INTRODUCTION
At the end of the last century, Alexander Von Winiwarter, M.D., Professor of Surgery, treated swollen limbs with a special 'massage' technique, compression therapy and elevation.

The manual therapy Dr. Winiwarter devised was improved in the 30's by Dr. Vodder from Denmark. He successfully treated various conditions with this technique, known as Manual Lymph Drainage.

In the 80's, Professor Michael Foldi, M.D. from Germany considerably advanced lymphedema therapy by combining a variety of techniques into what is now known as Complete Decongestive Therapy (CDT).

In 1994 Joachim E. Zuther founded the Academy of Lymphatic Studies and taught the first certification class in the United States according to the European curriculum.

MANUAL LYMPH DRAINAGE / COMPLETE DECONGESTIVE THERAPY
This non-invasive, painless and very effective therapy for lymphedema and other related conditions has been used in Europe successfully for decades and is now becoming widely recognized in the United States. The treatment consists of four basic steps:

1. Manual Lymph Drainage (MLD)
MLD is a gentle manual treatment technique which improves the activity of the lymph vessels by mild mechanical stretches on the wall of lymph collectors. MLD re-routes the lymph flow around the blocked areas into more centrally located lymph vessels that eventually drain into the venous system.

2. Compression Therapy
Compression therapy increases the tissue pressure and is applied between treatments in order to prevent reaccumulation of lymph fluid. In Phase I of the treatment compression therapy is applied using short-stretch bandages, in Phase II by custom made garments which the patient has to wear every day.

3. Decongestive Exercises
Performed by the patient wearing the compression bandages or garments as well as respiration therapy aid the lymphokinetic effects of the joint and muscle pumps.

4. Skin Care
Since infections are very common and serious complications of lymphedema, each patient is taught meticulous skin and nail care. Therapy cannot proceed until all infections, bacterial or fungal, are under control.

INDICATIONS

1. Lymphedema
Lymphedema , an accumulation of protein-rich fluid in the superficial tissues, is a very common and serious condition worldwide. Left untreated is has important pathological and clinical consequences for the patient.

Secondary lymphedema is often caused by surgery, radiation, trauma or infection. The reason for the development of primary lymphedema are congenital malformations of the lymphatic system. In such cases the swelling may appear after simple accidents such as sport injuries which can suddenly overload the transport capacity of the lymphatic system.

Today there are millions of patients living in the U.S. suffering from lymphedema (primary or secondary) and its complications. Manual Lymph Drainage and Complete Decongestive Physiotherapy is the only effective treatment for this condition.Other indications are:

2. Chronic Venous Insufficiency

3. Post-surgical swelling

4. Post-traumatic swelling

5. Lipedema, Lipo-Lymphedema

6. Amputee stump edema

7. Migraine headaches