Class Code

Lymph Drainage Therapy 1 (LDT1): Fluid Dynamics - Lymphatic Pathways - Anatomical Integrity


“Lymphatics are the next frontier of discovery in human disease. Long ignored because of their subtlety and complexity, the mysteries of our cellular ‘waste disposal’ system have been comprehensively deciphered by Bruno Chikly.”

Mehmet Oz, M.D., Cardiothoracic surgeon, Author of “Healing from the Heart”.


Lymph Drainage Therapy (LDT) - Inner Fluid Dynamics


Lymph Drainage Therapy is a cutting edge hands-on method of lymphatic drainage developed by Bruno Chikly, MD, DO, LMT.

It was created out of his award-winning research on the lymphatic system consistent with recent scientific discoveries.

LDT1 takes traditional lymph drainage techniques and adds a level of precision. LDT is the first technique that enables practitioners to detect and palpate the specific rhythm, direction, depth, and quality of the lymph flow anywhere in the body. Skilled practitioners with developed listening skills can practice Manual Lymphatic Mapping (MLM) of the lymphatic vessels.

LDT practitioners use their hands to assess and enhance overall circulation as well as determine the best alternate pathways for draining stagnant body fluid (lymph, interstitial, synovial fluid, etc…). Therapists work with flat hands, using all the fingers to simulate gentle, specific wave-like movements.

These subtle manual maneuvers activate lymph and interstitial fluid circulation as well as stimulate the functioning of the immune and parasympathetic nervous systems.


This class is to prepare practitioners to later be able to “map” the lymphatic pathways with their hands (Manual Lymphatic Mapping) as well as identify precise areas of the body where there is fluid stagnation or fibrosis, and then find the most appropriate pathways for drainage.

Trained students will learn in advanced classes how to work with mucosa, muscles, fascia, tendons, 
periosteum, most viscera, chambers of the eyes, dura, pia, interstitial, synovial fluid, and blood vessels.

Lymph Drainage Therapy 1 (LDT1): Fluid Dynamics - Lymphatic Pathways - Anatomical Integrity

LDT also includes advanced techniques such as Lympho-Fascia Release (LFR) to simultaneously release lesions in the fascia and fluid of the body. These techniques can be applied to viscera, ligaments, tendons, trigger points, or fascia in the body.

Another branch of LDT will use specific techniques for the synovial fluid to release articulations in the body, including articulations rarely addressed such as the embryological articulations. (See FAR - LDT Rhythmic Articular Fluid Technique)

Lymph Drainage Therapy 1 (LDT1): Fluid Dynamics - Lymphatic Pathways - Anatomical Integrity


LDT1 Class length: 4 days 

CEUs: 24 hours for numerous health professions

Please Note: LDT1 does not certify therapists to work on lymphedema.


Some Applications:

Relief of subacute and chronic painLymph Drainage Therapy 1 (LDT1): Fluid Dynamics - Lymphatic Pathways - Anatomical Integrity

Relief of numerous chronic and subacute inflammations, including sinusitis, bronchitis, and otitis

Regeneration of tissue, including burns, wounds, and wrinkles

Detoxification of the body

Reduction in the symptoms of chronic fatigue syndrome and fibromyalgia

Antispastic actions to relieve conditions such as muscle hypertonus and some forms of constipation

Deep relaxation to aid insomnia, stress, loss of vitality, and loss of memory

Anti-aging effects

And many other benefits


Audience: This class is for manual therapists. is a first-level, foundational class.

Please contact us for special needs requests.

Completion: A manual/oral test will be done by the instructor at the end of the class to make sure participants attain the class outcome. An instructor could ask a participant to retake the class.

Conflict of Interest: All classes presented by Chikly Health Institute have no financial conflict of interest. The Instructors are just paid  by the Chikly Health Institute. CHI is not sponsored by outside organizations or corporations.

Please read "Our Policies" for more information and cancellation policy:

Contact Continuing Education (CE) Hours Total: 24 CEUs for massage therapists - NCBTMB Approved Provider # 451238-10

NCBTMB CEUs are accepted in every US state for NCBTMB certification renewal.

Most states accept NCBTMB for license renewal but not all. We are also an approved provider for NY state.

Please look here for more information:

Because certification and license renewal policies vary from state to state, it's important for you to make sure the CEUs are accepted wherever you practice. Therefore, please be aware that this information may not apply in your state.

