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What's Hydrotherapy

Hydrotherapy, or Aquatic Physiotherapy, is physiotherapy practised in water utilizing the unique properties of the waters such as buoyancy, hydrostatic pressure, specifically for an individual to maximize function, which can be physical, physiological or psychological.

This therapy is been used for thousands of years and is a popular treatment for patients with neurologic and musculoskeletal conditions.



Benefits of Hydrotherapy


Muscular relaxation and decreased muscle spasm.

Everyone knows how good it feels to take a dip in the pool on a hot day, and how water can relax you and relieve tired muscles. Further warm water helps to decrease muscle spasms as well.


Decreased pain due to warmth and support.

Water slows and buffers movement, which then decreases the incidence of pain. Further Immersion in warm water increases an individual’s comfort, by increasing blood supply to sore muscles. Weight relief to weakened body structures also creates additional comfort. Consequently, decrease the pain.


Gravity is countered by buoyancy and decrease stress on joints.

The buoyancy of the water decreases the amount of pressure, or compressive forces, on your joints and spine. When you’re immersed in water up to your neck, the weight pressing down on your body is reduced by 90%. When the water is up to your waist, the pressure is reduced by 50%. This can be especially helpful after surgery when your body is healing and you need to be careful about how much weight is placed on the surgical site.


To maintain or increase the range of joint movement.

Water is a medium that supports and assists movement. It offers a safe and pain-free setting for you to focus on regaining joint range of motion.


Increased muscle strength and endurance due to the greater resistance in the water.

Aerobic conditioning can often be performed in the water even when it may be too soon or too difficult to do in the gym because the fluid resistance can be used as assistive or resistive force.


Improvement in swelling, due to hydro-static pressure.

The pressure of the water helps to move fluid from the injured area back into the body. Decreased swelling is essential for regaining the strength and motion needed for recovery.


Enhanced balance and stabilization.

Staying stable in the water challenges your core and balance, and sports-specific activity can begin earlier than it can on land.


To re-educate paralyzed muscles.

The resistance offered by the water, forces the patient to move at a slower pace. This allows the brain to process the signals from the muscles more thoroughly because it has more time, an added benefit for rebuilding muscle memory. If the patient has a neuromuscular condition, such as myasthenia gravis, spinal muscular atrophy, muscular dystrophy or other impairment, muscle re-education is made easier through specially designed aquatic exercises.


To improve circulation ( trophic condition of the skin )

The gentle flow of water currents acts as a normal form of massage. This helps promote circulation


Improved enjoyment and confidence to move better.

Water is a constantly changing environment that can keep you challenged and motivated during your recovery.



Physical properties of water and its effects on hydrotherapy


Water has certain physical properties which include buoyancy, hydrostatic pressure, surface tension, relative density, viscosity, cohesion, turbulence, specific heat, thermal conductivity, refraction and reflection. These are used by physiotherapists when giving hydrotherapy.


Buoyancy and its effects


Buoyancy is the force experienced as an upthrust which acts in the opposite direction to the force of gravity. It decreases stress and compression on weight-bearing joints, muscles and connective tissues and raises weakened body parts against gravity. Further, it can be used as assistive or resistive force.


Hydrostatic pressure and its effects


The molecules of a fluid thrust upon each part of the surface area of an immersed body. The pressure exerted equally at the same dept at rest, but it increased with the density of the fluid and with its dept. This means that swelling (oedema) due to venous or lymphatic insufficiency will be reduced more easily if exercises are given well below the surface of the water where the increased pressure may be used. Further, it assists in promoting circulation and returns blood to heart more efficiently (from legs to heart). Combination of buoyancy and hydrostatic pressure help in balance exercises.



Hydrotherapy equipments


Hydrotherapy equipment fulfils an important role in water-based rehabilitation.

Some of the most popular types of equipment are floats (noodles, vests/collars, belts), kickboards, webbed gloves, flippers/fins, hydro barbells, aquatic paddles, aqua/hydro dumbbells, jets, trays and resistance boots.



What conditions can Hydrotherapy benefit?


  • Back pain/sciatica/ lumbar instability

It is an effective rehabilitation tool for both acute and chronic back pain. It is used for reducing pain and muscle ache while regaining mobility and strength.


  • Sports injuries

If you have any sports injuries that are particularly common in impact sports, which can range from back / spinal injuries to bruising and swelling, then the various types of hydrotherapy can help during the rehabilitation and recovery stages.


  • Osteoarthritis

Hydrotherapy exercise programs can increase muscle strength and help people with osteoarthritis of the knee or hip walk faster and longer, which may reduce the risk of falls and disability.


  • Ankylosing Spondylitis

Hydrotherapy can reduce disease activity and pain in patients with ankylosing spondylitis.


  • Parkinson’s Disease

Hydrotherapy may provide significant balance and mobility benefits in patients with Parkinson's disease compared to medication and land-based exercises.


  • Stroke

Aquatic therapy is especially helpful in treating stroke patients. The water provides a safe place for relearning skills and retraining the body, regardless of the patient’s level of mobility.


  • Whiplash & other neck pain

  • Tendinopathy

  • Balance/coordination problems

  • Shoulder and arm pain

  • Rheumatoid Arthritis & Fibromyalgia

  • Cerebral Palsy

  • Back and pelvic pain during pregnancy

  • Work and accident-related injuries

  • Rehabilitation after bone fractures, joint replacement or tendon repair


Clinical Contraindications


  • Cardiovascular disease

  • Cardiopulmonary disease

  • Diabetic

  • Balance disorder

  • A cold

  • Influenza

  • Fever

  • Skin conditions

  • Urinary incontinence

  • Open Wounds

  • Recently Surgery

  • Hydrophobic



Chamara Lakshan



References


https://rehabcorp.com.au/other-services/hydrotherapy/

https://www.hss.edu/playbook/fitness-friday-benefits-of-aquatic-therapy-in-rehabilitation/



Further readings


https://cheshirefitnesszone.com/what-are-the-common-types-of-equipment-used-in-aquatic-therapy/

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