A 2014 report published in the North American Journal of Medicinal Sciences tells us that “The use of water for various treatments (hydrotherapy) is probably as old as mankind.” The history of hydrotherapy as a medicinal practice dates at least all the way back to ancient Greece, where warm water spas were used to help manage pain and for exercise.
There’s also evidence that water therapy as a naturopathic treatment modality was utilized among ancient cultures living in India, Egypt and China. Water aerobics, stretching, massage and colonics were used in the treatment of chronic pain, anxiety, stiffness, constipation, pregnancy aches, and for much more.
Hydrotherapy, or the application of water for the treatment of physical or psychological conditions, goes by several names, including: water therapy, aquatic therapy, pool therapy and balneotherapy. Hydrotherapy was also formerly called “hydropathy.”
Even before studies could explain just how hydrotherapy worked, people understood that water had specific properties that aided in rehabilitation. Hydrotherapy is recommended for people with a wide range of health problems because water helps to add gentle resistance to muscles without putting weight on sensitive or strained parts of the body.
What Is Hydrotherapy?
Hydrotherapy’s definition is “The external or internal use of water in any of its forms (water, ice, steam) for health promotion or treatment of various diseases with various temperatures, pressure, duration, and sites.”
Another way to describe hydrotherapy is an alternative medicine practice that uses water (usually in a pool, but not always) as a natural remedy to help manage a variety of symptoms.
What is hydrotherapy used to treat? Water therapy, sometimes called aquatics, has been used for thousands of years and is now considered a form of occupational therapy and physiotherapy (or physical therapy). Today, therapeutic applications of hydrotherapy include rehabilitation, exercise/fitness improvement, relaxation and injury prevention. Hydrotherapy is most commonly used to help to treat symptoms and conditions including:
- Joint pain, stiffness, sprains and any condition that is intolerant to weight-bearing exercises (such as back pain, ankylosing spondylitis, tendonitis, etc.)
- Arthritis symptoms and osteoarthritis pains
- Paralysis, such as due to a stroke
- Neuromuscular disorders
- Musculoskeletal disorders
- Cardiovascular disorders and risk factors (like high blood pressure)
- Pulmonary disorders
- Autism spectrum disorders (ASDs), disabilities and motor delays in children
- Problems with balance
- Reoccurring injuries and reduced range of motion that makes other forms of exercise difficult/uncomfortable
- Pregnancy-related aches and pains
- and more
Types of Hydrotherapy Treatments
Hydrotherapy sessions are usually led by physiotherapists, exercise physiologists, fitness instructors and in some cases school staff. Private, customized hydrotherapy treatments that are intended to manage disease symptoms are offered by trained physical therapists/occupational therapists (sometimes the term “aquatic physiotherapy” is used in this case describe what these physiotherapists do with clients in the water).
It’s also possible to attend public group water classes that operate just like other fitness/exercise classes, except that they are held in the water. Additionally, you can visit various spas and medical offices that offer treatments using water such as colonics, floating meditations, water massage, cryotherapy, etc.
Some of the more common types of hydrotherapy/aquatic therapy include:
- Aquatic physiotherapy, which involves specialized movement and gentle swimming for people with disabilities or injuries.
- Water exercise classes, such as water aerobics or water Zumba.
- Deep water running, which is used to improve fitness and strength.
- Aquatic massage, a form of aquatic bodywork in which a therapist cradles, moves, stretches and massages your body while you rest in chest-deep warm water.
- Temperature controlled hydrotherapy (various temperatures can produce different effects on different system of the body).
- Colon hydrotherapy, which uses water to remove feces and waste from the intestinal tract.
6 Hydrotherapy Benefits
Why is hydrotherapy still used today? Research shows that hydrotherapy benefits include some of the following:
1. Helps Decrease Pain and Swelling
Water has certain unique properties that make movement easier, even when someone is dealing with pain or injuries. For example, when in the water you experience decreased effects of gravity and float more easily thanks to the effects of buoyancy. This means that hydrotherapy treatments help take pressure off of achy joints, weak muscles, etc. The properties of water also allow for decreased weight-bearing on joints, even while increasing muscle activity and blood flow.
Improved circulation while exercising in the water is helpful for decreasing edema (fluid retention or swelling) and for promoting healing. During most hydrotherapy sessions in a pool, the water temperature is usually about 88–96 degrees F, which is warmer than a typical swimming pool and allows tense muscles to relax more easily. However, the opposite it also true: sometimes cold water in intentionally used for its natural pain-killing effects.
The application of cold hydrotherapy (cryotherapy) can reduce pain and swelling in several ways. For instance, cold temperatures have positive effects on inflammation, local edema, nerve conduction velocity (NCV) and muscle spasms.
2. Increases Range of Movement and Strength
Hydrotherapy can help people dealing with physical limitations to increase physical function and quality and life. Exercise performed in a pool is ideal for people with orthopedic problems that require decreased weight-bearing, yet want the added resistance that water has to offer.
Even if someone experiences pain when doing other types of exercises, there’s a good chance that moving in a pool will feel much more comfortable. Compared to other fitness classes, hydrotherapy “aquarobics” (or aqua aerobics) focuses on slow, controlled movements and relaxation of tense parts of the body. Because moving through water requires some force thanks to resistance, it’s possible to build muscle strength without aggravating injuries.
In the case of an orthopedic problem, injury or condition like arthritis, hydrotherapy is usually performed with a physical therapist. The therapist guides the patient through movements that help take pressure off of problem areas (including the spine), to strengthen the muscle and increase range of motion for the joints. A 2017 study found that adults with osteoarthritis of the knees experienced improvements in pain and function (including better performance for knee flexor and extensor strength, knee flexor power, and knee extensor endurance) after completing twice-weekly hydrotherapy sessions in a heated pool for six weeks.