Check your state’s website at:


•States Approved for PTs: 24 CEUs

Alabama, Alaska, Arizona, Connecticut, Florida, Georgia, Hawaii, Iowa, Kansas, Michigan, Missouri, Montana, Nebraska, New Mexico, North Carolina, North Dakota, Oregon, South Carolina, South Dakota, Texas(77398TX), Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming

24 Contact Hours / 2.4 CEUs for OT and OTA by American OT Association (AOTA)

AOTA Provider # 10304

Chikly Health Institute is an AOTA Approved Provider of professional development. Course approval ID#10304. This course is offered at 2.4 CEUs, educational level is introductory/foundational. The assignment of AOTA CEUs does not imply endorsement of specific course content, products, or clinical procedures by AOTA.

• 24 hours approved by the Massage Therapy Association of Manitoba, Canada (MTAM)


• 20 hours approved by the Certified Registered Massage Therapy Association of Alberta, Canada (CRMTA)


We are in the process of providing Continuing education for numerous other professions.  Please check back to this page later, as we will post all updates.


HIGHLIGHTS (subject to Change)

By the end of this workshop you should be able to:

Describe basic anatomy, physiology of the lymph system, and main body fluids.

Explain the scientific principles behind Lymph Drainage Therapy, and why the lymphatic system plays a crucial role in recovering from disease and enhancing health.

Explain the importance of the lymphatic system and how it relates to blood and other body fluids.

Describe the main indications and contraindications of LDT.

Perform techniques that help you move lymph and interstitial fluid through the body to cleanse it of toxins.

Describe the main specific locations of lymph nodes and lymph vessels.

Work with a 3-dimensional perspective of the lymphatic anatomy of the body.

Palpate lymph flow and explain key details to specifically do so.

Demonstrate specific lymph-drainage sequences for the face and neck, upper and lower extremities, superficial and deep abdomen.

Describe key points to observe for optimal lymph drainage results.

Travel through the body via the "lymphatic highway" to accurately understand fluid flow.

Perform techniques for pre-post surgical conditions.

Put treatments and self-help techniques right away into practice.



  • Lecture

  • Study Guide

  • Question & Answer

  • PowerPoint Slides

  • Demonstration

  • Practice sessions

  • Review


LEARNING OBJECTIVES (subject to Change)

  • By the end of the 1st-day participants will be able to correctly compare the anatomy of the blood and lymph circulations

  • By the end of the 1st-day participants will be able to correctly describe contraindications of LDT

  • By the end of the course, participants will be able to correctly describe the direction of the main superficial lymph flow in the anterior body

  • By the end of the course, participants will correctly demonstrate LDT techniques on the anterior Thorax

  • By the end of the course, participants will be able to correctly demonstrate LDT techniques on the Upper Extremity

  • By the end of the course, participants will be able to correctly demonstrate LDT techniques on the deep Abdomen

  • By the end of the course, participants will be able to correctly demonstrate LDT techniques on the superficial Abdomen

  • By the end of the course, participants will be able to correctly demonstrate LDT techniques on the Lower Extremity

  • By the end of the course, participants will be able to correctly demonstrate treatments for pre-and post-surgical patients

  • By the end of the course, participants will be able to correctly demonstrate LDT techniques on the Face

  • By the end of the course, participants will be able to correctly demonstrate LDT techniques on the Liver

  • By the end of the course, participants will be able to correctly design a self-drainage protocol for themselves

  • By the end of the course, participants will be able to correctly design a simple lymphatic treatment protocol for a specific pathology found in one person in the class


OUTLINE (subject to Change) 

Day One

8:30                                       - Registration

9:00 - 11:00                          - Introduction

                                             - Teaching material

                                              - History of manual lymph drainage therapy

                                              - Physiology: the liquids in the body, blood and lymph circulation

                                              - Physiology of the lymphatic system

                                              - General anatomy of the lymphatic system


11:00 - 11:15                        Break


11:15 - 12:30                        - Applications of L.D.T.

                                              - Contraindications of L.D.T.

