Hydrotherapy

Hello and welcome back to the ThreeSpires Physiotherapy blog where we take a look at all things physiotherapy and health related. In the theme of continuing to look at interesting topics in physiotherapy and because in the last blog we looked at repetitive task training after a stroke, I thought this time we could take a brief look at hydrotherapy and point out an amazing hydrotherapy resource that is available to patients in Walsall and the West Midlands.

What is Hydrotherapy?

Hydrotherapy is a general term to describe a programme of exercises done in a pool. Hold on, I hear you say, isn’t that just swimming? Well, swimming and attempting to swim could certainly be looked at as some form of hydrotherapy but in this context we are looking at exercises in a very warm heated pool, that has access to a hoist or a liftable floor. These exercises are designed to help promote strength and mobility in the patient. Often the exercises will involve using floats, paddles or "weights" that either help provide stability or resistance in the pool, also commonly there will be an instructor or physiotherapist present who will provide an exercise program and also supervise the exercises. Some exercises may be done in standing and involve marching or working on balance and others may invlve lying on your back and using your legs and core. Ideally these exercises are reviewed on a regular basis as patients improve in terms and of strength and mobility. So, although hydrotherapy is done in a pool I think that it is clear that there is a bit more involved than just going to the pool and having a swim.

What Conditions can Hydrotherapy help with?

Hydrotherapy is used in a wide range of conditions such as helping with Multiple Sclerosis, Parkinson’s, recovering from a stroke, spinal cord injuries and fibromyalgia, basically with anyone for whom land based exercises can be too challenging or present too much risk for. Hydrotherapy allows patients to do exercises in a reduced bodyweight environment that they would normally be unable to do and can often be helpful for patients with complex ankle or lower limb fractures who are struggling to put weight through their leg.

For example: after a stroke patients will often have reduced mobility, find that one side is weaker and that their trunk strength has been reduced. Land based exercises although essential and very helpful for these patients are very fatiguing and one way of doing rehabilitation without the full effects of gravity can be through hydrotherapy. Using hydrotherapy the patient and physiotherapist can target muscle groups and movements that the patient found very difficult to access when under full bodyweight and can work on promoting a good gait and movement pattern without the compensations that are necessary on land. For patients who have significant mobility issues after a stroke, they can be hoisted into the pool and made completely buoyant using floats and buoyancy aids.

What is a Hydrotherapy Pool Like?

A hydrotherapy pool is traditionally hotter than a normal pool, this is because when patients are not able to swim as normal they will often get cold in a normal pool and therefore need a warmer environment. The hydrotherapy pool will also have access to a hoist enabling patients with significantly reduced mobility to get in and access the pool and often the pool will have a floor that can be raised to adjust the depth of the pool. Floats and buoyancy aids can also be used to get patients into a good position or provide resistance to movements.

Do I Need to be Able to Swim to do Hydrotherapy?

Hmmm... this is a tricky question, technically it is not essential to be able to swim as the pool is shallow enough to put your feet down in and also most of the exercises will not require any ability to swim at all. The main point of hydrotherapy is the reduction in bodyweight in a safe environment. However, in all honesty most patients that are unable to swim are unlikely to feel confident or comfortable in doing exercises in a hydrotherapy pool and therefore won't be able to relax and enjoy the session.

Does Hydrotherapy Work?

This is an important question and one with no easy answer. Certainly hydrotherapy is an important way in which patients with any number of conditions can work on balance and mobility wthout being under full bodyweight. However hydrotherapy on its own without a land base rehab programme is very unlikely to be the whole answer and hydrotherapy is probably better thought of as a useful componenet of an overall physiotherapy and rehab program.. Research is growing regarding its effectiveness for patients and certainly there a number of trials that have shown benefits to patients for example this study shows how hydrotherapy helps stroke patients: http://journals.sagepub.com/doi/abs/10.1177/0269215515593392

This study shows that hydrotherapy can be effective in improving function and reducing pain in patients with Multiple Sclerosis:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3138085/

My own clinical experience as a physiotherapist is that hydrotherapy is a useful adjunct to usual therapy for many patients including those with a neurological condition such as MS or Parkinson's and gives patients another form of physical therapy which is fun, exciting and different to the rehab exercises that they will be doing on land. It is important to remember that these conditions are long-term and patients are likely to need to continue with their exercise program for a long period of time, so making the rehab program varied with different components such as hydrotherapy makes sense in terms of keeping patients engaged and motivated.

Where Can I Access Hydrotherapy?

Accessing hydrotherapy can often be difficult and expensive if you wish to do this privately and usually patients will need a referral to an NHS facility. Obviously these NHS hydrotherapy pools are oversubscribed and there is often a long waiting list and patients will not be able to have many sessions. However one of the main reasons for this article is that I wanted to draw attention to a fantastic hydrotherapy resource available to patients in the Staffordshire and West Midlands area. Walsall Council offer a fantastic community hydrotherapy experience via its Community Hydrotherapy Sessions. These are available at several pools including the Brine Pool and Oak Park. These sessions are incredibly good value (at time of writing £2 per session!), and are well run and organised. I really can’t recommend them enough. For more information you can click on the link https://go.walsall.gov.uk/leisure/Community-Health-Programmes/Community-Hydrotherapy  or call 01922 658080

I hope that you have found this article helpful and if you want anymore information about hydrotherapy then get in contact . If you or anyone you know has had a stroke, has a neurological conditions such as MS, Parkinson's or is struggling with their mobility then please feel free to get in touch. We are a home visit physiotherapy service serving Lichfield, Sutton Coldfield, Tamworth, Cannock, Rugeley and Walsall.