The Beginners Guide to Hydrotherapy

Hydrotherapy – What is it?

Hydrotherapy involves the use of various properties of water to promote physical and mental therapeutic effects.  Done primarily in warmer water (ideally in temperatures ranging from 93-98 degrees), the temperature combined with water properties is intended to allow neural and musculoskeletal rehabilitation, as well as enhanced flexibility, balance, and coordination, which can easily be transferred to land-based exercise.

Benefits of Hydrotherapy:

1. Increase in efficiency of total body circulation and decreases in swelling, particularly of distal joints (less issues with extremities, such as in osteoarthritis or rheumatoid arthritis)


2. Softens and relaxes the body, which promotes pain relief


3. Reduces tendency for muscle spasms


4. Increases range of motion through the joints (allows them to work through fluid movements, as opposed to jerky or abrupt and uncontrolled movements as tend to happen on land)


5. Muscular strength and endurance


6. Improved balance and coordination, particularly beneficial for the active older adult (as falls lead to so many serious or even potentially fatal injuries)


7. Re-education of damaged or paralyzed muscles (as in after surgeries and/or joint replacements)


8. Found to improve conditions such as muscular dystrophy, cerebral palsy, multiple sclerosis, Parkinson’s disease, and other neurological afflictions

Properties of Water that Promote Safety/Effectiveness:

• Buoyancy: lessened effects of gravity means less impact on the joints, particularly the knees, hips, and spine (axial load) which makes many land-based exercises doable for those who can only exercise in water. Buoyancy also allows for more reaction time so that some exercises which are difficult to do on land because they require fast actions are more doable in the water (i.e. jumping motions, lifting the legs, or even performing some stretches where it can be difficult to maintain the balance and coordination)


• Viscosity: provides natural resistance through gentle friction against the body (about 15x more in water than on land) which conditions and strengthens the body and repairs injuries


• Hydrostatic Pressure:  keep heart rate slightly lower than it would be on land proportionate to the work output, which means you can exert more effort without feeling as winded as quickly – this property also lends itself to improve heart and lung function.

Contraindications:

• Prominent inflammation (clearly visible, redness and heat are present)


• Fever (previously heightened core temperature is not advised for hydrotherapy)


• Heart disease/hypertension/vascular conditions (increased blood flow and/or circulation is not advised for these populations)


• Cancer


• Hemorrhages/infections/open wounds


• Osteoporosis - This population is not necessarily a contraindication as they DO benefit from hydrotherapy, however they also do need true weight-bearing training in order to improve bone density and reduce risk of fracturing or breaking a bone.

Customization of Intensity:

• Hydrotherapy can be approached as simplistically as floating in the water to benefit from increased temperature and relaxation properties.


• Intensify your experience with some static and dynamic stretching in the water.


• Intensify further with some dynamic movement including squats, lunges, kicks from the wall, water walking or even light jogging and other aerobics movements.


• Increase speed, duration and range of motion as other methods of intensifying the work or increase turbulence in the water to challenge balance and stability.


• Add objects such as floatation devices or water weights to enhance resistance and increase surface area.

Hydrotherapy Exercises:

1. Standing lunge stretch (shallower water if possible)


2. Standing calf stretch


3. Standing hip flexor stretch


4. Quad stretch (one hand against wall)


5. “Floating” full body stretch (both hands on wall, outstretched and core musculature engaged)


6. Knee-to-chest exercise (one hand on wall, leg outstretched to front, draw knee in and extend)


7. Leg raise exercise (one hand on wall, leg outstretched to front, pulse leg up and down)


8. Reverse leg raise exercise (one hand on wall, leg outstretched behind, pulse leg up and down)


9. Pool walking exercise (versions include arms out, arms to front, feet directly in front of one another, calf raise, backwards walking, arm circles, forward kicks, hamstring curls, breaststroke arms, etc.)


10. Quadruped floating exercise (lying supine with engaged core, paddle arms and feet simultaneously)


11. Floating char exercise (seated in chair position with levitated legs, use arms to keep balance)


12. Any other low impact aerobic move you enjoy!