajio taiso, a 3-minute national health program to encourage daily exercise which is broadcast several times a day on public TV and radio. The study program included :1. Gentle
Lymphoedema in Rural Bangladesh
My main role at the Centre for Neglected Tropical Diseases #CNTD - so far - has been to design and implement a study to see if we can improve on self-management for people affected by moderate to severe #LymphaticFilariasis and #Podoconiosis related #lymphoedema. And after almost a year of planning we started data-collection in Nilphamari District in north west Bangladesh at the beginning of October. Back at the beginning of my PhD research I conducted a systematic review on self-management fo
5 Reasons you need Applied MLD
Whether it's long-COVID brain fog, frozen shoulder, or long-term inflammatory disease, Applied MLD offers a lymphatic approach to treatment.
Lymphatic pathways, mapping your dynamic immune highway.
This post offers a brief review of the lymph pathways and a visualisation to imagine your own lymphatic system.
Lymphoedema and the Roadmap to 2030
Between COVID, climate change and the exponential growth of our connected world, it is obvious to me that we must now behave as as global co
The lymphatic system does not 'de-toxify' your body
there is no such thing as a lymph gland, the parasympathetic nervous system can be directly simulated by MLD & MLD does not remove fat cells
Another ICG update, do we need to change anything?
ICG imaging provides interesting visual data on superficial lymph pathways, and I love the way imaging can help us to understand the lymph system better, but I challenge that what has been found changes anything about how we perform MLD for unilateral BCRL of the arm
Lymphoscintigraphy guided MLD
It's exciting how much imaging is going on in the lymph system these days! And with this paper on lymphoscintigraphy guided MLD (1) I can see a future where we will be able to combine systems to create a 3D map of everyone's lymphatic system and know exactly where the open pathways are.
Revival of the World's Best Kept Beauty Secret
MLD helps to minimize bruising and hematoma formation and reduce pain and discomfort associated with plastic or cosmetic surgery. By quickly
Lymph flow, valves and why lymph loading is so important
Recent findings that lymph flow influences the formation and maintenance of the valves in lymph collectors is a valuable piece in the jigsaw puzzle that is our understanding of lymph formation and transportation. For me it was one of those pieces that just slotted into a little gap and suddenly explains a lot. The ....
Frozen shoulder - pain free in two treatments with Applied MLD.
Adhesive capsulitis, also known as frozen shoulder, is a condition characterized by pain and restricted range of motion at the shoulder joint. The cause is often unknown and can take longer than a year to resolve. The client's reduction in pain and increased range of motion following just two 1-hour sessions of MLD treatment is encouraging and suggests that MLD could be a useful treatment option for this condition.
MLD for post-COVID symptoms and the ?forgotten? intercostal pathways
Intensive drainage of the intercostal pathways are used during MLD for upper torso and arm lymphoedema, and along with the bronchitis techni
Navigating the Medical Publishing Maze - How we Published our Long-COVID Case Report
It is easy to say that we need to publish more of our Case Studies, but that simple statement belies the very challenging and expensive process involved in medical publishing. As Massage Therapists without any experience or training in academic writing, Bronwyn Overall and Kaori Langley did a stellar job of conducting and recording their results using MLD to resolve the symptoms of long-COVID in two cases.
MLD & the mechanics of skin-health
We can now link the very precise stretch and shear forces created by the original Dr Vodder method to the formation of new lymph vessels and the pathway of the pre-lymphatic channels, tissue healing on a molecular level and restoring the properties of the connective tissue fibres and skin-health.
The complex interactions that control lymph flow, and how Dr Vodder's MLD exploits them
A variety of intrinsic and extrinsic forces act in a co-ordinated way to maintain a constant lymph flow. New insights into how specific factors may be at play in different tissues and body regions, provides a neat connection to how MLD is applied, and the pronounced effect we see on lymph flow as a result.
Shedding light on fluorescent imaging
Also called near-infrared fluorescence imaging (NIRFI) or near-infrared fluorescence lymphatic imaging (NIRFLI) the technique uses a very sm
Does MLD make everything better?
Well obviously, not EVERYTHING, but ask that question of the client at the centre of this case study and they would give you a big "YES" and
MLD & CRPS
Early and frequent MLD may prevent the newly forming lesion from developing, and in more progressed disease MLD will be effective in this ki
Keeping up to date in the fast moving world of lymphatics
Research on #lymphatic_physiology has advanced in leaps and bounds. #Lymph_nodes are no longer passive filtering stations, rather the very walls of the nodes are controlling some immune interactions. #Lymph_vessels are not just a system of pumping units, we now know that the #endothelial_cells are actively checking...
