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 $750 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: $475

Student Discount: $475 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.

Perci K., NCBTMB Board Certified, Certification from the Board of Nursing in Virginia

"It is an honor and a privilege to be a student with Bruno and Alaya Chikly and the Chikly Health Institute.
As a veteran therapist (37 years) and a continuing ed course junkie, I can say with total conviction that CHI is by far the best; the best teachers, cutting edge material, and the most enjoyable experiences."

Perci K., NCBTMB Board Certified, Certification from the Board of Nursing in Virginia
Chikly Health Institute

I had one of the most profound, deeply inspired, loving, fun class ever.  I am very grateful.

Lupita Hernandez, LMT - California, USA
Chikly Health Institute

We put in a lot of effort to cover so much information and hands on training, yet I feel more relaxed than I do when I come back from vacation.  This was the best class I have ever attended and I am planning to take more Chikly classes.  I just wish they could all be done at your house.  You are amazing.
Thanks so much,

Tom Stokes (William), LMT
Chikly Health Institute

Bruno Chikly's book is an incredible resource for patients, their caregivers and health professionals. The extent of the information you make available to therapists and physicians is a gift we can all utilize in our practice and work.

Bernie Siegel, MD, Surgeon and author of Love, Medicine and Miracles; Prescription for Living and other books.
Jean Pierre Barral, DO, MROF, Developer of the Visceral Manipulation curriculum

At last someone that give to the lymphatic system its “nobility” / its sense/ significance / important scientific date….Lymph Drainage Therapy is a breakthrough in the filed of manual therapy (…)
I appreciate / admire both the man and the physician, the researcher and the writer.

Jean Pierre Barral, DO, MROF, Developer of the Visceral Manipulation curriculum
Chikly Health Institute

Silent Waves is the bible in the field of lymph drainage therapy. Author Bruno Chikly, MD, is a skilled physician and true healer, and he is the Einstein of this rapidly developing field. This book is a treasure not only for healthcare professionals but also anyone who whishes to learn more about one of the most neglected systems of the human body.

Larry Dossey, MD, Executive Director, Alternative Therapies in Health and Medicine, Author of nine books- including Healing beyond the Body, Reinventing Medicine and Healing Words.
Chikly Health Institute

Having taught Neuromuscular Therapy (NMT) since the early 1980's, I feel as though I have recently discovered a huge key to unlocking the mysterious patterns of pain and dysfunction in soft tissues. After taking Bruno Chikly's basic lymphatic drainage course, my eyes were opened to a significant factor in the problems of chronic pain. Integrating the NMT techniques and lymph drainage therapy will produce significant changes for even the most chronic pain conditions and the mastery of these techniques will enhance the practitioner's results significantly. This text has been long needed and will impact all fields of manual techniques.

Judith (Walker) DeLany, L.M.T., NMT Center Seminars - Founder, Director, NMT Instructor, Journal of Bodywork and Movement Therapies - Associate Editor
What Are the Best Ways to Get Lymph Moving? Question to Bruno Chikly, MD, DO.
Can Bone Dysfunction Create Lymphatic Pathologies?
What Severe Heart Conditions Are Contraindications to Lymph Drainage Therapy? Bruno Chikly, MD, DO.
A Heartwarming Video on Lymph Drainage Therapy (LDT) & Bruno Chikly, MD, DO
Dr Chikly's Lymph Drainage Therapy (LDT): Manual Palpation of the Lymph Flow
Why Advanced LYMPH Practitioners Are Required to Take Lymph Drainage Therapy Level 1 (LDT1)?
Dr Chikly's Overview of Lymph Drainage Therapy Level 1 (LDT1)
Releasing the Lobes of the Liver. A Lymph Drainage Therapy (LDT) Demonstration.
Fluid Articular Release (FAR): A Gentle Non Invasive Technique to Release Bones and Joints.
Understand and Treat the Lymphatic System & Adipofascial Disorders (Lipedema). Dr B. Chikly, MD, DO.