Aquatic Therapy for Joint Replacement Patients

Apr 9, 2018

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Aquatic therapy refers to performing exercises and activities in a pool. It is also called pool therapy or water therapy. Performing exercises in the water provides a variety of unique benefits compared to performing exercises on dry land. Because of this, the prevalence of aquatic therapy continues to grow. It can be an integral part to prehab before surgery and/or as part of rehabilitation after surgery for individuals going through the joint replacement process.

What are some of the benefits of aquatic therapy?

Decreased stress and compression on weight bearing joints:

This is due to the force of buoyancy, or the upward thrust on your body against the force of gravity. The amount that your body weight is reduced in water depends on how deep it is. With the water at your hips, you are at about 50% of your body weight, at mid-chest 30%, and up to your neck you are at 10%.

Buoyancy can also act as resistance, assistance or support for movements:

Depending on what plane of motion you perform your exercises in, you can take advantage of the buoyancy of the water. There will be resistance with downward movements, assistance with upward movements, and support with movements that are parallel with the surface of the water.

Hydrostatic pressure provides a number of benefits:

This is the pressure exerted by the water on all parts of your body that are immersed. This pressure can help improve the return of blood through your veins to your heart, decrease swelling, and improve the efficiency of you cardiovascular system. Hydrostatic pressure can also help with pain relief and provide input to help with balance and coordination.

Increased activity for those with too much pain:

Aquatic therapy is a great alternative for those with too much pain with land-based exercises. This is due to the decreased effects of gravity on your joints and because water has a relaxing effect on your muscles and body. This decreases muscle guarding and muscle spasms. The water allows you to exercise at higher intensities, improves weight bearing through joints, strengthen muscles, and you can incorporate cardio exercises, too.

Able to improve flexibility and range of motion:

Because of the decreased pain and relaxing effects of the water, you are able to work on and improve flexibility of your muscles and the range of motion at your joints.

Improved balance, coordination, and agility:

In the water, there is less of a risk of falling and increased support and sensory input to the body parts. This allows improved safety and tolerance to balance training with different upright activities.

Gait training:

The water is a great place to work on walking. This includes balance, coordination, and endurance, but also, range of motion and technique with walking, too.

What are some common aquatic therapy exercises?

  • Water walking
  • Water jogging
  • Side stepping
  • Backward walking
  • Stretches
  • Leg circles
  • Leg kicks
  • Side leg lifts
  • Marching
  • Leg lifts
  • Marching
  • Heel raises
  • Wall push-offs
  • Lunges
  • Squats
  • Stairs
  • Underwater jumping jacks
  • Squat jumps

What else should I know about aquatic therapy?

Many individuals will wear water shoes with aquatic therapy to provide improved support and stability, but they are not absolutely necessary. 

Your therapist or instructor may use different toys or equipment throughout your sessions including belts, paddles, pool noodles, floats, kickboard, flippers, underwater treadmills, steps, and more. 

Because of decreased pain and improved comfort, most individuals are able to perform a lot more exercise while in the water. Many individuals note that a couple hours after their first few sessions, they notice increased muscle soreness and fatigue. This is normal and should decrease with increased training and exercise, but be sure to let your therapist or instructor know of any signs or symptoms you experience during or after your aquatic session.

Be sure to stay hydrated while performing aquatic exercises. Your body does sweat in the pool, although you don’t realize it because of the water. 

It is usually best to utilize low resistance and perform a high number of repetitions with pool exercises, at least until your body adapts to training in the pool.

Who is appropriate for aquatic therapy?

You should be cleared by a medical professional before beginning an aquatic therapy program. You should be comfortable in the water and not have any underlying diseases or conditions that may be negatively affected with water exercise.

Prior to joint replacement surgery, you can begin an aquatic program about 6 weeks prior to surgery. Sessions are usually 30-45 min for 2-3x per week. After surgery, you can begin aquatic therapy as soon as you are cleared by your surgeon. Be sure that any incisions are properly covered with occlusive dressings to avoid infection or any damage to the incision.

Aquatic therapy has numerous benefits and regular aquatic training can provide you a leg up with your physical preparation before surgery and/or with your rehabilitation after surgery. Regularly performing aquatic exercises will help improve the speed of your recovery from joint replacement surgery and have you back to feeling good and doing the things you enjoy sooner.

Image used with permission of AdobeID.

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