                                              - Protocol and demo using lymph techniques


12:30 - 2:00                          Lunch


2:00 - 3:30                            - Body Level 1: Demonstration of the locations of lymph nodes and vessels

                                              - Body sequence level 1: Neck - front chain


3:30 - 3:45                            Break


3:45 - 5:30                            - Body sequence level 1: Thorax

                                              - Self-Help


Day Two

9:00 - 11:00                          - Review, questions and answers

                                              - Body sequence: Thorax (end) - Upper Extremity



11:00 - 11:15                        Break


11:15 - 12:30                        - Body sequence: Superficial Abdomen


12:30-2:00                             Lunch


2:00 - 3:30                            - Body sequence: Deep Abdomen


3:30 - 3:45                            Break


3:45 - 5:30                            - Body Sequence: Lower Extremity


Day Three

9:00 – 9:45 am - Review, questions and answers. Lymphedema: theory

                                              - Lymph exercises for the hands: “asynchrony - “The Arching” – Direction of lymph


9:45am – 10:30am                - Body Sequence: Lower extremity anterior side (continued)


10:30 - 10:45                        Break


10:45 - 12:30                        - Body Sequence: Lower extremity anterior side (continued): shin, ankle, foot


12:30 - 2:00                          Lunch


2:00 – 2:45                            - Systems affected by LDT

                                              - Pre-post surgery protocol and clinical cases


2:45 – 3:30                            - Treatment Programs


3:30 - 3:45                            Break


3:45 - 5:30                            - Face Sequence: The Neck: extensive sequence

                                              - Face sequence: Inside the “Cone of the Face”.


Day Four

9:00 - 10:30                          - Face sequence: outside the “Cone of the Face”

                                              - Final Techniques


10:30 - 10:45                        Break


10:45 - 11:45                        - Questions and Answers

                                              - Drainage of the Liver

                                              - General Review Face and Body


11:45 - 12:30                        - Self drainage L.D.T. Protocol


12:30 – 1:30                          Lunch


1:30 – 2:45 pm - Final questions and answers. Review. Take home Protocol

                         - Self-reflection and identification of changes for practitioner’s practice.



A manual therapist with a healthcare license (a license that legally allows you to touch): DO, DC, PT, OT, Massage therapist, etc.

Pre-Requisite Class: None

Required Reading - Must purchase the textbook: Silent Waves - Click here 

Silent Waves: All of Part 1, All of Part 2; Part 5 Chapter 1, all of Part 6.

Lymph Drainage Therapy 1 Anatomical Terms

To be best prepared for LDT1, be sure you clearly understand the following words and, as applicable, know where to locate them in the body:

Proximal, distal, medial, lateral, anterior, posterior, superior (cephalic), inferior (caudal)

Acute, subacute

Afferent, efferent vessel

Basal membrane, dermo/epidermic junction

Interstitial fluid, interstitium, intracellular/extracellular compartment

Colloid, plasma, cerebrospinal fluid (CSF)

Lymph node, thoracic duct, cisterna chyli

Lipid, fatty acid

Sympathetic and parasympathetic innervation, macrophage, B and T lymphocytes, primary and secondary lymphoid organs, humoral and cellular immunity


Antigen, antibody, plasmocyte, adenopathy, lymphoma, superior vena cava, inferior vena cava, internal jugular vein, subclavian vein, brachiocephalic (innominate) vein, common iliac artery, external and internal iliac artery, femoral vein

Parotid gland

Sternocleidomastoid, trapezius, spinal accessory nerve

Axilla, inguinal, femoral triangle

Medial-lateral epicondyle, medial-lateral malleoli

Peristaltic contraction

Antispasmodic (antispastic)

Price: $950  (unless posted otherwise)

Registration Discount: $750

This is a class with no CHI class pre-requisites. If you have never taken a class with CHI, you are invited to receive a $200 discount ($750) for this class if paid in full 45 days before the class start date.
(If the class is not paid in full 45 days before the start of class, the rate automatically goes up to $950)

For all other participants, you can receive the $650 discounted price by using your CHI-Pak  if it is set up prior to December 31, 2022, or by registering and making a minimum deposit of $200 at a prior CHI class and paying the balance in full 45 days prior to the class start date.  This offer of the $650 price for classes after January 1, 2023 applies only if the deposit is made prior to December 31, 2022

Repeat: $425

Student Discount: $425 in full-time hands-on program (no additional discounts)

Full-time students currently enrolled in a hands-on program that will culminate in a license/certification in bodywork are eligible to receive a special discount on entry-level courses.
To qualify, you must register with a $200 deposit before you graduate. The balance is due 30 days before your course begins. We also must receive proof of your enrollment in a full-time program.
Please have your school send us a letter stating that you are enrolled, the total number of hours of the program you are attending, and your expected graduation date.
The letter must be on the school’s letterhead and can be mailed to the Chikly Health Institute.
This is a class with no CHI class pre-requisite.

