Hydrotherapy Exercises

Hydrotherapy Exercises such as floating, general body movements, stretches, and

walking in water are beneficial, as water's natural buoyancy allows freedom of
movement without jarring or straining the body. Its natural resistance encourages
strengthening of the muscles, and its unique properties alleviate pain and facilitate
improved health.

Hydrotherapy Definition
Hydrotherapy also known as water physical therapy and aquatic physical therapy is the
use of a water environment to carry out exercise whilst being able to change the
intensity of the movement- a feature which is not possible out of water. Because the
body is buoyant, the water allows for more exercise to be carried out than on land, while
the increase in temperature and pressure encourages circulation and flexibility. This is a
particularly effective and comfortable way for patients to rehabilitate from a sports
injury.

The pool itself is specially designed to cater for hydrotherapy treatment. Namely, the
water temperature is hotter than the average swimming pool, with temperatures at
around 35 degrees the norm to allow patients muscles to relax and promote movement.
The water in the pool is warm, and is maintained at 3337C.
Father Sebastian Kneipp, a 19th century Bavarian monk, is said to be the father of
hydrotherapy. Kneipp believed that disease could be cured by using water to eliminate
waste from the body.
Drawing of Vincent Priessnitz (1799-1851), supporter of hydrotherapy and founder
of a spa.

Benefits of Hydrotherapy Exercises

Hydrotherapy Exercises can:

increase mobility

reduce pain and muscle spasm

improve and maintain joint range of movement

strengthen weak muscle groups

increase physical fitness and functional tolerances

re-educate normal movement patterns

improve balance

improve co-ordination

improve posture

improve self confidence

stimulate circulation

Warm Up and Cool Down Hydrotherapy Exercises

Warming up before exercising prevents muscle strain and injury. Submerge your body
and allow your muscles to relax, then walk in the water for five minutes to get your
circulation flowing. Spend another five minutes stretching while standing in the water,
holding each stretch for 10 seconds. Begin with stretching your legs -- thighs, hips,
calves, shins and buttocks. Move on to stretching your back, chest, and torso, then roll
your shoulders and your neck. Stop at any point that causes pain. After you complete
your workout, perform the same stretches, holding each for 20 seconds, before leaving
the pool.

Cardio Workout
Using a flotation vest or aqua noodle to keep you upright, perform aerobic exercisesfor
five to 15 minutes. Walk or run backwards and forwards or do jumping jacks or dance
moves to elevate your heart rate. If you begin to feel weak or dizzy, rest for a moment or
change activities.

Upper Body Exercises

Sitting or standing in the pool, gently move each joint through a complete range of
motion, repeating three to eight times as tolerated. Begin with your shoulders by
reaching your arms forward and upward, then out to the side. With your arms below
water level, make small circles, then larger and larger ones, first inward and then
outward. Bend your elbows, then straighten your arms. Turn your wrists in circles, then

bend them forward and backward. Touch the fingers of one hand lightly against the
thumb. Make fists with your hands, then straighten the fingers.

Lower Body Exercises

Sitting in the pool with back supported, straighten your knee and bend the ankle,
pointing the toes. Curl toes down, then straighten them out. Circle your ankles,
clockwise and then counter clockwise. Slowly raise one foot up to straighten out your
knee, then bend the knee again. Lift one knee and hug towards your chest, hands under
the thighs or over the knee to assist with the stretch. Sitting forward, straighten one
knee and slowly move the leg out to the side, hold for three seconds, then bring it back
to the centre. Standing with your left side to the aquatic physical therapy pool wall and
holding the wall with your left hand, raise your right leg forward with the knee straight,
hold for five seconds, then swing the leg backward. Raise leg forward again, swing it out
to the side, hold for five seconds and cross it in front of your body. Repeat with the right
leg. Place hands on hips and, without moving your feet, bend slowly toward the right,
then to the left. Repeat in the other direction.
Some Related Topics Discussed Here
Hydrotherapy For Neuro Rehabilitation
Hydrotherapy For Cardiac Rehabilitation
Hydrotherapy For Arthritis and Joint Pain
Hydrotherapy For Back Pain

Risks, Cautions, and Contraindications for Hydrotherapy Exercises

Persons with impaired temperature sensation run the risk of scalding or frostbite
at temperature extremes.

