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Manual Lymphatic Drainage and Compression Bandaging: The Lymphoedema Treatment Process
How manual lymphatic drainage is done, how long compression bandages stay on and how compression garments are chosen: intensive and maintenance phases of lymphoedema treatment.
Contents
Complete decongestive therapy (CDT), the gold standard for lymphoedema, has two phases: an intensive phase to reduce swelling and a maintenance phase to preserve results. Its cornerstones are manual lymphatic drainage and compression.
Manual lymphatic drainage (MLD)
Unlike classic massage, MLD uses very light, rhythmic, directed strokes to stimulate superficial lymph vessels.
- It starts by clearing healthy lymph regions away from the swelling (neck, opposite armpit, groin).
- Fluid is directed from the damaged area towards working pathways.
- Pressure gently stretches the skin and should not cause pain or redness.
- Sessions last about 30–60 minutes.
Not used with active infection (cellulitis), untreated DVT, uncontrolled heart failure, or active cancer where the doctor advises against it. A medical assessment is essential first.
Compression bandaging
After MLD in the intensive phase, multi-layer short-stretch bandages prevent refilling, improve the muscle pump and soften hardened tissue.
| Layer | Material | Purpose |
|---|---|---|
| 1 | Cotton stockinette | Protect the skin |
| 2 | Finger/toe bandages | Prevent hand or foot swelling |
| 3 | Soft padding | Distribute pressure, protect bony areas |
| 4 | Short-stretch bandages | Provide the main pressure |
Bandages usually stay on day and night and are renewed each session; the intensive phase lasts about 2–4 weeks. Loosen them and call the physiotherapist for numbness, tingling, discolouration, increasing pain or cold fingers.
Compression garments
In the maintenance phase, custom-fitted stockings, sleeves or gloves are used: measured when swelling is lowest (usually morning), with the pressure class set by a professional, worn during the day, replaced about every 6 months, with donning aids if needed.
Exercise under compression
Deep diaphragmatic breathing, finger, wrist and elbow movements for the arm, ankle pumps and knee bends for the leg, and gentle walking, swimming or water exercise.
Patients and families also learn simple self-drainage, key to long-term success.
We provide home MLD, bandaging, exercise and self-care training across Yalova, especially for arm lymphoedema after breast cancer and leg lymphoedema, with plans in Bursa, Istanbul and Kocaeli–Gebze.
