No products in the cart.
Hydrotherapy, What it is, Benefits and Uses | Complete Guide
What is Hydrotherapy?
Water therapy, also called hydrotherapy, aquatic therapy, or balneotherapy, is the use of water in any form (liquid, ice, or steam) to assist healing, ease pain, and improve overall physical and mental function. This form of therapy uses water’s special physical properties, like buoyancy, resistance, and temperature to aid this process.
The term includes many different treatments, ranging from simple home remedies like warm baths or cold compresses to specialised clinical treatments done in specially designed hydrotherapy pools. Hydrotherapy is different from regular swimming or other water activities because it is done for therapeutic reasons and follows strict, evidence-based rules set by trained professionals.
In the UK, hydrotherapy is well-known in both traditional medicine and complementary therapy. Practitioners tailor specialised treatments to each person’s needs, to treat a plethora of neuromusculoskeletal conditions. Hydrotherapy is becoming more popular as a way to treat different conditions without drugs. When performed correctly, it is effective and has few side effects.
The History and Principles of Hydrotherapy
Ancient Egyptians, Greeks, and Romans used water for healing purposes, as evidenced by their use of hydrotherapy. Hippocrates, the father of modern medicine, told people to bathe in spring water to treat several health problems. The Romans built large bath complexes that were used for both social and health purposes.
Bath, a spa town in the UK, exemplifies this long-standing tradition. Its natural hot springs have been used for healing since Roman times. During the Victorian era, people became interested in hydrotherapy again. Places like Malvern and Harrogate became popular health destinations.
Key Principles of Hydrotherapy
Buoyancy (Floating)
The buoyant force of water lessens the effects of gravity, which lessens the stress on joints and muscles that comes from carrying weight. When a person is in chest-deep water, they usually only carry 20–30% of their body weight. This procedure makes it easier and less painful for people with joint problems or limited mobility to move around.
Hydrostatic (Pressure from Water)
The pressure of the water on the body helps reduce swelling and improve blood flow. As you go deeper, this pressure rises, which helps the cardiovascular and lymphatic systems heal.
Resistance
Water naturally resists movement in all directions, which helps build muscle. You can change the resistance by changing the speed of your movements or using special equipment.
Effects of Temperature
Cold water can help with swelling and inflammation, while warm water (32–36°C) can help with pain, relax muscles, and increase blood flow. Contrast therapy alternates between hot and cold to stimulate blood flow and ease pain.
These basic traits make water a great way to treat a wide range of conditions and patient groups. The controlled water environment lets people gradually increase the difficulty of their exercises and often lets them do movements that would be demanding or painful on land.
Different kinds of hydrotherapy treatments
Hydrotherapy includes a wide range of treatments that use water in different ways and at different temperatures. Each method has its pros and cons, and one may be better for you depending on your situation or treatment goals.
Aquatic Exercise Therapy
This is done in a pool that is usually between 33 and 36 degrees Celsius. It includes structured exercise programmes that are meant to improve strength, flexibility, balance, and cardiovascular fitness. The procedure is especially beneficial for people with arthritis, joint pain, or limited mobility because the water offers buoyancy.
Whirlpool Therapy
Massages tissues and improves blood flow with jets of water. Warm water and pressure together can help relax tight muscles and stiff joints. This therapy is often used to target specific areas of the body or provide full-body treatments in specialised tubs.
Contrast Baths
Switching between hot and cold water baths to get the blood flowing and lower inflammation. This method works really well on the arms and legs, and sports medicine often uses it to help people recover from intense workouts or small injuries.
Cold Water Therapy
Includes taking ice baths, putting cold compresses on your body, and swimming in cold water. These treatments lower inflammation, numb pain, and can help with acute injuries by making blood vessels smaller and swelling go down.
Warm Water Applications
Includes baths, warm compresses, and immersion. These treatments relax muscles, get more blood to tissues, and can help people with chronic pain conditions by speeding up the healing of circulation.
Steam Therapy
Uses steam to open up airways, improve blood flow, and help you relax. People often use steam rooms, facial steamers, or special equipment to achieve this.
Hydrotherapy Techniques That Are Specialised
Watsu
A type of passive hydrotherapy that combines shiatsu massage and gentle stretching while floating in warm water. The therapist assists the patient by performing flowing movements that promote deep relaxation.
Bad Ragaz Method
The Bad Ragaz Method involves the patient floating with the assistance of rings or flotation devices, while the therapist exerts pressure against their movements. This method is all about controlled movements that make muscles stronger and more stable.
Ai Chi
A type of Tai Chi that is done in water and combines deep breathing with slow, flowing movements. Very helpful for reducing stress, and improving flexibility and mobility.