If you have diabetes, avoid hot application to the feet or legs. Also avoid full body
heating treatments, such as body wraps.

Hot immersion baths and long, hot saunas are not recommended for those with
diabetes or multiple sclerosis, women who are pregnant or anyone with abnormally
high or low blood pressure.

Avoid cold application if you are diagnosed with Raynaud's disease.

Don't take cold foot baths if you are prone to bladder or rectal irritation. People
suffering from sciatica, pelvic inflammation or rheumatism in the toes or ankles
should avoid cold foot baths.

Elderly people and young children may be exhausted by too much heat and
should avoid long full-body hot treatments such as immersion baths and saunas.

If you are pregnant or have heart disease, consult a doctor before taking a sauna.
When a condition is recurrent or persistent, please consult your physician to
determine whether a physical therapy of this type is suitable in your case.

Hydrotherapy Exercises For Neuro Rehabilitation

Mobility can be improved with hydrotherapy exercises for neuro rehabilitation as people
are able to perform activities in the pool that they are unable to perform on dry land.
With the appropriate progression of exercises these activities, such as walking or
running, will be able to be performed outside the pool. The support of the water and the
reduced fear of falling can aid mobility practice. Exercises against the resistance of water
and dynamic exercises within the water can also improve muscle strength, balance and
co-ordination.

Hydrotherapy is great for treating an array of some neuromuscular

problems such as -

stroke

head injury

spinal injury

Parkinsons disease

Multiple Sclerosis (MS)

Muscular Dystrophy

Cerebral Palsy (CP)

Guillain-Barr syndrome (GBS)

Fibromyalgia

Myalgic Encephalopathy (ME)

Motor Neurone disease (MND)

Chronic Fatigue syndrome

Patients tend to prefer the treatment because it helps allay symptoms such as
general pain, muscle spasms, limited joint movement, weak muscles, bad circulation,
instability, and paralysis. Most of the general principles of land-based exercise are also
recommended for water-based exercise, such as including a warm-up and cool-down
and allowing adequate rest between sessions (e.g., one day). Most importantly, exercise

should be focused towards achieving client-directed goals that are meaningful and
relevant to the individual. The types of exercise commonly used in water include
strength, fitness, balance, stretch and relaxation exercises.

Stretching and relaxation ( hydrotherapy exercises for neuro

rehabilitation )
Many people with MS enjoy stretching and relaxation exercises such as passive range of
movement exercise or massage. These exercises can be part of anyones aquatic exercise
program but are found to be particularly enjoyable by people who are less mobile
because they are able to move the muscles and joints beyond what they can achieve on
land.
Aquatic pool therapy exercise examples

The person floating in the supine position has an assistant behind their head, who gently
holds them at the trunk sides, and slowly guides their body through an arcing motion (from
side-to-side).

The supine body sway exercise allows the trunk and hips to stretch at the end of each
movement.

Supine hip abduction (passive)

Supine hip and knee flexion (passive)

Supine shoulder flexion and abduction (passive)

Exercise modifications

Stretching may be difficult for people who experience strong spasms or spasticity. It is
important for the assistant to position the person so that they avoid excessive strain on their
own body, for example when passively moving the hips into abduction with the person in the
supine position. Rather than having the assistant stand at the feet and separate the legs with
one hand on each ankle, it may be better for them to stand between the persons legs at the
distal end. The assistant can then rest their own back against one leg to stabilise it, and use

both their hands to push and separate the other leg. This is usually more comfortable for
both the assistant and the person undertaking the stretching exercise.

People who have spasticity and some active muscle control may benefit from stretching
techniques that alternate resisted contraction of the spastic muscle with stretching of the
spastic muscle. For example, for a person with excessive knee extensor tone,
alternate isometric resisted active knee extensor contraction, with passive knee extensor
stretch.

Repeated contraction and stretch may lead to increased relaxation of the knee extensor
muscle, which may improve the persons comfort and ability to participate in other exercises
during the aquatic exercise session.

