What is Hydrotherapy and What is it Good For?

At a glance:

  • Hydrotherapy is a physiotherapeutic technique that utilises an aquatic environment to aid in pain relief, range of motion, chronic disease and healing
  • Therapy is usually done in a pool heated to between 33°C and 36°C
  • Immersion in warm water allows muscles to relax, takes pressure off joints and muscles, adds resistance to movements, offers increased range of movement and promotes blood flow
  • Only a qualified physiotherapist or specially trained exercise physiologist can deliver hydrotherapy
  • People of all ages may benefit from hydrotherapy
  • Like most physiotherapy, hydrotherapy is not frequently covered by medicare but may be included in an NDIS (National Disability Insurance Scheme) plan

What is Hydrotherapy?

Sometimes also referred to as hydropathy or aquatic therapy, hydrotherapy utilises a water based approach to pain relief and healing. The natural buoyancy of water helps support the body, taking strain off injuries or ailments, allowing for immediate relief of some pain, and for those with motion difficulties to undertake low impact exercises they may not be able to on land.

Hydrotherapy typically uses a pool heated to a higher degree than normal, with a temperature range between around 33°C and 36°C being standard. The warmth of the water allows muscles to relax, and immersion has a compressive effect on the body, adding resistance and stability as well as increasing blood flow to the muscles. Some hydrotherapeutic techniques also utilise cold water baths to stimulate blood flow to the skin and the underlying muscles.

Although hydrotherapy is typically done in a pool, patients do not need to be able to swim. Patients with movement disabilities can typically be gently lifted into a hydrotherapy pool using a special hoist. Exercises and therapy are typically performed sitting, standing or floating (using floatation devices) and are constantly monitored and aided by a trained therapist. In some cases, hydrotherapy may utilise smaller tanks intended for individual patients.

Only a qualified physiotherapist or specially accredited exercise physiologist can deliver hydrotherapy. Practitioners must be registered with AHPRA (Australian Health Practitioner Regulation Agency).  It is important to have a individualised program as it is common to overdo it in the hydrotherapy pool, due to the warmth and support from the water, and patients have reported increased soreness once back on dry land. 

Although hydrotherapy, like many other Allied Health professional services, is typically not covered by Medicare, it may be covered in an NDIS (National Disability Insurance Scheme) package. 

Aqua aerobics differs from hydrotherapy in the intensity of the exercises. Whereas exercises performed in hydrotherapy are typically low impact and geared more towards stabilisation and mobility, aqua aerobics is much more strenuous exercise, designed for fitness rather than the treatment of disability, disease, injury or pain. Hydrotherapy sessions are also tailored to each individual patient and are one-on-one sessions rather than group exercises.

What Are the Benefits of Hydrotherapy?

A good deal of study has been done into the efficacy and benefits of hydrotherapy. Proven 8 benefits and uses of hydrotherapeutic techniques include:

  1. Pain Management - the buoyancy and warmth of the water reduces impact on joints and loosens muscles. Immersion in water also offers support, enabling people with back or neck pain relief and the ability to perform exercises that may be impossible on land.
  2. Preoperative Preparation - recipients of joint replacement surgery may benefit from hydrotherapy exercises in preparation for surgery to strengthen the muscles surrounding the joint without stressing the joint itself or causing pain.
  3. Postoperative Rehabilitation - after surgery (such as joint replacement), hydrotherapy can speed recovery and aid in the restoration of mobility and range of movement.  It must be delayed, however, until full wound healing has been achieved. 
  4. Increases Muscle Strength and Elasticity - warm water allows muscles to relax and stretch more easily. Water adds resistance to movement, increasing with the speed or size of a motion. This resistance may help strengthen muscle. 
  5. Circulation - the hydrostatic pressure of water promotes circulation. This increased circulation sends more oxygen and vital nutrients to injured or otherwise damaged muscles, reducing inflammation and promoting recovery.
  6. Physical and Mental Health - people who may have health barriers to maintaining physical fitness or mobility may be at increased risk for developing mental health issues. Hydrotherapy may offer an outlet, both for fitness and for socialisation.
  7. Minimising Effects of Trauma/Injury - after injury or trauma, muscles or joints may not be able to support weight, making exercise difficult if not impossible. Hydrotherapy allows people to work around these injuries to both maintain physical fitness during healing, and promotes faster healing.
  8. Pain Free Exercise - people living with arthritis or other conditions that affect mobility and joints may not be able to exercise on land without pain. The buoyancy of water helps to alleviate stress on joints, allowing people to exercise with a reduction in, or absence of, pain.  In this way, deep water running may allow an injured runner to return to the biomechanics of running, long before they can actually return to the road.  The deeper the water, the greater the support to the body. 

Who is Hydrotherapy For?

When people think of hydrotherapy, the first image that springs to mind for many people is senior citizens doing gentle exercises in a pool. While the elderly can definitely benefit from hydrotherapy, all ages can be treated using hydrotherapeutic techniques.

Anyone with chronic pain, mobility issues, weakened or atrophied muscles, trauma or injury, issues with balance and more can potentially benefit from hydrotherapy, no matter the age. Children with disabilities or developmental issues may benefit from interaction with the water and therapist, such as helping them to improve their range of movement, head control and neck strength, muscle tone, balance and coordination.

While all age groups can benefit from hydrotherapy, some conditions or ailments may preclude a person from being able to take part in the treatment, including:

  • Angina and other heart problems
  • Blood pressure issues
  • Breathing difficulties
  • Chest infections
  • Chlorine allergy
  • Diabetes - poorly or uncontrolled
  • Epilepsy
  • Fever
  • Incontinence
  • Kidney conditions requiring dialysis
  • Open or fresh wounds and/or skin infections
  • Viral infection

Having one of the above conditions may not necessarily stop you from having hydrotherapy - your physiotherapist will discuss options and potential solutions with you if necessary. 

A 2017 literature review/meta-analysis of studies of the efficacy of hydrotherapy in treating balance issues in hemiplagic stroke (paralysis on one side of the body), showed that hydrotherapeutic techniques were far more effective a treatment than any land based practices. 

What is Hydrotherapy Used to Treat?

Hydrotherapy may be used to treat a wide range of conditions, illnesses and injuries, including:

  • Arthritis and related rheumatic complaints
  • Balance problems
  • Cancer – management of symptoms and rehabilitation after treatments
  • Cerebral Palsy
  • Chronic pain
  • Fibromyalgia
  • Fractures
  • Stress Fractures
  • Joint pain
  • Mobility issues
  • Multiple Sclerosis
  • Obesity
  • Orthopaedic conditions
  • Osteoarthritis
  • Osteoporosis
  • Parkinson’s Disease and other neurological conditions
  • Pre-surgical strengthening of muscles
  • Postoperative rehabilitation following joint surgery
  • Respiratory issues such as COPD and Asthma
  • Scoliosis
  • Spinal pain (neck or back)
  • Stroke

If you experience chronic pain, have difficulty exercising, have issues with mobility or balance or think you may in some way benefit from hydrotherapy, schedule an appointment with a physiotherapist .

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