The Halliwick Concept
Developed in 1949 by James MacMillan, it is based on the principles of kinesiology and hydrodynamics. It is a 1:1 therapy based around a 10 point programme a that focuses on moving in water, controlling balance, rotation, and breath control. It was first used to help people with disabilities learn how to swim, and later became a rehabilitation tool.
Hydrotherapy has many benefits for different conditions
Musculoskeletal Benefits
Arthritis
Hydrotherapy is especially good for people with rheumatoid arthritis and osteoarthritis. The buoyancy of water takes some of the weight off of your joints, and warm water helps with pain and stiffness. Studies indicate that regular hydrotherapy sessions can greatly improve pain scores, joint function, and quality of life.
Back Pain
Aquatic exercises can help people with chronic back pain strengthen their core muscles without putting pressure on their spines. Research indicates enhanced functionality and diminished pain severity with regular hydrotherapy, especially for ailments such as herniated discs and spinal stenosis.
Neurological Benefits
Rehabilitation after a stroke
Water is a supportive environment that lets stroke patients practise movements that might not be possible on land. Hydrotherapy can help you get stronger, more coordinated, and more balanced, and it can also make you less afraid of falling.
Hydrotherapy can help to decrease muscle spasm and improve range of movement and pain.
Multiple Sclerosis
Water can be very helpful for people with MS who are sensitive to heat because it can help with cooling. Aquatic therapy helps keep muscles strong, improve balance, and deal with fatigue without over-heating.
Hydrotherapy is an effective treatment choice for other conditions such as cerebral palsy, Parkinson’s Disease, fibromyalgia, scoliosis and ankylosing spondylitis.
Psychological Benefits
Hydrotherapy has many benefits for the mind as well as the body. Water therapy can help lower anxiety and stress levels because it is so immersive. Doing movements that might be hard to do on land can also boost mood and confidence. After regular hydrotherapy sessions, many patients say their sleep quality has improved and their depression symptoms have lessened.
Advantages for the heart and lungs
The hydrostatic pressure of water helps the heart and blood vessels work better by helping blood flow back to the heart and reducing swelling in the arms and legs. For people with breathing problems, putting pressure on the chest wall can make the muscles that help you breathe stronger and change the way you breathe. When done with the right supervision, hydrotherapy can help with chronic heart failure and COPD because of these effects.
“In my clinical practice, I’ve seen wonderful improvements in patients with complex conditions who had previously plateaued with conventional land-based therapy. The water environment often unlocks movement potential that transforms both physical function and psychological outlook.”
Hydrotherapy can help with more than just symptoms; it can also improve overall function and quality of life. For many patients, being able to move freely in water is a big mental boost that goes along with the physical benefits of treatment.
A Focused Approach to Hydrotherapy for Arthritis
Osteoarthritis and rheumatoid arthritis are the two most common types of arthritis that affect millions of people in the UK. Hydrotherapy has become one of the best non-drug ways to treat arthritis symptoms and improve life.
How Hydrotherapy Can Help Arthritis
- Less Stress on Joints: Water’s buoyancy greatly reduces the stress on painful joints that comes from carrying weight, making it possible to move without pain.
- Less Pain Sensation: Warm water stimulates sensory nerve endings, which can block pain signals (the gate control theory of pain).
- Better circulation: Hydrostatic pressure increases blood flow to muscles and joints, which helps them heal and reduces swelling.
- Relaxing muscles: Warm water makes muscles less protective around sore joints, which makes it easier to move.
- Resistance Training: Water naturally resists movement, which strengthens the muscles that support arthritic joints without putting any stress on them.
Results Based on Evidence
Clinical studies consistently demonstrate that arthritis patients engaged in regular hydrotherapy experience:
- Pain scores go down a lot (usually by 20–40%)
- The affected joints experience increased mobility
- Better speed and distance when walking
- Better at doing everyday tasks
- Less need for painkillers
- Better mood and sleep quality
Clinical Insight: For people with arthritis, consistency is essential. Most people see the best results after 2–3 hydrotherapy sessions a week for at least 6–12 weeks. Thereafter, they should have maintenance sessions to keep the improvements going.
The National Institute for Health and Care Excellence (NICE) says that hydrotherapy is a beneficial way to treat arthritis, and many rheumatologists now suggest it as part of a full treatment plan.
Hydrotherapy Exercises and Techniques
Structured hydrotherapy exercises use the unique properties of water to help people reach specific therapeutic goals.
Moving around in water is not enough for hydrotherapy to work. Structured exercises use the unique properties of water to help people reach certain therapeutic goals. Here are some of the most common types of exercises and techniques used in hydrotherapy programmes:
Range of Motion Exercises
Upper Body
- Arm Circles: Stand in water that is chest-deep and move your arms in circles, getting bigger as you go.
