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Is EMLD covered by insurance?
All of the major equine insurance companies have been informed about EMLD, and as long as it is referred by your vet there should not be a problem.
How do mechanical massage systems which stimulate the lymphatic system compare to EMLD?
EMLD is very specialised and can be adapted to what the therapist is sensing in localised areas during treatment, which is not possible with a mechanical system. When these are stimulating blood circulation they are also creating an additional workload for the lymphatics, whereas EMLD does not do this, and works entirely to support the action of the lymphatic system. EMLD also takes into account that there may be damage to the lymphatic vessels which could be increased by massage and works around this. Available research on the use of these massage systems is with human models and is based on this following the principles of manual lymph drainage. There does not appear to be any relating to their use with horses. Having spoken to a number of users of a popular system a concern is that they may not have sufficient knowledge about the lymphatic system and the conditions that affect it, or of the potential for harm created by this.
How do I know if someone who offers to use manual lymph drainage on my horse is qualified to do so?
A practitioner should be willing to show you their qualification, equine manual lymph drainage is certificated under the ESEL, so a practitioner with this qualification will have met the requirements to perform EMLD. It is very difficult for someone not qualified and experienced in the practice of manual lymph drainage on people to train to do EMLD, and those with my own qualification through the Dr Vodder School have to do a two yearly review to keep this and to maintain their standards. Having said this, the term 'MLD' is not protected and there are people who claim to perform manual lymph drainage (as seen on YouTube!) on people and horses who are really doing something quite different, so valid qualifications are important. The practitioner should also be insured to perform EMLD and again able to show proof of this. An EMLD practitioner requires the permission of your vet to work on your horse, so your vet should also be aware of their qualifications, or prepared to follow this up if necessary.
My vet wants me to put a compression bandage on my horse, where do I begin?
Your vet probably has something quite different in mind to the compression bandaging used to support the horse's lymphatic system when EMLD is used to treat swollen legs or tendon injuries. This is highly specialised and must be applied properly by a practitioner with the expertise to do this. It's important too, to know when a compresion bandage should not be applied. If you have any concerns, ask your vet to apply the bandage.
What is the difference between compression bandaging and support stockings for my horse's swollen legs?
Compression bandages work in combination with manual lymph drainage to reduce oedema and soften fibrosis, and are used as part of the treatment for lymphoedema. Support stockings are used as part of aftercare to help prevent the legs filling up again.
Can hot and cold therapy be used with EMLD?
Yes, but temperature changes affect the action of the lymphatic system, e.g. by temporarily stopping lymph flow. Therefore it is important that EMLD is applied after this, and 20-30 minutes allowed in between.
What about massage?
EMLD combines very well with massage, but again, to be effective the order in which these are used is important.
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