Strength training ( hydrotherapy exercises for neuro rehabilitation )

Strength training involves working against the resistance of the water, body, or
floatation devices. Slow leg kicks or arm movements through the full range in flexion,
extension, abduction and adduction, as well as squats, calf raises and jumping.

Increase resistance by using aquatic dumbbells, hand paddles, aquatic ankle weights or
by moving through the water at a faster rate.

Decrease resistance by slowing movements, eliminating body weight (by supporting the
body with floatation devices such as pool noodles, floatation mats or buoyancy vests, or by
exercising in deeper water) or performing movements close to the surface of the water.

Increase repetitions and amplitude of movements (e.g., jump higher or further).

People who are unable to maintain a standing position independently (e.g., due to
weakness or balance impairment) may be able to do so by holding onto a rail at the edge of
the pool or with the assistance of a floatation device such as a pool noodle, buoyancy vest or
buoyancy ring.

Alternatively, many exercises can be performed in supine instead of standing. people can
be safely supported in supine by using a combination of floatation devices, such as a neck
float to maintain the head above water, a trunk float such as a buoyancy vest or ring, and
lower limb floats such as pool noodles or ankle floats. The choice of floatation device is

usually guided by the persons size and comfort level in addition to the need to allow
movements suitable for the desired exercise.

Some people may have difficulty maintaining balance during resistance exercises due to
the turbulence created by their movements. They may be able to stabilise the body more
effectively by leaning against the pool wall during upper limb exercises, holding a rail during
lower limb exercises or by exercising in shallower water.

Fitness training ( hydrotherapy exercises for neuro rehabilitation )

Fitness

training

involves

variety

of

Hydrotherapy

Exercises

For Neuro

Rehabilitation that increase the work rate of the heart and lungs. Exercise examples are
Swimming, kicking, running, walking, cycling and jumping.

Increase intensity by adding resistance such as hand paddles during swimming or

flippers during kicking, increasing speed of movement or increasing duration of activity.

Decrease intensity by minimising resistance, slowing movements, reducing activity

duration or reducing body weight (e.g., exercising in deeper water).

People who have difficulty swimming (e.g., due to impaired coordination or weakness in
upper or lower limbs) may be able to participate by focusing on the upper limbs separately to
the lower limbs. For example, the legs may be supported with ankle floats, a pool noodle or
other buoyancy device when working the arms. Then the arms and trunk may be supported
by a pool noodle or buoyancy ring when working the legs. A neck float may also assist people
who have difficulty with swimming to feel more water confident.

People who have difficulty maintaining balance during walking, running or jumping
activities may benefit from holding on to a pool edge rail or a floatation device such as a pool
noodle or aquatic dumbbells.

Cycling and kicking exercises can be performed in supine or prone positions (using
floatation devices) to maximise comfort and safety.

Balance training ( hydrotherapy exercises for neuro rehabilitation )

Balance training involves Hydrotherapy Exercises For Neuro Rehabilitation that reduce
the base of support (e.g., standing with one foot directly behind the other or standing on

one leg) and/or which perturb the body (e.g., balancing when performing arm or leg
movements against the resistance of water).
Aquatic pool therapy exercise examples

Tandem standing (one foot directly behind the other)

lunging

reaching

standing on one leg

walking (forwards, backwards, sideways)

running and jumping

Exercise modifications

Increase difficulty by reducing the base-of-support (e.g., heel-toe walking, reaching or

jumping with the feet close together)

Reducing vision dependence (e.g., walking backwards or balancing with the eyes closed)

Increasing water turbulence (e.g., combine balance exercises with arm or leg movements
that perturb the water, or perform balance exercises in choppy water).

Decrease difficulty by increasing buoyancy (e.g., exercise in deeper water), increasing

base-of support (e.g., reaching with feet wide apart),reducing movement complexity (e.g.,
avoiding combined arm and leg exercises such as start jumps), minimising water turbulence
and providing minor balance assistance (e.g., exercise within reach of a rail or walking with
pool noodle in front of the body).

