By Carol Bailey
Water has been used for healing purposes for centuries. Because the human body is primarily composed of water, it feels like a natural place for many people in need of rehabilitation from injury or to help manage chronic pain conditions. Aquatic therapy continues to evolve as an option within the world of physical therapy. It is important for people to understand whether or not it’s a viable treatment option for their particular condition.
There are documented uses of water in medicine dating as far back at 1500 B.C., when it was used to combat fever. Prior to becoming President, Franklin D. Roosevelt helped popularize hydrotherapy in America when he claimed pool exercises helped combat the leg paralysis brought on by polio. Physical therapists began training in the use of water exercise during the following decades, with its popularity as a treatment rising and ebbing periodically.
Today, aquatic therapy treatments can be used in rehabilitating from almost any physical injury. The buoyancy of water unloads pressure on joints, making exercises less painful than they would be on land. Patients can gain a greater range of motion and strength, eventually transitioning back to exercising on land and ultimately returning to their jobs and other everyday activities.
Buoyancy is an important benefit of aquatic physical therapy. I have had patients with the degenerative back condition known as spinal stenosis experience strong positive responses upon being fully suspended in the water with flotation devices. These are people who haven’t been able to move without pain for years. When the spine unloads it brings tremendous relief. Another benefit of aquatic therapy is hydrostatic pressure. For patients with injuries to their shoulders, knees or other joints, soft tissue injuries or arthritic conditions, being vertical in the water can help reduce swelling.
The possibilities for using water to make exercise easier or harder are almost limitless, so it can be really fun. (Although we should note that we are not having patients swim and we do not provide swimming instruction.) We have buoyant devices and weights that can be used in the water. Turbulence can also be created to provide greater resistance. Most people who come to pool therapy really like the water. So just the psychological benefit of being in the water and being able to move without pain, even for half an hour, can be a motivational boost and get them on their way to healing.
People typically come to aquatic therapy because they are not progressing with traditional, land-based therapy. Just like regular physical therapy, we perform a thorough evaluation to assess their condition. What’s causing the pain? Are there certain muscles that are weak or tight? Are there postural deviations? Then we generate a list of short-term and long-term goals. We want patients to be able to achieve a certain level of accomplishment during their sessions with us. The hope is that the patient meets their goals and develops techniques to manage their conditions independently.
This is our second year offering aquatic physical therapy at BMH through an agreement with Colonial Motel and Spa. When I go with my current patients it’s really nice to see some of my former patients who have obtained memberships there and are continuing their therapy. They’re very encouraging to the current patients and it creates a great sense of camaraderie.
Even beyond those people who have a fear of water, there are some patients who shouldn’t do aquatic therapy. Anyone with an unstable cardiac or respiratory condition should not get in the pool; nor should a person with incontinence issues or uncontrolled diabetes. Insurance coverage can be an issue for some patients as well, so make sure you talk to your physician and your insurance provider before looking into aquatic therapy programs to make sure you are eligible.
Carol Bailey, PT, is a licensed physical therapist with BMH Rehabilitation Services. She has intensive, advanced training in safely applying aquatic therapy principles and techniques. She can be reached at 802-257-8255.