Dr. Vodder's Manual Lymph Drainage: A Practical Guide will be a welcome addition to any therapist's or teacher's resource library on the lymphatic system and the techniques of manual lymph drainage. This book is well-organized, the content divided into theoretical and practical sections. The first third of the book discusses the anatomy and physiology of the lymphatic system, the pathophysiology of lymphedema, combined venous and lymphedema, and lipedema, and the theory of manual lymph drainage. There is a set of review questions with an answer key and page references for the reader to return to for review of specific topics for better understanding. The theoretical section of the book ends with a chapter on "Equilibrium and Balance as the Aim of the Massage" which provides a practical explanation of Starling's Equilibrium and how manual lymph drainage can help to restore that equilibrium in the body when it is disrupted by pathology or a physical therapeutic intervention that causes an increase in blood flow. Indications, relative contraindications, and absolute contraindications for manual lymph drainage are listed. The authors do emphasize that "malignant diseases that have not been treated surgically or with radiation or chemotherapy" are at the top of the list of absolute contraindications, nevertheless "manual lymph drainage does not evoke metastasis or promote the spreading of tumor cells" and "is used palliatively."
The rest of the book details the practical application of manual lymph drainage, specifics about the technique and its application to various body areas and for specific pathologies. The illustrations and photographs are in full color and clearly show proper hand positioning, direction of stroke, as well as anatomical location of watersheds on the models. The final section discusses manual lymph drainage as a key component of Complete Decongestive Therapy (CDT) for lymphedema. It gives an overview of the intensive treatment phase of CDT in both the inpatient and outpatient settings as well as the maintenance phase. There are illustrations of compression bandaging for lymphedema and an overview of compression garments which they refer to as "stockings" for both the upper and lower extremity. The tabular listing of compression classes lists Classes 1-3 as appropriate for "arm lymphedema." I do have some concern that Class 3 (36-46 mmHg) is too much compression for most individuals with upper extremity lymphedema. The authors emphasize that individuals with lymphedema, particularly those with lymphedema secondary to surgical procedures and/or radiation treatment may also have postural, joint and muscle impairments that should be evaluated and addressed to maximize functional outcomes. A brief description of Kinesiotaping and its role as an adjunct in managing lymphedema concludes the practical section. The final pages of the book contain the preface to the 1978 edition written by Dr. Emil Vodder, detailing the history of his work in Manual Lymph Drainge as well as the first publication about his work from 1938. What an inspiration to learn the development of Dr. Vodder's Manual Lymph Drainage as we practice it today from the master himself! The final pages contain a tribute on Dr.Vodder's life given by Prof. Hildegard Wittlinger on the occasion of Prof. Dr. Horst Weissleder's 75th birthday. The passion these great lymphologists have for this work is infectious!
This book provides an excellent review reference for students of manual lymph drainage. It is not meant as a "How to" guide for novices wanting to learn the technique but rather as a helpful adjunct for practitioners already trained in manual lymph drainage or as a supplement for students in a certified program or review course. The authors caution that "the technique is complex and the movements involved require special training. They cannot be learned from a book." That being said, this most practical guide with its detailed illustrations and photographs accompanied by in-depth descriptions of specific techniques will help both new student and seasoned certified manual lymph drainage therapist refine and enhance their techniques to better serve their clients.