Hydrotherapy, also known as aquatic therapy, water rehab, or pool therapy, is any rehabilitation exercise performed using water. The word literally translates as water therapy, so in some cases it has also been used to describe therapeutic processes where water is consumed or inserted into the body. For the purposes of this article, we are only talking about treatments where the water stays in the pool…unless you splash a lot!! From an active rehabilitation perspective, we use pool based hydrotherapy to manage pain, offload joints and allow injured individuals to move freely in ways they are unable to on dry land.
People who are experiencing both acute and persistent pain can benefit from rehabilitation based in the water. For example, an individual who recently sprained their ankle (acute injury) and cannot walk on land can often achieve a normal gait pattern when they’re in water up to their chest. This can help reduce their pain while also speeding up the healing process and avoiding developing a limp that might cause additional problems over time. Someone who has been experiencing lower back or sciatic pain for months or years (persistent pain) can rest with the assistance of a pool floatie in deep water and feel an almost traction sensation in their lower back and hips, helping to reduce their pain. Those with fibromyalgia or inflammatory conditions like rheumatoid arthritis can also benefit from floating in the water with gentle movement, as the reduction in gravitational force and the decreased effect of weight on their bodies helps calm down some symptoms.
After severe injuries like broken bones, torn ligaments and surgeries, you are often limited for many weeks and restricted to crutches or a wheelchair. This is because the injured area is unable to support your full body weight and might be unstable or re-injured if you try to walk on it. But the pool often allows us to get you in the water sooner and moving more normally, as long as your wounds are closed or covered with a waterproof bandage. The deeper you are in the water, the less body weight your lower limb is supporting. This means that someone recovering following a hip replacement or broken leg can start to walk and move much earlier in the water compared to on land. The addition of hydrotherapy to the recovery process can help improve strength and stability faster and help you return to the activities you love both in and out of the water sooner. Even for injuries to your upper body, water can be helpful. We often get individuals with shoulder injuries working in the water, both for pain management and because the water helps support the shoulder. This allows the person to work their shoulder through ranges of motion they are unable to achieve outside of the pool.
Free range of motion:
Basically this is a combination of both the aforementioned points: Pain is a fantastic motivator to avoid it whenever possible. Avoiding pain can result in the development of a limp, slouched shoulder, or many other postural adaptations that feel better in the moment but can become problematic long-term. Rehabilitation based in the water can help manage the pain while simultaneously offloading the body enough that it can perform a movement pattern that isn’t manageable on land. Even years after an initial injury has recovered, an accommodation or adaptation in a movement pattern can persist. In the water we can work to retrain movement patterns and improve strength that will translate to land based activities. Being in the water also reduces risk of injury from falling, making it the perfect place to retrain balance and stability.
Hydrotherapy is a fantastic tool for active rehabilitation. Both as a long term pain management and as a short term stepping stone to returning people to their pre-injury or illness activities, if you’re uncertain of where to start, the water may be the right place for you!