What is aquatic physiotherapy?
Aquatic physiotherapy uses the skills and knowledge of the physiotherapist related to rehabilitation, health, muscles, bones, walking, posture and exercise. It also involves individual assessment and goal setting. Aquatic Physiotherapists have extra training and knowledge in exercising in water related to the physiology of being immersed and the physics of forces and load in water. Exercise in the water utilises the properties of buoyancy and the subsequent unloading of joints, drag and turbulence for strengthening and a supportive environment for cardiovascular fitness training. Aquatic physiotherapy is active and involves exercise. Aquatic Physiotherapy is used in arthritis, back pain, shoulder pain, joint sprains and for rehabilitation following injury or surgery,
What is the difference between hydrotherapy and aquatic physiotherapy?
Hydrotherapy is the older terminology for aquatic physiotherapy in Australia. The term aquatic physiotherapy has been used in Australia for 10 years (Australian Physiotherapy Association, 2002) and more recently this change has also been made by physiotherapists in the UK. In the USA it is called aquatic physical therapy. Aquatic physiotherapy is usually done in a hydrotherapy pool but can also be done in a swimming pool. Hydrotherapy Pools are defined as a pool that is purpose built for therapy and maintained at a warmer temperature than a swimming pool, usually around 34 degrees (Australian Standards AS3979-2006 Hydrotherapy Pools). In Europe, physiotherapists still use the term hydrotherapy. Hydrotherapy can encompass any therapy that uses water in any way (hot, cold, steam or ice). Hydrotherapy has been used by many ancient civilizations (for further information, see Wikipedia). Balneology or balneotherapy is another term commonly used in Europe for bathing in (or drinking) mineral spa water for health. Balneotherapy doesn’t usually involve exercise so in this way it is very different from hydrotherapy supervised by a physiotherapist or aquatic physiotherapy.
Does aquatic physiotherapy work?
Yes. High quality clinical trials in both hip and knee osteoarthritis and joint replacement have shown aquatic physiotherapy to be beneficial for pain, quality of life, walking and stair climbing. Aquatic Physiotherapy has also been found to be effective for other types of arthritis, back pain and many conditions. For further information please read more on the evidence in aquatic physiotherapy on our Benefits and Research page.
I would like to try aquatic physiotherapy for my hip or knee but I also have lower back pain, is the hip and knee group suitable for me?
It is common to have lower back pain and also hip or knee pain. The hip and knee groups focus mainly on leg flexibility, balance and strengthening. A small number of back exercises can be added in to your water exercise program by your aquatic physiotherapist but it will not be the focus of your sessions. If in doubt, please call us to discuss further. If back pain is your main problem then it would be better to join the other aquatic physiotherapy sessions we offer.
I would like to try aquatic physiotherapy but your times and locations don’t suit me, where can I go?
Community health centres often have aquatic physiotherapy sessions at local pools. Community Rehabilitation Centres based at your local hospital will also usually have an aquatic physiotherapy service. Contact these centres to find out what services they offer and how you can get referred. Alternately there are a number of private hospitals or private aquatic physiotherapists offering sessions. The Australian Physiotherapy Association has a Find-A-Physio section that you can use to search for an aquatic physiotherapist near you.
For further information on the Australian Physiotherapy Association Find-A- Physio and other options please visit our Useful Links page.
What is the difference between a physiotherapist and an aquatic physiotherapist?
All physiotherapists in Australia have University qualifications that allow them to be registered through the Australian Health Practitioner Regulation Agency with the Physiotherapy Board of Australia. Aquatic physiotherapists are just physios that work in the water with their clients. They still use the same methods of assessment and interview to create an individualised program to address the main problems. They also use their expertise with movement, joints, muscles, inflammation, load and exercise to progress this exercise program and provide other advice.
Do I need to be able to swim to join the hip and knee aquatic physiotherapy group?
Quite a few people in these groups cannot swim and are nervous of exercising in water but still enjoy aquatic physiotherapy. The pools usually have a shallow end where most exercises are done standing up. During the first few sessions the Aquatic Physiotherapist will never be far away. All the exercises are initially easier and then progressed to be more difficult as your confidence in water grows. All exercises can be modified for someone that cannot swim.
Do I need a referral from my Doctor to join the hip and knee aquatic physiotherapy group?
No, you do not need a referral from your Doctor or your physiotherapist to join the hip and knee aquatic physiotherapy groups. We do require a referral from your physiotherapist about your physical assessment for the general aquatic physiotherapy groups. If there are any concerns related to your medical history then we will contact you Doctor, with your permission, for further information.
How soon after my hip or knee joint replacement can I start exercising in water?
You need to discuss this with your surgeon. The timing mainly relates to wound healing and your surgeon will have a protocol about whether the wound needs to be totally closed over and healed before you start in the pool which may take 2-3 weeks or they may allow you to start earlier than this with the wound covered by a waterproof dressing. Speak to your surgeon further about this.
When is the best time for me to do an aquatic physiotherapy program for my hip or knee joint replacement?
The research shows us that early after the surgery aquatic physiotherapy allows comfortable normal movement particularly with walking and helps improve your muscle strength. 3 months after the surgery is another window of opportunity to push a bit harder with exercise and water based rehabilitation. Usually up to 12 months of rehabilitation and ongoing exercise is recommended but ongoing commitment to exercise and physical activity is important.
Folllow this link for further information on the research in hip and knee joint replacements.
I am scheduled to have a hip or knee joint replacement in a few months, is there any value in me doing aquatic physiotherapy before the operation?
It depends on your individual situation. In most circumstances, exercise to become a little stronger before the operation will be of benefit after the operation. Aquatic exercise is a comfortable way to exercise prior to your surgery except in situations where you are in extreme discomfort. For further information on the research in this area please see articles under the benefits and research in aquatic physiotherapy section.
What other options are available for water exercise groups for people with arthritis?
Outside aquatic physiotherapy sessions, general water exercise can be accessed via aqua fitness or aqua aerobic classes at your local pool. Arthritis Victoria also has a great program called WAVES that is run by volunteer leaders for people with arthritis. Always consult your doctor about the most suitable exercise for you.
For further information on Arthritis Victoria and other options see the aquatic physiotherapy and water exercise links on our useful links page.
What is the difference between an aqua aerobics or aqua fitness class and an aquatic physiotherapy session?
Most water fitness or aqua aerobics sessions are done in a class format in deeper water. Most participants are completing the same or similar fitness exercises for the whole session with general fitness or flexibility aims. The instructor can modify exercises you are having difficulty with. Group size with aqua aerobics can be 20 participants or more. This is a good option if you want to improve your fitness but speak to your doctor about whether this type of exercise is appropriate for you.
An aquatic physiotherapy session is based on an individual assessment before you start and is tailored specifically to your needs. A large proportion of aquatic physiotherapy exercise is done in the shallow part of the pool making the most of partially weight bearing strengthening exercises. The group size in aquatic physiotherapy sessions will usually be 6-8. Physiotherapists have extensive training around joints, muscles, coordination, motor control, posture, function and pathology as well as exercise.
Physiotherapists base their programs on clinical research and evidence. Aquatic Physiotherapists have further training on exercise in water and in conjunction with an individual assessment can target your pool-based exercises to get specific results. You can build on your progress with each session in a logical way to maximise your improvements.