Manual Lymphatic Drainage for Upper Limb Lymphedema: A Clinician's Perspective for Its Adaptation

Upper limb lympedema is a frequent consequence of breast cancer treatment. The International Society of Lymphology recommends physical therapy for lymphedema management. This treatment includes a combination of manual lymphatic drainage and high-compression bandaging. Actually, the effectiveness of manual lymphatic drainage remains an area of controversy, especially because of the many different techniques called "manual lymphatic drainage" since 1930. The purpose of this review was to emphasise the efficacy of these different techniques according to physiological data and evidence-based practice. To improve the manual lymphatic drainage efficiency, the pressure, sometimes important, should be tailored to each edema and the techniques had to consider altered lymphatic drainage patterns. The methods used by physical therapist in the studies should be specified for higher lightness.