Which of the following is NOT a listed contraindication to MLD?

• A. Hypertension
• B. Cardiac edema
• C. CHF
• D. Renal insufficiency

Answer: (A)

The key idea here is recognizing which conditions truly prohibit Manual Lymph Drainage (MLD). Hypertension by itself is not listed as a contraindication to MLD. MLD is a gentle technique to stimulate lymph flow and reduce edema, and it does not inherently worsen blood pressure. In a patient with well-controlled hypertension, MLD can be used safely, and it may help reduce edema without causing dangerous blood pressure spikes.

In contrast, the other conditions reflect situations where moving fluid more aggressively through the circulation can burden the heart or kidneys. Cardiac edema and congestive heart failure involve impaired cardiac function and fluid overload; increasing venous return with MLD can worsen heart failure or lead to careful monitoring and avoidance in acute or decompensated states. Renal insufficiency raises concerns because mobilizing fluid from tissues into the bloodstream can place additional work on the kidneys and alter fluid and electrolyte balance, so MLD is typically used with caution or avoided depending on the severity.

So, the option that is not a listed contraindication is hypertension, while the others are considerations that therapists assess before proceeding with MLD.