Manual Lymphatic Drainage (MLD) is a specialist massage technique used in the treatment of lymphoedema. Training in the Casley Smith method is one of thesix recognised schools of MLD. The technique was developed by Drs Judith and John Casley Smith, co-founders of the Lymphoedema Association of Australia (founded in 1982). The technique was based on the Földi methods and principles of treatment and was taught in the first practice – based courses delivered outside Western Germany (Casley Smith and Casley Smith 1997).
The method provides a systematic approach to the clearance of the lymphatic drainage regions (Földiand Kubik 1989) and the technique comprises of varying hand manoeuvres, effleurage strokes and breathing exercises. The technique is delivered in a slow and rhythmical fashion using gentle pressures. MLD is usually provided within a programme of physical therapies, including exercise and skin care. The swollen area may also be bandaged or a compression garment used to provide support to a swollen limb. When MLD is used to treat severe or complicated lymphoedema (such as swelling of the body as well as a limb) it is usually given on a daily basis over two to three weeks. The time spent each day will depend on the site and size of the swollen area but will always include treatment of the main drainage routes in the body. The technique utilises a number of specific techniques, some of which can be simplified into slow effleurage movement over the skin which the patient or carer can learn as part of a self-management routine.