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Hydrotherapy treatment involves the use of unique properties in water to achieve therapeutic benefits.

Hydrotherapy is a word most of us have heard but a lot of us probably don’t have a clear idea exactly what it is.

Essentially the word means ‘water as treatment/therapy’, thus it can mean lots of different things.

It has long been known that water has some very interesting properties particularly when it comes to the human body.

In ancient civilisations (think Egypt, Greece etc.) bathing in warm water and oils was used a method of relaxation and stress relief.

But it wasn’t until the 19th century that water started to be formally used for treatment by doctors and therapists.

Even then it was poorly understood why water was so helpful in curing pain and various ailments.

In this article we will aim to explain what beneficial effects of water we employ in hydrotherapy and what hydrotherapy means in a physiotherapy setting.

What is hydrotherapy?

Hydrotherapy, sometimes known as aquatic therapy, is a form of physiotherapy that uses water to warm the body and gently increase resistance. It is commonly prescribed by doctors for the treatment of a wide variety of conditions, including:

• Arthritis
• Back pain
• Stress and Anxiety
• Poor circulation
• Muscle pain and inflammation
• Headaches
• Hip and joint replacement rehabilitation
• Strokes and brain injuries

During a hydrotherapy session you’re not swimming, but rather performing a specific series of exercises. The pool is also heated to a warm 33-36°c in order to relax and soothe your muscles.

Other complementary treatments that can be used alongside hydrotherapy to alleviate the symptoms of arthritis may include massage, chiropractic adjustments, gentle exercise and adding fish oil to your diet.

Principles of Hydrotherapy

Hydrotherapy is unique as it can act as a treatment choice for either assistive or resistive force. There are unique principles of water that can make this possible:

Buoyancy: As per Archimede’s Principle of Buoyancy, a body immersed in a liquid experiences an upward force equal to the weight of the displaced liquid. This is why the body feels less weight in water than on land (this is also the principle behind hydrostatic weighing). The buoyancy of the water can assist or resist with the exercises of the extremities. In addition, changing the speed will either grade or change the exercise difficulty. In addition, the buoyancy of water is affected by postural alignment and the surface area immersed in the water.

Hydrostatic Pressure: A perpendicular pressure against the surface of the body exerted by water is called hydrostatic pressure. This pressure increases as the depth and density of the liquid increases. This is why a motion is performed more easily near the surface of the water than at greater depths.

Cohesion: Water molecules have a tendency to attract to each other. As a result, molecules are cohesive. This causes an increase in resistance to range of motion compared to that of the air.

Viscosity: Viscosity is an internal friction that directly depends on the speed of the liquid. In other words, the higher the speed, the higher the viscosity, and thus, the higher the resistance to the movement. Furthermore, the shape of the object (the body) also affects viscosity. A larger or more spread out object faces greater resistance to motion in the water.

Hydrotherapy Treatment Benefits

The two most beneficial mechanical effects of being in water are buoyancy and a little thing called hydrostatic pressure.

Buoyancy produces a feeling of partial weightlessness through your joints (you are only taking 10-15% of your bodyweight in chest high water) and can relieve a lot of pressure, which is particularly useful in arthritic joints or in people returning to walking after time in a cast or non-weight bearing.

It’s basically like taking a break from gravity for a while! Hydrostatic pressure is a property of water on solid objects, like your body!

Without going too in-depth some of the many benefits of this property include reducing swelling in injured joints, stimulating the immune system, improving cardiac function and blood flow and allowing participants to exercise more vigorously with less strain on muscles and the cardiovascular system.

Hopefully you’re starting to see the amazing benefits of exercising in warm water!

Hydrotherapy is useful in the treatment of:

• Management of acute or chronic pain
• Rehabilitation for pre- and post-joint replacement surgery
• Relieve arthritis pain
• Improve muscle flexibility
• Improve range of motion
• Improve strength via resistance training
• Weight loss
• Reduce muscle spasm
• Fight fatigue
• Aid in relaxation and lower stress levels

Additionally, hydrotherapy is a good alternative to vigorous exercise during pregnancy, and can help with labour pains during childbirth (water birth).

Hydrotherapy Contraindications

Hydrotherapy should be avoided in the following conditions:

• Open wounds
• Active infection
• Altered sensation
• Hydrophobia
• Heat or cold intolerance
• Poor balance

Do you use hydrotherapy in your practice? If so, tell us about your results in the Comments section below.

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