3. Can Improve Mood and Sleep
Studies suggest that hydrotherapy treatments can improve relaxation, help defend against the effects of stress (just like other forms of exercise) and improve your mood. In some cases, the temperature of the pool will be adjusted during hydrotherapy treatments to promote certain psychological effects. For example, warm water helps to relax muscles and increases relaxation, while cold water can be energizing and help to release endorphins/adrenaline.
One type of hydrotherapy that has a long history of use and is still utilized in many countries today for its stress-relieving effects is immersion therapy or mineral bathing. Today, sitting in a hot whirlpool/hot tub offers an easy way to unwind and relax tension.
A 2013 study found that patients with anxiety and chronic myofascial pain syndrome (MPS) who were randomly assigned to receive “whirlpool therapy” in a heated whirlpool bath for 30 minutes, twice weekly experienced significant decreases in symptoms. A similar approach has even been shown to promote relaxation and decrease anxiety and pain in pregnant women during labor, thereby helping with the birthing process.
4. Improves Fitness and Helps Prevent Future Injuries
Among athletes and those looking to improve strength, performance and recovery, hydrotherapy treatments have a lot to offer. Working out in the water adds gentle resistance to muscles and offers variability without causing impact-related soreness or stress. Hydrotherapy is also a way to help future prevent injuries and reduce repetitive movements that can lead to over-use injuries and pain.
An example of a “deep water fitness” practice that is ideal for building strength in a safe way is running in the water. Compared to running on a hard surface, such as pavement or a treadmill, water running is more appropriate for people dealing with aches, common running injuries or reduced recovery times.
Studies have found that walking in water at increases the activity of erector spinae and activates the major muscles in the legs in a similar manner, or even more so, than walking on dry ground. The use of cold hydrotherapy is also one of the most popular interventions used after exercise to improve muscle recovery. Cold water can reduce fatigue and muscle soreness and potentially improve physical recovery.
5. Supports Cardiovascular Health
Because certain types of hydrotherapy classes function as a form of aerobic exercise, they offer benefits for the cardiovascular system. Water exercise can increase circulation, cardiac output and endurance, and also be supportive of weight loss. A regular water aerobics program can lead to improvements in blood pressure (a reduction in hypertension) and increased lung capacity.
Something that’s especially valuable about water exercise is that it’s accessible to a wide range of people, including those who struggle with other forms of aerobic exercises like walking, cycling or dancing— such as due to obesity, arthritis, pregnancy, pain, etc. Indoor water aerobic classes that take place in a temperature-controlled pool offer variety in terms of exercise options and can be practiced all year long.
6. May Help Treat Social and Behavioral Impairments
Hydrotherapy has been used for musculoskeletal and neuromuscular rehabilitation for over 100 years and recently has gained attention for its use in improving motor performance and social behaviors in children with a variety of disabilities. For example, as an alternative medicine practice, hydrotherapy has shown promise for treating symptoms related to autism, muscular dystrophy, cerebral palsy, cystic fibrosis, spina bifida and Rett syndrome.
According to a 2014 report published in the journal Multidisciplinary Healthcare,
Hydrotherapy is thought to provide multiple sensory stimuli through water temperature, weight relief, and vestibular input. The properties of water assist active movement, provide postural support, and promote relaxation of spastic muscles, improved circulation, and strengthening, allowing a variety of fundamental motor skills to be performed….Aquatic activities also provide opportunities for social interaction and play, which can facilitate language development and improve self-esteem, self-awareness, and sense of accomplishment.
In addition to the benefits listed above, hydrotherapists claim that sessions offer additional benefits including:
- Enhancing metabolic rate
- Improving digestion
- Hydrating skin
- Aiding in muscle tone
- Boosting the immune system and preventing future illness
Precautions and Considerations
If you’re new to hydrotherapy, you can expect feel some initial soreness after your first several treatments, just like with other forms of exercise. Any soreness and discomfort should ease up after your body gets accustomed to moving in the water. In order to see results, you’ll probably need to complete a course of hydrotherapy that involves attending about five or six 30–60 minute sessions.
If you’re concerned about your ability to take part of hydrotherapy sessions because you can’t swim, here’s some good news: You don’t have to be a strong swimmer to benefit from movement in the water. You can still take water aerobic classes while you stand in shallow water.
If you have other health concerns that may make hydrotherapy treatments difficult, such as infection, wound or asthma, speak with your doctor before getting started. Hydrotherapy usually isn’t advised if you have certain conditions, such as:
- An open wound or skin infection
- Virus or stomach upset
- Raised temperature
- Very high or low blood pressure
- Breathing difficulties
- Serious kidney condition requiring dialysis
- Chest infection
- Chlorine allergy
- Uncontrolled diabetes, asthma or epilepsy
Because it’s a form of physical therapy, hydrotherapy sessions may be covered by insurance (including private insurance in the U.S. or U.K.). Sessions are usually available on the NHS if you live in the U.K. You can find a hydrotherapist by asking your doctor or regular physical therapist, or inquiring at a hospital that has a hydrotherapy pool.
- Hydrotherapy is an alternative practice that uses water to aid in rehabilitation, provide an accessible form of aerobic exercise and decrease symptoms associated with a variety of conditions.
- Types of hydrotherapy include: Aquatic physiotherapy, water exercise classes, deep water running, aquatic massage, temperature controlled hydrotherapy and colonic hydrotherapy.
- Hydrotherapy treatments can be led by a physical therapist or practiced in a group setting.
- Examples of hydrotherapy benefits include: decreased pain and swelling, improved range of motion and strength, and improved mood/sleep, fitness, and cardiovascular health.