Dr John and Dr Judith Casley-Smith were Australian (Adelaide) researchers and the founders of the Casley-Smith method of Complex Lymphatic Therapy. (The term "Complex" described the fact that it was a group of treatment regimes used to manage lymphoedema rather than a single method.) They both dedicated their careers to lymphology and the education of lymphoedema sufferers and health professionals. Dr John Casley-Smith was internationally acclaimed for his pioneering imaging of the lymphatic system and highly regarded by his peers. Together they published a 335 page textbook on lymphatic therapy titled "Modern Treatment for Lymphoedema."

Casley-Smith courses were originally taught in Adelaide under the auspices of the Lymphoedema Association of Australia. "Casley-Smith International" was established in 2010 to progress and continuously update educational training and research. Elsebeth Petersen was one of the founding members of C-SI. The course name varies from country to country and in Australia has more recently changed to "Decongestive Lymphatic Therapy" for readily appreciated meaning.   

In 1998 Dr Judith Casley-Smith published a paper, in the respected journal Cancer, describing the Casley-Smith method. The paper details that the four principles of the method are "skin care, manual lymphatic drainage, compression in the form of bandaging and/or garments, and exercise."  The paper can be accessed for free via this link.

(Reference: Casley‐Smith JR, Boris M, Weindorf S, Lasinski B. Treatment for lymphedema of the arm‐The Casley‐Smith method: A noninvasive method produces continued reduction. Cancer: Interdisciplinary International Journal of the American Cancer Society. 1998 Dec 15;83(S12B):2843-60.)


Courses in Australia meet the requirements of the Australasian Lymphology Association and as such are listed as accredited training. Equivalent Casley-Smith courses are taught in China, Hong Kong, The Netherlands, Israel, the UK and the USA. 

Andrea Mangion and Elsebeth Petersen are currently the only Australian instructors who have undergone the formality of the international training standard requirements set by Casley-Smith International (C-SI). Accredited Casley-Smith instructors are listed on the Casley-Smith International website. 

Training in the management of lymphoedema is suitable for a variety of health professionals who encounter lymphostatic disorders, and need to know either, how to work safely "around" them or how to directly treat the symptoms. The scope of practice dictated by each health profession will determine what any individual therapist is able to offer. 


Decongestive Lymphatic Therapy (DLT) aims to decongest excessive fluid load from the tissues. It includes the following:  

Compression Bandaging & Garments
Compression is the mainstay of treatment with two layer and multi-layer systems being available to achieve a reduction in limb volume. Compression garments (sleeve or stockings) are worn to maintain the reduction and to prevent further accumulation of fluid.  

Manual Lymphatic Drainage (MLD)
The aim of MLD is to stimulate the movement of lymph inside the lymphatic vessels and increase the uptake from the swollen tissues. Techniques vary according to tissue texture, structures and the individual's scenario.

Exercise creates variations in tissue pressure that allows fluid to move within the system and enhances lymph formation. 
Aqua lymphatic therapy (AQL) is a form of water exercise researched and developed by Physiotherapist Dorit Tidah, a Casley-Smith International instructor from Israel. The method uses specific movements and exercises in the water to facilitate lymph drainage. Participants are measured before and after each session. 

Skin Care
The practice of keeping skin in good condition is important in infection prevention. Infection in lymphoedematous tissue can quickly escalate to serious levels (commonly called cellulitis) where hospitalisation becomes necessary.

Engaging patients to self care is not only empowering but is at the heart of the Casley-Smith method. The foundation for this is self-education. 

Copyright © 2020  Casley-Smith International Australasia 
 ABN 19 641 960 081
Contact us via  info@lymphoedematherapist.com.au