April 11, 2011

Aquatic Therapy

As an aquatic therapist and former patient, I am a proponent of aquatic therapy.  I believe that aquatic therapy can be an excellent adjunct or replacement to land based therapy pre-operatively. For example, I was unable to exercise pain-free on land prior to my surgeries.  I was able to swim and participate in an aquatic program without pain.  As a result, I was able to achieve a satisfactory level of physical fitness before proceeding with the surgeries.

I heavily relied on aquatic therapy post-operatively.  When my incisions were fully healed, I initiated exercises in the deep end of the pool in order to adhere to my non-weight bearing status.  When I was instructed to begin partial weight bearing, I  utilized the shallow end of the pool and an underwater treadmill.  I truly believe that my rehabilitation progress was significantly enhanced with the combination of aquatic and land-based therapy.

Benefits of Aquatic Therapy*
Aquatic therapy utilizes the properties of water to assist with healing and exercise performance.  These properties of water and corresponding benefits for hip rehabilitation are as follows:
  • Buoyancy:(1) decreases weight bearing, joint compressive forces, and stress on connective tissue; (2) supports weak muscles and enhances range of motion
  • Hydrostatic pressure: (1) improves proprioception (2) enhances flexibility and ROM (3) decreases pain
  • Viscosity: (1) provides resistances that promotes muscle strengthening and balance
  • Temperature:  (1) relaxation of muscles (2)  vasodilates blood vessels, which increases blood flow to the injured area

Therapeutic pool 
Since many patients who have had hip surgery have both hip ROM limitations and weight bearing restrictions, I strongly recommend that patients seek out a facility with a chair lift.  Thus, the patient may get in and out of the pool safely without breaking the precautions. 

Underwater Treadmill
Utilizing an underwater treadmill allowed me normalize my gait pattern while maintaining my weight bearing precautions.  I held onto the edge of the tank/pool until I was able to ambulate without a limp.

If you are interested in receiving examples of aquatic exercises (for both deep and shallow water), please contact me.

Surgical procedures
I have treated patients in the pool who have undergone the following procedures:   Ganz osteotomy, total hip replacement, arthroscopy for labral debridement, hip resurfacing, and open surgical dislocation (labral tear, acetabular rim trimming, osteochondroplasty of the head/neck junction).

Aquatic therapy locations:
If you are interested in finding an aquatic therapy facility in the U.S, please click on the link below to access the Aquatic Therapy Section of the American Physical Therapy Association:


* A special thanks to Emily Viguers, PT, DPT, C/NDT for her contribution to this post.