People who are non-ambulant on land may be able to balance and walk in water if they
are supported with floatation devices such as a buoyancy vest, buoyancy ring or a pool
noodle.

People who are fearful of being unable to stand up after slipping in the pool may feel
more confident if they have a neck float which will keep their head above water at all times.

Research Articles emphasizing importance of Hydrotherapy exercises for

Neuro Rehabilitation

Kesiktas N, Paker N, Erdogan N. The use of hydrotherapy for the management of

spasticity. Neurorehabil Neural Repair. 2004 Dec;18(4):268-73. [PubMed]

Mehrholz J, Kugler J, Pohl M. Water-based exercises for improving activities of daily

living after stroke. Cochrane Database Syst Rev. 2011 Jan 19;(1):CD008186. doi:
10.1002/14651858.CD008186.pub2
Aquatic Cardiac Rehabilitation

Aquatic Cardiac Rehabilitation

Aquatic Cardiac Rehabilitation (ACR) is a medically supervised aquatic aerobic
exercise program held in a swimming pool to promote healthy cardiorespiratory fitness.
ACR classes are designed for patients with coronary atherosclerotic disease or pulmonary
disease, who have orthopedic limitations preventing them from participating in traditional
land based rehabilitation.

An aquatic environment can boost cardiac efficiency, but pay attention to exercise
guidelines. Before beginning a cardiac aquatic rehabilitation program, you should
participate in at least 8 weeks of supervised land-based exercise to establish baseline
measures for blood pressure, heart rate and angina. Your physician should consider
arrhythmia history and medication side effects before providing a medical release.
Look for a pool between 88 and 92 degrees F. Cold water can trigger arrhythmia; warmer
water can impede heat dissipation. If you have a low vital capacity (less than 1.5 liters), the
hydrostatic pressure of the water may make breathing difficult, so stay in shallow water or
use a supine float. Keep exercise sessions short and intensity levels low; increases should be
gradual. Take frequent breaks. Keep yourtarget heart rate 12 to 17 beats per minute
lower than an equivalent land exercise . Avoid horizontal swimming, which is too
demanding for cardiac patients. Have a health professional monitor vital signs before,
during and after sessions. Also, you should never exercise unattended. Stop exercising and
alert a clinician if you experience pain or shortness of breath.

Benefits of Aquatic Cardiac Rehabilitation Exercises:

Increased functional capacity or V02 max.: This is the maximal ability of the
body to activate its energy systems to cope with the demands of exercise.

Improved cardiac efficiency: increased tolerance for and practice of ADL,

reduced heart rate, blood pressure, and rate of perceived exertion when exercising at
submaximal levels.

Increase in Myocardial Perfusion: improved blood supply to the heart muscle.

Reduced CVD risk factors: reduced total cholesterol, reduced triglycerides,

reduced resting blood pressure, improved control of Type 2 Diabetes, better control of
body fat.

Reduced symptoms of CAD: reduced Angina threshold, reduced pain.

Improved psychosocial well being: reduced anxiety, muscular tension, reduced

depression, increased self confidence, greater ability to cope with stress.

Aquatic Cardiac Rehabilitation

Prerequisites

MD Referral

History and Physical, baseline ECG (electrocardiogram), Exercise Stress Test if

available but not necessary, exercise history

Able to tolerate hour exercise comfortably

Preferable to have come from a Phase II program

American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR )

guidelines for Phase III/IV, patients exercising at 5 Met level.

Emergency Equipment/Staffing

AED (Automatic External Defibrillator)

Emergency drugs according to ACLS (Advanced Cardiac Life Support) guidelines

Oxygen tank / nasal cannula or mask

Blood pressure cuff/stethoscope

2:15 ratio of staff members to patients; 1 staff needs to be ACLS certified and trained
Cardiac Rehab professional, 1 staff needs to be trained by AEA or ATRI for water fitness;
lifeguards according to individual pool policy

An emergency telephone should be within reach of the pool.

Clients should bring their medications to class to a predetermined place. `Meds'

should be labelled with the clients name and instructions.

Aquatic Physical Therapy Exercise Guidelines

Slow warm-up to reduce possibility of chest pain and allow patients to adjust to
aquatic environment.

