The Dr Vodder Manual Lymphatic Drainage (MLD) Technique

Combined Decongestive Therapy

Combined Decongestive Therapy (CDT) is a combination of treatment approaches including manual lymph drainage, multi-layer compression bandaging, tailored compression garments, exercise and self care.

Who needs CDT?

Treatment is individualised for each lymphoedema client and not all components of treatment may be necessary in all cases. Those with mild lymphoedema may only require education, exercise and skin care whereas for more severe cases treatment may be longer and require two phases.

Phase I is an intensive treatment provided by a trained Lymphoedema Therapist followed by Phase II, which is self management that you, the client, continues at home. With improved health education people are reporting early limb changes promptly and this is contributing to a reduction in the need for intensive treatments.

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Phase I – intensive

Phase Is all about getting the extra lymph out of the arm, hand, or other part of the upper body to reduce visible swelling and other symptoms of lymphoedema. This phase typically involves a number of treatments which alway have Manual Lymph Drainage followed by applying multi-layer compression bandaging and providing exercise plans. You need to move the lymph by physically moving, so this is encouraged. As we progress through the treatments, I will show you how to apply the bandages on your own so that you can remove them for showering and bathing.
**The costs to complete a reduction phase will be pre-quoted which will cover the multi-layer bandaging (you own and keep), the exercise plans and the the treatment time and frequency. This need to be agreed prior to commencing this intensive phase**

What is optimal?

Optimally I would treat each day from Monday to Friday with weekends off. Treatment frequency and dosage is individually tailored so this time frame will be discussed and agreed. I realise it’s a lot of a commitment time wise, financially, physically and mentally to go through this each day.
– I recommend at 5 x a week for at least two weeks to see how you progress as an individual.
– Less than 5 treatments in the first two weeks will extend the overall treatment time and most likely poorer results

Phase II – self management

Phase II is all about self management and maintaining the results of the initial intensive phase, on your own. This phase includes getting fitted for compression sleeves for arms, garments for you legs e.g. pantyhose, capris or stockings to control the lymphoedema. You will learn how to put these garments on correctly and the appropriate care for these garments.
*I will continue to work with you to create a long term plan to help you maintain control over your own condition

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Further reading and support

  • Lymphedema Guru – YouTube video on Combined Decongestive Therapy *note based on US (LANA) however in New Zealand we are affiliated with the Australasian Lymphology Association (ALA) for accreditation<
  • Lymphoedema NZ – click here
  • Breast Cancer Foundation New Zealand – click here
  • Australasian Lymphology Association – click here
  • Alexa’s recent CDT treatment – click here
  • Move that lymph!