Abstract
Comprehensive decongestive physiotherapy (CDP), a combination of physical therapy modes, is the gold standard for the treatment of primary and secondary lymphedema (7,8). In the 1930s, Emil Vodder, a Danish physician, used a type of therapy
known as manual lymph drainage (MLD) to treat lymphedema. This massage is a
light, circular, superficial tissue stretching preformed with varying degrees of pressure. The effect is to increase the transport of the lymph collectors and the development of new routes for lymph drainage. Decongesting lymphotomes ‘‘upstream’’
from the lymphedema areas and utilizing the watershed anatomy for directional flow
enhanced treatment efficiency. CDP as practiced today was introduced, applied and
refined by Drs. Michael and Ethel Foldi, in Germany (9). This method has been
further modified by the contribution of the Casley-Smiths in Australia (10).