The Tidhar Method
Aqua Lymphatic Therapy is based on the principles of the Casley-Smith exercise program for lymphedema and is applied in an aquatic environment.
Developed by Dorit Tidhar, PhD
Physiotherapist and lymphedema researcher
Therapy that works with the water, not against the body.
The method enhances lymphedema therapy by combining the principles of lymphatic anatomy and physiology with the effect of water immersion, giving people a way to maintain and improve the results of conventional treatment.
Read the published researchAn aquatic environment
Water at 31 to 33 °C lets slow limb movement happen without increasing swelling. Buoyancy holds the limb afloat, so exercise and self-massage take minimal effort.
Lymphatic physiology
Hydrostatic pressure increases lymph and venous return, much like a compression garment, combined with the anatomy and physiology of the lymphatic system.
Self-directed care
A self-treatment in a group setting. Participants get monthly limb-measurement charts and choose the exercises that help them most, building independence.
Dorit Tidhar, PhD
Physiotherapist and lymphedema researcher
Dorit was trained in lymphedema management by Prof. Judith Casley-Smith in 1999 and certified by her as a teacher in self-management and exercise for lymphedema in 2003. She designed Aqua Lymphatic Therapy to help people with lymphedema maintain and improve the results of conventional treatment.
She is national director of research and development at Maccabi Healthcare Services, completed her PhD at the University of Missouri School of Nursing with Prof. Jane Armer, and teaches the Casley-Smith method of lymphedema management.
Publications on ResearchGateSelf-management at home
Lymphedema self-management movies
A downloadable folder with movies of the full ALT exercise sequence, illustrations of the exercises to print and laminate and take with you to the pool, and the articles behind the method. Movies available in English.
Example exercises
Short demonstrations from the self-management program, filmed in the pool.
Resources and references
Published studies on Aqua Lymphatic Therapy, a recorded lecture, and the organisations that support lymphedema care worldwide.
Recording of a lecture on ALT
Watch on YouTube
ALT articles
- Aqua Lymphatic Therapy in Managing Lower Extremity Lymphedema
- Water: is it good for lymphedema?
- ALT in women with breast cancer treatment-related lymphedema: a randomized controlled study
- Aqua Lymphatic Therapy: an alternate approach to controlling lymphedema
- Breast cancer-related lymphedema: a randomized controlled pilot and feasibility study
Valuable links
Find a therapist or group near you
ALT-trained therapists and groups run sessions across the world. Tell us where you are and we will point you to the nearest practitioner or group.
Request a referral- USA
- Israel
- Canada
- Quebec
- Saskatchewan
- Brazil
- Mexico
- Ecuador
- Spain
- Italy
- Netherlands
- Australia
- Aruba
- Morocco
Let’s chat
Questions about the method, a course, the movies, or finding a therapist near you? Send a message and Dorit will get back to you.
