The technical definition of hydrotherapy is the application of water for the treatment of physical or psychological dysfunction. Hydrotherapy or aquatics is the use of water or an aquatic environment to help with advancement of a rehabilitation program. The use of hydrotherapy began in ancient Greece with the use of warm water spas and exercise programs. Today there are thousand of physical therapists that use water for various therapeutic applications.
People that would most benefit from hydrotherapy include people that have neuromuscular disorders, musculoskeletal disorders, cardiovascular disorders, and pulmonary disorders. Specific diagnoses that have shown benefit from the pool include orthopedic problems that require decreased weight bearing to perform the specific exercises, neurological disorders that need increased balance and proprioceptive input, decreased cardiovascular functioning, exercise-induced asthma, pregnancy, and any condition that is intolerant to weight bearing exercises. Many people with back pain will also experience benefits from hydrotherapy.
Hydrotherapy works by using the specific properties of water to aid in rehabilitation. The specific properties of water used include increased buoyancy, increased resistance, and increased hydrostatic pressure. These properties will allow for decreased weight bearing on joints, increased muscle activity, increased blood flow, and decreased edema. Overall, a person will have a decrease in recovery time and an increase in healing rate.
A physical therapist will perform the treatment with a patient in the desired depth of water. The depth will depend on the activity that the patient will be performing, the patient’s tolerance to the water, and the amount of body weight to be unloaded. The entire treatment will be performed with the patient in the water and will include therapist- and patient-directed movements. Some of the movements will be active with the patient performing all the activity, and others will be passive with the therapist performing the activity. Overall, the treatment will include activities that unload the spine, strengthen the muscles, and increase range of motion for the joints. All activities performed will be based on the patient’s tolerance and ability to perform the activity.
When using hydrotherapy, a person can expect to have decreased weight bearing on joints with increased resistance and increased motion. A person will be able to move easier and further with fewer symptoms while at the same time providing greater resistance. While being in the water, the person’s body will have increased circulation with increased cardiac output, which will lead to an overall decreased heart rate, decreased blood pressure, and increased cardiac efficiency. There will also be an increase in lung capacity with fewer issues with exercise-induced asthma. A person will also find that they will have increased kidney and renal function from the increase pressure and blood flow. This increased kidney function will help to decrease edema and help reduce hypertension. That last benefit is that hydrotherapy has a psychological effect of making a person feel relaxed if using warm water or feel invigorated or energized with cold water. The warm water provides a calming environment while cool water will help facilitate more active exercise.
A person can expect to have an increase in range of motion and strength with decreased symptoms. Overall a person will see improvement in all areas of rehabilitation and functional activity. It is expected for a person to have some slight discomfort and soreness while performing hydrotherapy and after a treatment session. This discomfort should be the same as what any person would experience when starting a new exercise program. Once this initial soreness has subsided, a person will continue to see progress.