Hydrotherapy: Water Based Therapeutic Exercise

24 Feb, 2020

  • Have you been diagnosed with a chronic health condition?
  • Are you struggling to exercise due to pain?
  • Do you have a musculoskeletal injury, or have you had a musculoskeletal surgery?
  • Are you losing confidence with balance or have you had a recent fall?
  • Do you want to lose weight?

If this is you, read on to learn about what hydrotherapy is and how it works, the benefits and how it may be appropriate for you.

What is Hydrotherapy:

Hydrotherapy is most easily defined as water based, therapeutic exercise, typically completed within a heated pool. A hydrotherapy pool is specifically designed to be heated between 30 and 33 degrees Celsius. This temperature provides both immediate and lasting therapeutic effects. The warm water, combined with buoyancy promotes muscle relaxation, improved joint mobility and increased blood flow which is explained further in this post.

This can be very effective when trying to recover from an injury or manage chronic health conditions, for example osteoarthritis or persistent pain.


How does it help:

There are four distinctive properties of water that allow water-based exercise to be such a beneficial form of rehabilitation, as well as a therapeutic environment for exercise.

These properties result in a reduced weight-bearing environment which allows for smoother movements with reduced joint loading, and greater overall range of motion for affected joints.

Buoyancy: Buoyancy reduces weight bearing stress on the body, and this is directly proportional to the amount of the body which is submerged below the water surface. Buoyancy allows fluid movement with reduced loading, which can provide a feeling of freedom whilst moving in the pool.

Hydrostatic pressure: This is the pressure exerted by the body of water on an immersed object. That pressure and depth allows the client to perform exercises more easily, however it can result in a loss of body fluid (dehydration) and an increased demand on your cardiovascular system. Therefore, it is very important to complete a risk screening with a therapist prior to commencing a program.

Viscosity & Surface Tension: These properties create resistance to all active movement in water.

Our Exercise Physiologists can help you to determine what depth of water you should be exercising in based on your functional capacity and diagnosis, in addition to prescribing a specific, graded, progressive program. Your Exercise Physiologist should also complete a thorough assessment to make sure you are safe to complete a hydrotherapy program.

Benefits of Hydrotherapy:

Hydrotherapy can be very effective in treating or managing a range of injuries or chronic health conditions. Due to the buoyancy of the water, hydrotherapy can allow individuals to exercise to an intensity which they cannot on the land. This is particularly helpful for patients with persistent pain, joint degeneration or neurological conditions which cause spasticity or loss of motor function.


Other benefits include, but are not limited to:

  • Increased mobility for individuals with neurological disorders (e.g. Multiple Sclerosis, Cerebral Palsy, Muscular Dystrophy, Motor Neuron Disease etc.)
  • Gait Retraining
  • Increased Cardiovascular Endurance & Health
  • Faster recovery time from surgery, especially knee/hip/ankle replacements
  • Increased Muscle Strength and Endurance
  • Improved Pain Management for a range of chronic health conditions
  • Improved physical activity levels/social interaction and behaviours of children with autism spectrum disorders.

Apart from the physiological benefits, research shows hydrotherapy helps to reduce depression and anxiety. It is also found to result in improved quality of life, in some cases more than land-based exercise.

How to get started:

Before commencing a hydrotherapy program with Generation Physio, an Exercise Physiologist will complete an individual assessment and risk screening to fully understand your relevant medical history. Your Exercise Physiologist will then help you to create relevant goals and formulate a plan for you to commence hydrotherapy.

Your Exercise Physiologist will then determine a treatment program that will help you to achieve your desired goals. When completing hydrotherapy, you will usually share the pool with other people during your treatment sessions, however, your Exercise Physiologist will be there, by your side to assist you and modify the program accordingly to your needs.


Batten, M., Stevenson, E., Zimmermann, D., & Isaacs, C. (2017). Implementation of a hydrotherapy protocol to improve postpartum pain management. Journal of midwifery & women’s health, 62(2), 210-214.

Carere, A., & Orr, R. (2016). The impact of hydrotherapy on a patient’s perceived well-being: a critical review of the literature. Physical Therapy Reviews, 21(2), 91-101.

Ellapen, T. J., Hammill, H. V., Swanepoel, M., & Strydom, G. L. (2018). The benefits of hydrotherapy to patients with spinal cord injuries. African Journal of Disability (Online), 7, 1-8.

Sawant, R. S., & Shinde, S. B. (2019). Effect of hydrotherapy based exercises for chronic nonspecific low back pain. Indian J Physiother Occup Ther, 13(1).

Turner, A., Chander, H., & Knight, A. (2018). Falls in geriatric populations and hydrotherapy as an intervention: a brief review. Geriatrics, 3(4), 71.

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