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Physical Therapy in Water

Physical Therapy in Water

By Margaret Vence, DPT, ATRIC

As year-round residents of the Finger Lakes, we naturally think of the recreational properties of water. But water has powerful healing qualities, as well. In the field of aquatic therapy, we utilize the buoyancy, hydrostatic pressure, and resistance of water to help patients gain strength, balance, flexibility, and find relief from chronic pain.

The buoyancy of water relieves pressure on our weight bearing joints. Physical therapy treatment and therapeutic exercise in water significantly reduce the pain and stress in sore joints, making it much easier to strengthen and stretch dysfunctional joints and muscles. The traction effect of water's hydrostatic pressure can slightly separate areas of pressure in the spine, which enables people with low back pain to exercise and move about. Finally, the resistive quality of water helps to strengthen muscles and increase cardiovascular fitness. If you have ever tried running in waist-high water, you've experienced the impact of water's powerful, yet gentle, resistance.

What is aquatic therapy?

Aquatic therapy is physical therapy used to help people who, for any number of different reasons, cannot tolerate exercise on land and require decreased weight-bearing exercise options. Aquatic therapy is guided by a licensed physical therapist or physical therapy assistant.

For what types of conditions is aquatic therapy recommended?

The majority of people in aquatic therapy suffer from serious arthritis or low back pain. Other conditions that may improve with aquatic therapy include post-operative pain and weakness, athletic injuries, pain in knees, hips, and shoulders, chronic pain conditions, and neurological problems such as Parkinson's disease, stroke, and multiple sclerosis.

How does aquatic therapy work?

Aquatic therapy begins with a referral from your physician. During your first visit, you will undergo a physical therapy evaluation on land to determine the nature and extent of dysfunction, loss of strength, range of motion, gait deviations, and balance deficits.

Based on this evaluation, your physical therapist will devise a treatment program to address your specific problems. Aquatic therapy is particularly helpful for people who need to work on their balance and gait because the fear of falling is reduced in the water. It is possible to make substantial progress in regaining balance and the ability to walk without suffering injury, which gives people independence while they work out.

What if I can't swim?

We often have people in aquatic physical therapy who can't swim and are fearful of the water. The pool we use for aquatic therapy is five feet at its deepest point. We keep nonswimmers in the shallow end of the pool in waste-deep water, and they are always supported, personally and with flotation devices. As they become accustomed to being in the water, most people overcome their fear and gain the confidence to venture into deeper water. And there is always a physical therapist or physical therapy assistant in the water at all times during aquatic therapy.

What kinds of gains can patients make as a result of aquatic therapy?

Patients typically gain strength, flexibility, increased function, pain relief, and the ability to walk further with less dysfunction in their gait.

Where is aquatic therapy offered?

Aquatic therapy is offered at the Island Health Center (IHC) in Ithaca. The advantage of undergoing aquatic physical therapy at IHC is that once patients have completed their physical therapy, they can enter a two-month, supervised transition program that will help ease them into a community-based membership program at Island Health and Fitness. They can join the club, use the pool, and continue to make progress on their own.

Participants each have individualized treatment plans (based on their doctor's referral and their physical therapy evaluation). We can work in the pool with several people at a time or on an individual basis depending on each patient’s needs.

Aquatic physical therapy can be a very effective tool for healing and for regaining lost independence. Many people are able to exercise again, while reducing their chronic pain symptoms. In addition to the flow of water, we typically also feel the flow of positive energy during aquatic therapy, which enhances the healing process.

Vence holds a doctor of  physical therapy from Simmons College and practices at Cayuga Medical Center and the Island Health Center. She is manager of the medical center's Joint Solutions program and is certified in aquatic therapy.

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