Water Therapy Exercise Program

Water therapy exercise programs consist of a variety of treatments and exercises that are done in a pool and may be specifically designed to provide relief of low back pain or neck pain. These exercises also serve to condition and strengthen muscles to help avoid future recurrences of back pain. Water therapy exercise is especially helpful in cases where a land-based exercise program is not possible due to the intensity of pain, decreased bone density, disability or other factors. As such, water therapy is a versatile exercise and is particularly good for people with conditions such as: Osteoarthritis Advanced osteoporosis (with susceptibility to and/or pain from fracture) Muscle strain or tears

In This Article:
Water Therapy Exercise Program Water Exercise Therapy Limitations and Considerations Water Therapy Exercises

In addition to those conditions, water therapy is frequently recommended as one form of exercise therapy to treat those with diabetes as well as individuals with high blood pressure. Both conditions can improve and become more manageable with aquatic exercise. All of these conditions can make it uncomfortable or painful to exercise on a hard or even padded surface, or while standing. Water provides a much gentler, welcoming environment. Water therapy offers many of the same benefits associated with a land-based exercise program, including development of a treatment plan that is carefully tailored to the individual Water therapy may also be referred to as pool therapy, hydrotherapy, or aquatic therapy.

Benefits of Exercising in Water

The physical properties of water make it a highly desirable medium in which to exercise to treat back pain and other musculoskeletal injuries. Some of the most important properties of water that make exercise easier are: Buoyancy: water counteracts gravity and helps to support the weight of the patient in a controlled fashion as the patient is immersed. This can aid the development of improved balance and strength. The buoyancy of water also permits a greater range of positions due to the virtual elimination of gravitational forces, particularly for exercises that require lifting the legs, the heaviest limb of the body for most people. Viscosity: water provides resistance by means of gentle friction, allowing strengthening and conditioning of an injury, while reducing the risk of further injury due to loss of balance.

Hydrostatic pressure: there are powerful effects produced by hydrostatic pressure that improve heart and lung function, making aquatic exercise a very useful way to maintain and strengthen heart and lung function. This pressure effect also aids in improving muscle blood flow.

Together, these properties allow development of an exercise regimen that minimizes the weight placed on the spine (axial load) and risk of injury due to unintended movements during exercises. For example, individuals with osteoarthritis in the neck and shoulder could practice arm circles or shoulder rolls in water to improve their range of motion and strength. Because the water provides both mild resistance and support through buoyancy, the person would most likely not experience the pain caused when a tired arm drops suddenly, as it can do at the end of land-based exercises. Moreover, the perception of pain may be diminished as a result of many factors associated with water therapy, such as the relaxing sounds as well as the warmth of the water, making it a different and often very pleasurable experience. Often it is easier to start an exercise program in the water before trying it on land. For example, range of motion stretches for hip flexors and abductors are generally much easier to try out first in water because the leg is supported somewhat as the individual learns the right positioning. Buoyancy when doing water therapy exercises can be increased with the use of floats

For many back pain patients, water-based exercises should only be performed under the guidance of a qualified health professional. Water therapy exercise should usually be avoided if a person has any of the following: Fever Severe heart failure Incontinence Infection

In This Article:
Water Therapy Exercise Program Water Exercise Therapy Limitations and Considerations Water Therapy Exercises

The water temperature may be too warm to accommodate some conditions. Water therapy is generally conducted in pools or tanks with water that is between 90 to 94 degrees (Fahrenheit), almost as warm as bath water, so blood circulation is increased. Consequently, patients with any of the conditions listed above should avoid or limit their water therapy exercise, or make sure the pool or tank used is cooler so that their conditions are not exacerbated. Individuals with severely limited endurance or range of motion may not be able to safely navigate a tiled (and slippery) pool apron to participate in a water therapy exercise program. Rubber mats are often used to increase traction to reduce this risk.

The perception of objects (like the instructor demonstrating exercises) in water is also affected by refraction, leading to difficulty in learning specific motor skills for people with limited eyesight, or impaired sense of body position or balance due to stroke or other injury.

Finally, for patients with low bone density or osteoporosis, the buoyancy provided by the water may not be as beneficial for building bone as weight bearing land-based exercises. The added strength and balance achieved through an aquatic exercise program may facilitate a safe return to land-based exercise, which is more helpful in building bone strength.

The techniques used in water therapy exercise for back pain include spa therapy, standing or floating pool exercises, swimming, and conditioning using specialized equipment, such as surgical tubing, flotation devices and resistive devices for the hands or feet.

In This Article:

Water Therapy Exercise Program Water Exercise Therapy Limitations and Considerations Water Therapy Exercises

.Active water therapy exercises for back pain are diverse and should be tailored to the individual and his or her specific condition. Exercises range from simple routines performed in a shallow pool to conditioning using underwater treadmills and other high-tech equipment.

Pool Therapy Exercise Techniques

Some of the basic techniques for pool therapy exercises are as follows (they can be modified for varying degrees of difficulty):

Knee-to-chest exercise. This movement is performed while standing on one leg, which is slightly bent, and one leg outstretched in front while one hand holds onto the side of the pool. It strengthens and stretches the muscles in the leg, hip and lower back. Leg raise exercise. This movement is performed with one leg outstretched and the supporting leg slightly bent while one hand holds onto the side of the pool. It strengthens and stretches the muscles in the leg, hip and lower back. Wall-facing leg stretch exercise. In this stretching exercise individuals assume a Superman position with hands resting on side of pool and the body and legs outstretched into and supported by water. This extends all regions of the back and the joints in the back, as well as stretching shoulder muscles. Pool walking exercise. Walking both forward and backward in chest-high water works the leg muscles while exerting no impact of the knees or hips, which is particularly important for people who

have arthritis in those joints. The walking exercise can be made more demanding with the addition of hand floats or light weights, so a stroll in the pool becomes an aquatic version of power walking. Quadruped activity and exercise. This exercise works legs and arms and is performed while floating on ones back (sometimes achieved with a therapist supporting the trunk or using a flotation jacket). The individual makes paddling motions with his or her arms and legs. Spa treatments complementing water therapy for back pain typically involve relaxing in warm, agitated water such as that found in whirlpool baths. This form of hydrotherapy relaxes muscles, improves muscle blood flow and increases general blood circulation, which make the body more flexible and can prepare it for water therapy or land-based exercise.

Combined Water Therapy for Back Exercise with Land-based Methods

Water therapy for back exercise can be a short-term exercise option if back pain or a back injury makes land-based exercise too difficult. Or it can be adopted as part of an ongoing exercise program if landbased methods worsen symptoms or if the person prefers water exercises. If their functional status or competitive goals require it, people may transition to exercise in a dry environment once they are successfully performing exercises in water. Some people may find mixed use of wet and dry exercise therapy environments most beneficial. There is a small but growing body of scientific studies demonstrating the benefits of aquatic exercise in the management of spine pain. Although more scientific evidence for the specific benefits of water therapy exercise in treating back pain will be helpful in creating specific programs for particular spine problems, the value of appropriate aquatic exercise programs is well established overall and has been beneficial in many thousands of individuals. The aquatic medium is ideal for patients for whom landbased options for back exercise are limited, and may provide a safe and effective method of managing spine pain while improving function.