Low impact aerobic exercise increments with RPE and Heart Rate checks.

Baseline HR, Peak HRs, recovery HR.

Blood pressures at least once a week or more according to patient condition.

Use only one arm overhead when doing stretches and aerobic work (two arms creates
a back pressure and stress on the heart).

Intermittent long lever/short lever moves throughout workout.

Keep RPE at 11-13 at peak exercise.

20-30 bpm above resting heart rate for peak exercise.

For recent Exercise Stress Test results, use peak heart before ischemic changes (Ask
the patients physician) as heart rate maximum; then calculate a straight percentage.

50 - 85% of heart rate max.

Use 20 beats above resting heart rate is used if a patient is on a beta-blocker

medication such as Atenolol.

Use 10 bpm less than angina or chest pain threshold (For example: if a patient
normally gets chest pain at a heart rate of 100, then make sure this patient does not
exercise with a heart rate more than 90 bpm at peak exercise).

Wait 6 weeks post heart attack before water exercise.

Wait 3 months after coronary bypass surgery before water exercise.

Patients are knowledgeable for monitoring RPEs, heart rates.

Guidelines on how to increase and decrease water workloads, working with hand
buoys and webbed gloves.

Observe for high B/P (blood pressure) with buoy work.

Add toning/abdominal work with cool down.

Absolute Contraindications to cardiac rehab exercise

Unstable angina

Uncontrolled congestive heart failure

Arrhythmia that affects hemodynamics

Uncontrolled hypertension

Acute myocarditis

Severe valvular stenosis

Hypertrophic cardiomyopathy

Acute pulmonary emboli

Examples of education series incorporated in aquatic rehabilitation exercise

Low fat diet maintenance

Weight reduction

Caffeine, smoking reduction/cessation

Safe exercise progression

Water workloads

Water THR

Cross training/home walking program

Stress reduction

Lipid lowering therapies

Further Reading

Jill M. Thein, MPT, ATC and Lori Thein Brody, PT, SCS, MS, ATC. Aquatic-Based
Rehabilitation and Training for the Shoulder. J Athl Train. 2000 Jul-Sep; 35(3): 382389.

Choi JH, Kim BR et al. Comparison of Cardiorespiratory Responses During Aquatic and
Land Treadmill Exercise in Patients With Coronary Artery Disease. J Cardiopulm Rehabil
Prev. 2014 Nov 18.

Aquatic

therapy:

scientific

foundations

and

clinical

rehabilitation

applications. researchgate.net

Use of Aquatic Therapy for Adults with Chronic Heart Failure: An Evidence-Based
Review. ucsf.edu
Hydrotherapy for Arthritis

Description of exercises that can be done in hydrotherapy for arthritis of hip and knee,
ankle and foot, shoulder and elbow plus wrist and fingers. Warm water exercise is an
excellent way for those with arthritis to build up strength, ease stiff joints and relax sore
muscles. Waters buoyancy greatly reduces the pressure on your joints, making it easier
to perform needed range of motion exercise.
Hydrotherapy is great for treating an array of some Arthritis problems such as

osteoarthritis (OA)

rheumatoid arthritis (RA)

juvenile arthritis

ankylosing spondylitis (AS)

A soak in warm water can help alleviate the stiffness of the knee caused by injury and
arthritis. It provides an opportunity for exercise in an environment that puts less strain
on muscles and joints, which is especially beneficial for those suffering from arthritis
and joint pain. In hydrotherapy for arthritis and joint pain, the warm water increases
circulation during exercise, and the buoyancy of water supports joints and muscles
without unnecessary pressure.

Hip and Knee exercises performed in hydrotherapy for arthritis

Walking Submerge your body and allow your muscles to relax, then walk in the water
for five minutes to get your circulation flowing. Simply walking in waist-deep water can
provide benefits for knees. Knee muscles and joints are used during every step, and lifting the

knees up high works the muscles and joints even more. The buoyancy of the water will
protect knees from high impact, unlike walking or jogging on solid ground.

