Background: The history and development of manual lymphatic drainage (MLD) from Winiwarter to Vodder and the Vodder School of today are discussed.
Methods: The Vodder technique differs in the use of adapted pressure and its application. The constant change in pressure optimizes results, moving fluid in the skin, increasing lymphomotoricity, and softening fibrosis, with the positive side effects of reducing pain and relaxing tense muscles. Another difference from other methods is the technique of stretching skin, not sliding it. Because of the fluid content in lymphedema, which is different from all other edemas, the combination of MLD with compression treatment is the only solution for this pathology. Depending of it severity, each case requires individualized treatment. Phase 1 (intensive treatment) consists of daily treatment with up to two sessions per day for up to 2 hours. This phase is combined with special, individual skin care and remedial exercise. In phase 2, the goal of treatment is to maintain the results achieved in phase 1. The frequency of treatment is changed, but there is still the need for permanent, continued therapy.
Results: In phase 1, an average reduction of more than 40% of edema volume is achieved. In phase 2, the results are maintained and, with repetitions of phase 1, further improvement is possible. Thus, long term results with permanent improvement are possible.
Conclusions: Because of the complexity of the technique, no one can learn MLD in 1 week. Students require a great deal of correction, and the technique must be checked constantly. To become a certified Vodder therapy, a 4-week education program must be completed, and reviews must be attended every 2 years to maintain certification. The best education produces the best results for patients as long as patients are compliant. Therefore, the Vodder School also includes a patient education program as part of its curriculum.