Smashing another long held belief in lymphology
Just when you thought the lymphology couldn't get any more fascinating, latest research show neuro-cellular connections inside lymph nodes
Lymph Taping update - the debate on replacing #compression with #lymphtaping continues
Could the inclusion of waving equidistant tapes over a large area of unaffected skin account for the better results observed during taping?
The Crucial Role of Mechanical Forces in Wound Healing and Scar Minimisation
Understanding and mitigating excess scar formation is of paramount importance in allied health care, and MLD and Elastic Taping are two of the most effective modalities in your scar management tool box.
My 10 favourite facts about MLD
explain the scientific basis of the effects of MLD, the specific tissue or system effects achieved by individual techniques, and the expecte
'Tis the Season to Be Jolly: Why Laughing is Good for Your Lymphatic System
The idea that simple actions such as talking, shouting, singing , laughing, crying, sighing and yawning can influence our physical health dates back to the 19th century, and Harry Campbell’s observations published in the The Lancet in 1897 laid the groundwork for understanding how these actions affect circulation.
Lymphatic endothelial cells, so much more to know!
The study looked at how the lymphatic endothelia cells behave when there is tissue hypoxia, so there are three interesting things here. How
Why I dislike 'keto'
... not surprising when you consider the strong links between lymphatic disease and fat disorders, they are reciprocal risk factors for each
Brain drainage – what’s all the fuss about?
An area of great excitement in lymphatic research - and I think great confusion - is the ‘new discovery’ of ‘lymph vessels’ in the brain. The idea of functioning lymph vessels inside the brain is fascinating, as is every new discovery in lymphology, but the research doesn't exactly show this.
Obesity Matters: How do You Know if You are Overweight and Why Jumping on the Scales May be a Bad Idea.
As many of us resolve to lose weight this year, it’s vital to consider how success is measured to avoid unrealistic goals and setbacks. BMI
The Unique Innervation of Facial Skin: Why MLD Facials are So Good.
Comparing innervation of the facial skin and the rest of the body affords us an appreciation of the direct connection that skin has to autonomic centres of the brain, and explains how the seemingly simple techniques of MLD, which are mainly gentle, repetitive, circular movements of the skin, can have such a direct effect on both vascular issues such as rosacea, and in emotional stress such as anxiety.
Basic Pre-Quiz, how did you do?
The Basic Pre-Quiz is being updated. Here are the results on the 500 responses received
March is the month for raising #LymphoedemaAwareness
Depending on where you are in the world you can celebrate #LymphoedemaAwarenessMonth (AU) #LymphoedemaAwarenessWeek (UK) #WorldLymphedemaDay (USA) In Australia, the Australasian Lymphology Association is focusing their lymphoedema awareness campaign on early detection. Read more....
Why MLD should be started as early as possible.
There's nothing quite so satisfying as reading a well written paper which summarises everything interesting that we know about the lymph system. In this regard, the recent paper by Weber et al (1) is a good read for anyone fascinated by lymphatics, regardless of academic ability. Personally I can't help but make connections with the descriptions given, and what I know about lymphatic physiology and the effects of MLD. It's also very affirming when new understandings in lymphology, support the b
LKN Foundation launches during #LymphoedemaAwarenessMonth
By now I knew that I was never going to be in a financial position to volunteer large chunks of my time to work in LF-endemic countries, so
Its never too early to start MLD
Thompson et al, found evidence for MLD to prevent onset in early breast cancer patients and to reduce arm volume in early stage lymphoedema
What is the best measure for lymphoedema?
There has been a lot of discussion lately around systematic reviews and RCTs on the effectiveness of MLD in our treatment mix. Measuring tre
Wound Healing, Tissue Repair and Scar Formation; How Early Application of MLD Improves Visual and Functional Outcomes for Almost Everything
Accelerated Wound Healing with Manual Lymph Drainage (MLD). Learn how MLD promotes lymphangiogenesis, reduces scarring, and enhances tissue repair. Discover its role in accelerating acute wound healing and preventing chronic wounds like venous ulcers.
Brain inflammation and neurodegenerative diseases. Can MLD prevent progression?
Cerebral spinal fluid (CFS) is sometimes referred to as a 3rd circulation system, functioning as the lymphatic equivalent to clear wastes fr
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
How can Vodder's MLD resolve trigger points without pain?
People are often surprised when I start talking about #MLD to resolve trigger points, or treat conditions like #adhesive_capsulitis and #piriformis_syndrome. This article describes how #Vodders #MLD resolves #trigger_points, #joint_stiffness and #myofascial_pain.
How to write a case study and why we need them
Randomised controlled trials are not suited to assessing the effectiveness of treatment of lymphoedema and other chronic diseases.
Inflammation and fibrosis in lymphoedema. What's really going on and does MLD help?