Chikly Health Institute

Bruno Chikly’s pioneering and innovative development of Lymphatic Drainage Therapy (LDT) is the most significant contribution to the field of Lymphatic Drainage since its inception almost a century ago.
LDT is a fundamental technique for all physical therapists to learn. It is here presented by one of the world’s leading teachers of manual therapy today. LDT is a powerful and effective technique for all physical therapists to learn.

Kenneth I. Frey, PT, Diplomate in CranioSacral Therapy, Director, Institute of Physical Therapy, New York, NY
Chikly Health Institute

The completely new enhancement of Lymph Drainage Therapy (LDT) is the palpation of the lymph flow in the different layers of the tissues, including its rhythm, quality and direction. His work has opened the possibility for practitioners to map the lymphatic flow, greatly enhancing effectiveness of the work. A.T. Still, the father of osteopathy, stated several times, that the importance of the lymphatics cannot be overestimated.

Roger Seider MD, DO (MROD) Orthopedic Physician Hamm, Germany
Chikly Health Institute

In Lymph Drainage Therapy, Dr. Chikly has brought the healing arts a powerful approach to the treatment of both chronic and acute conditions. It enhances the clinical acumen of those interested in an osteopathic approach to the management of systemic as well as musculoskeletal problems. His courses are a celebration of the integration of basic lymphology and manual medicine.

T. Reid Kavieff, DO, CSPOMM
Chikly Health Institute

Lymphatic Drainage Therapy is one of the most powerful therapeutic techniques I have ever learned or experienced. Using LDT, I have successfully treated patients with diagnosis ranging from acute conditions such as athletic injuries, edema, headaches and sinus infections, to chronic problems of the respiratory system, as well as the musculoskeletal system such as chronic fatigue syndrome, and fibromyalgia. Dr. Chikly''s work has definitely changed my approach to treating patients.

Janet Weiss Quate, LPT, CNMT
Chikly Health Institute

Incorporating Lymph Drainage Therapy into my practice has added an essential component to my work. Palpating obstructions in the lymph flow gives me important diagnostic information, resistant conditions are clearing much quicker, and patients are noticing immediate changes. This text is a comprehensive and much needed addition to the literature in the field of lymphatic techniques.

Signy Erickson, DC, CST-D
Chikly Health Institute

As an occupational therapist, lymphatic drainage therapy is one of my most important tools. I use it for many different conditions including hand therapy, post surgical recovery, scar treatment, pain, swelling, arthritis, back and neck conditions and lymphedema. Lymph is the fluid of life which I am able to enhance with my clients. This book is an important addition to the scientific literature.

Liz Blum, OTR
Chikly Health Institute

Dr. Bruno Chikly has significantly refined lymphedema therapy by creating manual lymphatic mapping (MLM). MLM provides the skill of assessing the rhythm, direction, and other qualities of lymphatic flow dynamically. The physician or therapist is enabled to monitor the patient''s progress by palpation throughout the therapy. Manual Lymphatic Mapping is an important complimentary skill for the repertory of established Vodder or Földi trained therapists.

Frank Gentzke, MS, LMT - Vodder certified Manual Lymphedema Therapist
Liver, Pre & Post Treatment: Lymph Drainage Therapy (LDT) Level 1 and 2
Pre- and Postsurgical Applications of Lymph Drainage Therapy - Bruno Chikly, MD, DO.
Dr Chikly Demonstrates an Application of Lymph Drainage Therapy: Lumbar Release.
Releasing the Lobes of the Liver. A Lymph Drainage Therapy (LDT) Demonstration.
Lymph, Fascia and Viscera Dr Chikly Interviewed by Terry Schibler, LMT.
Introduction to the Fluid Articular Release (FAR) Online Classes by Bruno Chikly, MD, DO, LMT
The Foundational Stroke of Dr Chikly's LDT
Liver, Pre & Post Treatment: Lymph Drainage Therapy (LDT) Level 1 and 2.
Dr. Chikly, MD, DO Demonstrates How to Treat Engorgement-Mastitis with Lymph Drainage Therapy (LDT).
PT Treatment of Severe Ankle Fractures & Post-Surgical Scars Using Lymph 1, Brain 1, FAR, HCT, etc.