Knee Bends Bending the right knee while bringing the right foot behind the body
works the knee and upper leg muscles. Knee bends can also be performed standing against
the pool wall for support. Bend your right knee so that your right thigh is parallel to the
water's surface. Straighten your knee and then bend it again, lowering your leg back down.
Knee bends should be repeated while alternating legs.

Knee Pushes Using the knees to push down items in the water strengthens muscles
without force of impact. While holding the side of the pool for balance, pull your right knee
up as far as possible. Place a flotation device underneath the right foot, such as a flotation
noodle, and use leg and knee muscles to push the item down to the bottom of the pool.
Repeat this exercise with the other leg, but continue to hold onto the side of the pool for
balance.

Knee Extension Exercises Knee extension exercises can be done in water with ease.
Enter a swimming pool and hold the edge of the pool standing with your legs completely
immersed in the water. Slowly raise your leg, bending the knee at a 45-degree angle and then
relaxing it again. Do this exercise for both knees for at least a half hour every day. A body
weighs 50 to 90 % less when in water; the percentage varies according to the depth of the
water. This helps reduce the discomfort and resistance of any knee exercise and also allows
extra exercises to be done with more exertion and less pain.

Leg Raise The exercise is similar to the knee-raise exercise. Stand in the water on one
leg with a slightly bent knee while holding on to the side of the pool or other support. This
time, the leg is kept straight and raised in front of you as high as your range of motion allows.
Lean slightly forward and raise the leg behind you. Then raise the leg off to your side,
although the range of motion for sideways raising is naturally limited. This exercise also
strengthens the hip, leg and lower back muscles.

Squats under water Squatting in deep water is excellent closed-chain-kinematic

exercise for strengthening quadriceps and hip muscles.

Water Cycling Lying on the bed or sitting on the stool, cycling legs forwards and
backwards.

Under water treadmill

Aqua aerobics Aqua aerobics or water aerobics exercises are some of the best
swimming pool exercises that you can try for weight loss. There are numerous water aerobics
exercises that you can easily learn. Water cycling is an easy and effective water aerobics
exercise that you can try. To perform this exercise, you need to find support of a pool wall
and then place your arm over it. Make sure you can hang from that wall, without slipping
down. If you are not so confident, then you can simply wear a swimming tube and put your
arms over it. Now, that you are hung comfortably on a support, start cycling. Continue
cycling for about 20 minutes and increase the duration gradually.

Ankles and Toes exercises performed in hydrotherapy for arthritis

Do an ankle bend by sitting in a spot that offers back support and straightening your
knees.

Bend your ankle and point your toes down. Then point them up toward the ceiling.

Next curl and straighten your toes. Finally, make inward circles with your foot by moving
your ankle, followed by outward circles.

Perform ankle inversion and eversion exercises under water.

Do these exercises for each ankle and foot.

Shoulders and Arms exercises performed in hydrotherapy for arthritis

Work your shoulder with a forward arm reach.

Raise your arms upward and forward as high as you can.

Do one arm at a time if one arm is weak, helping the weak arm with the stronger arm.

Further work your arm with a sideways arm reach. Raise your arm out to the side slowly.
Keep the palms facing down. Go only to shoulder height. Lower your arms and repeat.

Do arm circles by bringing both arms up and forward, keeping them a couple of inches
below the water level.

With straight elbows make small circles with your arms. Make bigger and bigger circles,
and then make the circles smaller and smaller again.

Perform scapular elevation and depression exercises in water.

Next progress to protraction and retraction of scapula.

Do horizontal arm adduction exercise with thumb pointing upwards and horizontal
abduction of arm with thumb pointing downwards.

Elbows, wrist and finger exercises performed in hydrotherapy for arthritis

Strengthen your elbows by bending the elbows under water and bringing your thumbs
toward your shoulders. Then straighten the elbows again.

Next, turn your arms so your palms face down and bend your elbows, bringing your
fingertips toward your shoulders.

Straighten your elbows, keeping the palms facing down.

The warm water eases stiff joints and relaxes sore muscles and tendons. Thus performing
finger and wrist joint mobilization is beneficial in hydrotherapy pool.