While there are multiple studies showing that MLD & CDT reduce the symptoms of inflammation and can reverse some fibrotic changes, there is
Taking best practice lymphoedema self-care to Asia and Africa
More than 20 years ago when I first learned about lymphatic filariasis, I knew straight away where I wanted to work. 15 years in the clinic and 8 years in research later I started on a PhD on filariasis-related lymphoedema
MLD and total knee replacement
Next week my Mum will have a knee replacement. Scans show almost no cartilage left between the condyles and the tibial plateau, and the meniscus is sever disintegrated. I already know how much MLD will benefit, because of the physiological effects of MLD, and my experience in treating many clients after TKR.
Breaking the Cycle of Inflammation with MLD, Effective Drug-free Therapy for Symptom Management in MCAS.
Explore how Mast Cell Activation Syndrome (MCAS) is influenced by environmental factors and how Manual Lymphatic Drainage (MLD) helps reduce inflammation and manage symptoms effectively.
Almost all women treated for vulvar cancer will have symptoms of lymphoedema in the first 2 years
One of the most important things about this study is that it used self-reported-symptoms (SRS) to determine if lymphoedema was present,...
How do new discoveries in lymphology influence our clinical practice?
Across two decades of teaching therapists how to interact with lymphatics through MLD and Lymph Taping, I have witnessed an explosion in research on lymphatic function and disease.Some observed truths have been completely reversed,like the advice around exercise for people affected by lymphedema. Once it was shown that any post-exercise swelling is temporary, and that overall people who exercise have better lymphedema outcomes than those who don't, our advice did a big 180 turn from don’t overlo
Does MLD make you sick?
A long time ago I made the mistake of watching some YouTube videos purporting to teach Dr Vodder's MLD and was quite disturbed by the number of chats insisting that you should feel nauseous or ill somehow after lymph drainage. There was even an insistence in some comments that it hasn't worked unless you feel dreadful. This is the exact opposite of what I have learned and observed in nearly 25 years of performing MLD. If you are receiving Dr Vodder's MLD you should not have headache or nausea
Lymphoedema in Rural Ethiopia
The study I am involved with through #CNTD on enhanced #self_care for people affected by moderate to severe #LymphaticFilariasis and #Podoconiosis related #lymphoedema has started in Ethiopia. We recruited our participants in November and then did a four-week follow-up in early December. The study methods are the same as in Bangladesh (see the post Lymphoedema in Rural Bangladesh), but the two countries and the patients are worlds apart.Access issues in Bangladesh were mainly due to roads and wa
MLD for Pain and Stress
When I teach MLD we talk a lot about the way the body responds to stress. We're all familiar with the symptoms, sweaty palms, knotted stomac
Winter-days in Walchsee
The Dr Vodder Akadamie International hosts an International Teacher Meeting and Lymphology Conference every 18 months, so in alternative years we have "Winterdays" and "Summerdays".
A Pressing Matter: What is the Right Pressure in Lymphatic Massage?
The reality is that effective lymphoedema management demands an individualised approach. One that takes into consideration the progressive nature of lymphoedema, and delivers a nuanced application of MLD appropriate to the presentation, and a tailored self-care program designed to deliver optimal outcomes for the investment made in time, effort, and family resources that lymphoedema inevitably requires.
Doing Good or Doing Harm: The Pitfalls of Compression Therapy in Lymphoedema Management.
Lymphoedema is a daily challenge, even for those with access to the best specialty care. For most, poverty, ignorance and stigma with amply these challenges. #LymphoedemaTherapists are not well placed to address world poverty, but we can make a considerable contribution to raising awareness by spreading quality information wherever we can.
AromaticaLymphatica: A Synergistic Blending of Ancient Remedies and Modern Lymphology.
"AromaticaLymphatica" is the modern synthesis of ancient aromatic arts, with advances in lymphology, to maximise the synergistic potential and create next level Lymphatic Therapy.
Elastic Taping; A Non-Drug Therapy with Potential to Prevent Chronic Post-Op Neuropathic Pain.
Discover how elastic taping techniques offer promising, drug-free relief for post-surgical pain and may help prevent chronic neuropathic complications. Explore evidence-based non-pharmacological pain management strategies, including Kinesio taping, for better post-op recovery and long-term outcomes.
Using Guided Meditation to Embody Lymphatic Anatomy and Improve Clinical Clarity.
For students of lymphatic therapies, mapping the vessel pathways can feel like navigating a shapeshifting landscape. Guided meditation focuses on inner sensation and perception to assimilate two dimensional, text-based descriptions, and internalise the lymph vessels and pathways using you own body as a reference map. Research shows these exercises do more than aid learning, they can reduce study-related stress and lead to increased clinical confidence and observation skills.
