By Erika Kruger

Some debate exists around the standing of Manual Lymph Drainage in relation to the profession of Therapeutic Massage Therapy. There appears to be three schools of thought: 1) that it is a separate therapy 2) that it is one of the many techniques available to a therapeutic massage therapist 3) that it is a field of specialisation of Therapeutic Massage Therapy.


The arguments that MLD is a therapy separate from Therapeutic Massage Therapy does not hold water when compared to a standard definition of massage namely the manual mobilisation of soft tissue (e.g. muscle, fascia and body fluids etc.) to restore normal systemic, biomechanical and functional use including the circulatory and lymphatic functioning. MLD is a manual technique, it affects soft tissue –lymph tissue in particular but indirectly the surrounding tissue e.g. muscles and it aims to restore normal circulatory function.


It follows therefore that MLD should be considered one of the tools available to a therapeutic massage therapist in achieving a particular goal namely to stimulate the flow of lymph from the affected area under specific circumstances.


Does that make MLD a field of specialisation for the Therapeutic Massage Therapy profession? May a therapist, on his or her stationery, make it known to the public that they specialise as an MLD therapist?

The law is very clear on this: MLD cannot be considered a specialisation field of the Therapeutic Massage Therapy profession.

According to the Ms Debbie Drake-Hoffmann, in an article in the most recent edition of Access, the Allied Health Professions Council (SA) newsletter, a therapist is only allowed to state the qualifications that they are registered for or any other qualification approved by the council.

“No further qualifications obtained after your registration may be stated unless the relevant professional board has recommended such qualification can be added and such recommendation has been approved by council”, she explains. Hence therapists are not allowed to use phrases such as specialising in ….. This implies that describing oneself as a Therapeutic Massage Therapist specialising in MLD on official stationary, is not permitted. Also adding words before or in their official title e.g. Therapeutic Sports Massage Therapist or Manual Lymphatic Drainage Therapist is prohibited.

If therapists allude to or state that they specialise in a particular area, the public legitimately assumes that they hold an AHPCSA-recognised and evaluated qualification or a registered speciality over and above the general requirements for registration. In cases of litigation this may be construed as deception.

“Until such areas of interests are formally registered as specialities, such interests may not be stated on professional stationery and shall not be contained in any literature to patients to imply that it is a registered speciality,” Drake-Hoffmann warns.

Also, although therapists may show an interest in a specific area of treatment e.g. working with children or cancer patients it does however not amount to specialisation, says Drake-Hoffmann.


So, what are the options for therapists who feel strongly that they want to make it known that their field of interest is MLD or any other area of activity?

According to Drake-Hoffmann, anyone wishing to have any other qualification or a speciality registered in the official register may apply to council to evaluate whether it meets the standards of a specialisation. But to date she says, the council has not received any applications for the registration of a speciality in any profession.

Until that happens, the only legal option available is to state that MLD is a preferred field of interest or field of interest. “This statement clearly denotes a preferred interest without giving the impression of a specialisation or specialist knowledge”, she says.