Hydrotherapy describes many different activities that involve or are done in water. These activities have a therapeutic effect. Hydrotherapy often refers to movement and exercise for rehabilitation carried out in a warm pool. These pools are usually quite shallow so you can stand up easily in them and have a rail to hold on to. Often the pools have a few different ways of getting in the water such as steps, a ramp or a hoist.  

What is the difference between hydrotherapy and aquatic physiotherapy?

Hydrotherapy describes many different activities that involve or are done in water, often referring to movement and exercise for rehabilitation carried out in a warm pool. These activities have a therapeutic effect. 

Aquatic physiotherapy is carried out in a pool and can only be provided by physiotherapists who have special training in rehabilitation in water. Aquatic physiotherapists use their skills to find the main problems with a person’s flexibility, strength, posture, balance, general movement, or walking. A targeted treatment program in the pool can help you address your main difficulties in these areas.

Aquatic physiotherapy can also help you to change and improve everyday activities you are having difficulty with or would like to improve. This can include work or home tasks, or helping you recover from an injury to get back to your usual activities like gardening or playing sport. Your physiotherapist will know how to support you in the water if you need help. Physiotherapists can challenge you at the right level and help monitor all of your medical conditions to keep you safe while you exercise in the water.

When is hydrotherapy or aquatic physiotherapy appropriate?

Aquatic physiotherapy can help most conditions that result in pain, stiffness, weakness, deconditioning or low fitness, balance problems or difficulties moving, for example walking or going up stairs.

Aquatic physiotherapy focuses on gentle exercise in the early stages of your rehabilitation. These exercises can become much harder when you need or when you can manage more difficult exercises.

To undertake aquatic physiotherapy your medical conditions needs to be stable. If you have high blood pressure, check with your GP to make sure it is steady (and controlled with medications in some situations). If you have had surgery that involves a cut in your skin, this wound needs to be covered with a waterproof dressing before you get in the pool. It is best to get clearance to start hydrotherapy from your surgeon or doctor or talk to your physiotherapist about whether you are ready.

How do I know if I need aquatic physiotherapy?

If you have difficulty or pain with movement, problems with your balance or mobility, or find exercising on land challenging, then aquatic physiotherapy is worth a try. It’s also beneficial if you would like to learn to swim after an injury or want to work on your fitness after being unwell. Speak to your physiotherapist about whether hydrotherapy or aquatic physiotherapy is a good option for you.

What issues should I consider treating with aquatic physiotherapy?

Aquatic physiotherapy can be beneficial for people of all ages, from babies and children to older people. Many different conditions are treated with aquatic physiotherapy including musculoskeletal, neurological and cardiopulmonary (heart and lung) problems.  

Exercise in water may be the most beneficial for people that find exercising on land very difficult or very painful.

  • When you stand in water up to your waist you are only taking 50 per cent of your body weight through your back and your legs.
  • In chest deep water you are only taking 30 per cent of your body weight.


This may make moving easier in water for the joints and muscles that are painful or weak. If you are unable to walk or find walking difficult after an injury, then learning to move or swim in water is a great option to keep fit and regularly exercise. 

How can hydrotherapy or aquatic physiotherapy help?

Your physiotherapist will first complete a land-based assessment to test your movement. They will chat wtih you about what you or your family think your main problems with moving around are. Your physiotherapist can then design an aquatic exercise program to start working on these goals in the pool.

Aquatic physiotherapy programs include lots of different types of exercise depending on what you need. They can include walking practice, fitness exercise, strengthening, flexibility, relaxation, balance or swimming. Your physiotherapist can work with you one on one if you need help in the water, for example with babies, younger children or after you’ve had an injury when movement is limited (such as a stroke).

Your physiotherapist can also work closely with you if you’re nervous in water. It’s a good place to exercise if you’re worried about falling, as moving in the water is slow and you won’t hurt yourself if you have a wobble.

Some physiotherapists also offer warm water exercise classes for pregnant women or people with arthritis and will adjust the exercises to the individual needs and abilities.

How effective is hydrotherapy or aquatic physiotherapy?

Research shows that doing aquatic exercise results in similar improvements in walking, balance, pain and quality of life as land-based exercise in many conditions. The most research has been done in hip and knee arthritis or joint replacements, other types of arthritis, older adults, fibromyalgia and low back pain. There are also studies in neurological conditions, showing benefits for people with Parkinson’s Disease, stroke, multiple sclerosis and traumatic brain injury. Similarly, research in pregnant women, paediatrics and heart and respiratory conditions demonstrates that people can benefit from aquatic exercise.

How long until I improve?

Aquatic physiotherapy programs may vary. Improvement in strength can be best achieved if performed at least twice a week, but this may not be suitable for everyone. Studies have shown that in many conditions there is often significant improvement over a six-week period. For long-term problems or conditions that you are trying to manage, your aquatic physiotherapist will aim to teach you your aquatic exercise program so you can keep going by yourself or with your carer. Your physiotherapist will be able to recommend the ideal frequency for your condition to help you improve.


Source: Choose.physio