Self-Care: The Essential Key to Chronic Pain Management
Celebrate International Self-Care Day by exploring the essential nature of self-care in chronic pain management. True self-care involves sustainable strategies that support both body and mind.
Pain, Itch, and Inflammation; Why You Want to Scratch that Healing Scar
It's natural for us to touch, hug and stroke those we love. These caring actions don't just maintain our social networks, they are rooted in biological processes which ensure the skin remains healthy, and that immune reactions favour would healing and tissue repair. Recent research has illuminated the role of itch in the context of immune function, lymph formation, wound healing, and connective tissue homeostasis
From Lymphoedema to Alzheimer’s: The Expanding Role of MLD in Ageing Well
Discover the role of MLD in healthy ageing. Learn how Manual Lymph Drainage can improve ageing well by reducing inflammation and boosting brain health.
Why Systematic Reviews Can’t Guide Clinically Relevant MLD Practice for Post-Knee-Replacement Clients
Explore why Systematic Reviews fall short in guiding MLD practice for post-knee-replacement clients. Understand the limitations of Systematic Review findings.
Lavender Essential Oil, Inflammation and MLD: Synergistic opportunities in Lymphoedema Prevention.
Explore how Lavender essential oil can reduce inflammation and support lymphoedema prevention. Discover Lavender's potent synergy with MLD.
The Invisible Superhighway: Why Your Gut-Lymph Axis is the Secret to Immunity Inflammation, and Weight Management
Explore how the gut–lymph axis influences immunity, inflammation and weight management, and learn practical ways to support a healthy lymphatic system.
The Science of Seamless Recovery: Why MLD is Essential After Cosmetic Surgery Recovery
This professional guide highlights the crucial role of MLD in cosmetic surgery recovery. The Vodder Method has been shown to reduce post-surgical oedema and minimise scarring for superior aesthetic outcomes.
Revised Starling Equilibrium and the Endothelial Glycocalyx: Why Are We Still Getting This Wrong?
Groundbreaking evidence that changed our fundamental understanding of fluid dynamics at the capillary was published in 1999 (1), However, the 'old' model, where most interstitial fluid was thought to be resorbed at the venous end of the capillary, is still being taught in most lymphatic programs, and even Chat GPT gets it wrong! This post reviews the Starling Equilibrium and the Endothelial Glycocalyx and highlights the importance of understanding fluid dynamics in lymphedema management.
The Cost of NOT doing MLD in Phase 2 Lymphoedema Management.
Learn why skipping Manual Lymphatic Drainage (MLD) during lymphedema maintenance incurs a hidden cost on quality of life and symptom control. We analyze peer-reviewed evidence to show MLD's active role in promoting lymph flow, the need for continuous professional support, and tailored solutions for complex cases like leg lymphedema.
MLD vs Pressure Massage: Which One When?
Compare the physiological differences between MLD vs pressure massage. Learn how the body responds to each can inform clinical choices and understanding the mechanism that make MLD the treatment of choice in acute or chronic oedema, recovery, and chronic pain.
Why MLD is Essential for Facial Cosmetic Surgery: The Science of Manual Lymphatic Drainage in Aesthetic Rehabilitation
Explore how the precision of the original Dr. Vodder MLD technique transforms cosmetic surgery recovery, from managing rare lymphedema risks to accelerating skin rehabilitation and reducing stress.
Clearing the Mind: MLD and Glymphatic Health in an Age of Neuroinflammation
Explore how Glymphatic health and Manual Lymph Drainage (MLD) can combat neuroinflammation and boost neurological longevity. Discover Glymphatic insights now!
The 24/7 Reality: Why Self-Care is the Cornerstone of Lymphoedema Management
Discover why self-care is the cornerstone of lymphoedema management. Learn how daily habits and therapist support can transform long-term health
Why Lymph Flow Matters: Human Skin Lymphatics, Tissue Health, and the Power of MLD
Explore the cellular science behind MLD. Learn how human dermal lymphatics differ from mouse models and how manual therapy reverses tissue hypoxia and ECM fibrosis.
Unblocking the Drain: How Glymphatic Discoveries are Revolutionising Mental Health, and the Promise of Lymphatic Drainage in Neurotherapy.
Explore how neuroinflammation impacts dementia and mental health, how the glymphatic system depends on peripheral lymphatics, and why Manual Lymph Drainage (MLD) offers a promising treatment for long-COVID brain fog and neurodegeneration.
Can Targeted MLD Maximise Surgical Outcomes after Liposuction and LVA?
Discover how combining targeted MLD with advanced surgeries like LVA and liposuction for lymphoedema and lipoedema, can transform outcomes in post-surgical rehabilitation.
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