Piano exercise: Keep your elbow close to body and both forearm horizontal to the
water surface with palm facing down. Then flex and extend fingers of both hands one at a
time as if playing a piano.

Perform wrist circumduction under water with closed fist.

Perform radial and ulnar deviation of wrist joint.

Research Articles

Al-Qubaeissy KY, Fatoye FA. The effectiveness of hydrotherapy in the management of

rheumatoid arthritis: a systematic review. Musculoskeletal Care. 2013 Mar;11(1):3-18. doi:
10.1002/msc.1028. Epub 2012 Jul 16.

Lis Eversden, Fiona Maggs. A pragmatic randomised controlled trial of hydrotherapy

and land exercises on overall well being and quality of life in rheumatoid arthritis. BMC
Musculoskelet Disord. 2007; 8: 23. [Pubmed]
Water Therapy For Back Pain

Hydrotherapy possible cure for lower back pain

Water Therapy For Back Pain has been used for therapeutic purposes since the dawn of
civilization. Hippocrates advised his patients to bathe in spring water as a treatment for
illness. Hydrotherapy helps in treating an array of some back problems such as

chronic low back / neck pain

sciatica

Facet pain

whiplash

Spondylosis

The following list is to provide examples of some of the Hydrotherapy exercises carried
out in the pool by people with back disorders. It is in no way comprehensive and should
be used as a guide only. Let the therapist and your body guide you on the exercises and
number of repetitions appropriate for you.

WATER THERAPY FOR BACK PAIN

Back Pain Exercises

Warm up, mobilizing exercises

1. Flex, extend, side flex and turn your neck.

2. Roll your shoulders forwards, backwards and shrug alternate shoulders.

3. Let your arms float on top of the water and stretch them from side to side.

4.With your arms in the water bend over sideways as far as possible.

5. Holding on to a float, turn round from feet from side to side look around as you
turn.

6. Circle your hips in both directions in the water.

7. Facing the wall, holding onto the bars, with your feet touching the wall, let your
hips drop away from the wall.

8. Facing the wall, holding onto the bars keep your hips/pelvis close to the wall and
let your upper body fall away from the wall.

Stretching exercises

1. Repeat any of the exercises from the above list that felt good to you.

2. Holding onto the bar, swing your leg forwards, backwards and sideways.

3. Holding onto the bar, flex hip and knee to 90 degrees, laterally rotate the hip.

4. Holding onto the bar, flex one knee up behind you, so your foot moves towards
your bottom.

5. Holding onto the bar, take one foot out behind you, keeping the leg straight.

Strengthening exercises

1. Holding onto a float, turn your body round from side to side. Progress by putting
floats further into the water.

2. Holding onto a float push it down in front of you into the water.

3. Holding onto two floats, push them down together or alternatively on either side
of the body.

4. Walk in the pool, forwards, backwards and sideways.

5. Lying on the bed or sitting on the stool, bend your hip and knees up and rock them
from side to side.

6. Lying on the bed or sitting on the stool, separate your legs out sideways and bring
them back together like scissors.

7. Lying on the bed or sitting on the stool, lower your legs alternatively into the
water.

8. Lying on the bed or sitting on the stool, cycling legs forwards and backwards.

Relaxatation exercises

Heat soothes the body, relaxes tight muscles and eases stiff joints.

Floatation and other relaxation exercises like stretching encourages the muscles to
relax and eases any pain and discomfort in joints making it easier to exercise.

Resource

Hydrotherapy and chronic lower back pain: A pilot study

Swimming workouts

As we all know, swimming is the best exercise for people of all ages! There are
various types of swimming workouts included in water therapy for back pain that you can
try. There are many simple swimming workouts like front crawl, sidestroke and
breaststroke that you can learn and carry out on a regular basis.

Swimming exercises are excellent for elderly, as well as people who are suffering with
back pain and joint pain.

Most manuals of swimming workouts for beginners often recommend that one
should not overuse these exercises since, they can aggravate certain injuries like lower
back pain and leg pain.

Other than that, moderate amount of swimming is always healing and refreshing for
your body, with the added benefits of keeping you healthy and fit.