- Wall Slides: To make your shoulders more flexible, slide your hands up and down the wall of the pool.
- Finger Fanning: Put your hands in water and alternate between spreading your fingers wide and making a fist.
Lower Body
- Hip Circles: Hold on to the edge of the pool and lift one leg. Then, move it in circles at the hip.
- Ankle Rotations: While sitting or holding onto a rail, move your ankles in both directions.
- Knee Flexion/Extension: While supported, bend and straighten your knees.
Exercises to Build Strength
Core and Trunk
- Standing Rotation: Use a float or noodle to turn your upper body while keeping your lower body still.
- Wall Press: Press back against the wall of the pool and use your core muscles to stay in place.
- Floating with Core Engagement: Using flotation devices while tightening your stomach muscles.
Lower Extremities
- Water Walking/Jogging: Forward, backward, and sideways walking with proper posture.
- Step-Ups: Going up and down on steps or platforms that are underwater.
- Heel Raises: Getting up on your toes while staying balanced. If you need help, use a wall.
Coordination and Balance
Water balance exercises are a safe way to test your balance without worrying about falling:
- Single Leg Stand: Stand on one leg while keeping your body in the right position and slowly lowering your hand support.
- Dynamic Reaching: Keeping your balance while reaching for things on stable or unstable surfaces.
- Tandem Walking: Walking heel-to-toe in water that is waist-deep and then slowly lowering the depth to make it harder.
Cardiovascular Conditioning (heart and blood vessels)
Water aerobics are a great way to train your heart and lungs without putting too much stress on your joints:
- Deep Water Running: Running in deep water without touching the bottom with a flotation belt.
- Interval Training: Alternating between high and low intensity movements.
- Water Aerobics: Structured workouts that combine arm and leg movements to work out the whole body.
Professional Tip: The FITT principle governs how hydrotherapy exercises progress. It stands for Frequency (how many sessions per week), Intensity (how hard you work), Time (how long the session lasts), and Type (the type of exercise you do). A qualified physiotherapist will change these factors based on each person’s ability, needs and responses to treatment.
The StandSure Board: A Specialised Tool for Improving Hydrotherapy
The StandSure therapy aid keeps feet in place during hydrotherapy, stopping unwanted floating and facilitating weight bearing through the legs.
The Floating Feet Challenge
When feet float around during hydrotherapy, several issues arise:
- The therapist will struggle to keep the right foot posture for standing exercises
- Patient is not able to weight-bear sufficiently
- Less stability during balance training
- Patient may become anxious
The StandSure Board Solution
Standsure Board: Made For Hydrotherapy
Physiotherapists use the Standsure Board to address the issue of feet floating during water-based therapy by securing them in place. By adding standard ankle weights to the board, it becomes a stable platform that changes what can be done during hydrotherapy sessions.
Important Benefits for Patients and Therapists
For Patients
- Allows the right foot position for effective exercise
- Allows for activities that gradually increase weight-bearing
- Helps with proper biomechanical alignment
- Improves proprioceptive feedback during workouts
For Physiotherapists
- Lessens the need for hands-on help
- Allows treatment to move forward more effectively
- Can be used with patients of all ages, different sizes and conditions
Uses in the clinic
The StandSure Board has been especially helpful for patients who have:
- Neurological disorders that make it hard to control the lower limbs and core
- Rehabilitation after surgery that involves gradually increasing weight-bearing
- Problems with balance and proprioception
- Weakness or instability in the lower limbs
The StandSure Board has made a big difference in our hydrotherapy sessions. In the past, I spent a lot of time just trying to keep patients’ feet down.
Useful Information: Sessions, and Availability on the NHS
How a typical hydrotherapy session works
This is how a typical hydrotherapy session goes:
- Assessment (5-10 minutes): The physiotherapist checks on your current condition, talks about how you’ve been doing since your last session, and makes any necessary changes to your treatment plan.
- Warm-up (5-10 minutes): Gentle movements to get the body ready, like walking in different directions and doing basic range of motion exercises.
- Main therapeutic exercises (20-30 minutes): These are exercises that are tailored to your condition and goals and get harder as you get better.
- Cool-down (5-10 minutes): To finish the session, do some gentle stretching and relaxation exercises.
- Post-session review (5 minutes): Talk about how things went, suggest exercises to do at home, and plan for future sessions.
Session Duration and Frequency
Most hydrotherapy sessions last between 30 and 60 minutes, and the water-based part usually lasts between 30 and 45 minutes. The best frequency depends on each person’s needs:
- Acute conditions: 2-3 sessions a week for 4-6 weeks
- Chronic conditions: You should have 1–2 sessions a week for 6–12 weeks
- Maintenance: One session every week or two weeks for maintenance
NHS Hydrotherapy Availability
The NHS does provide hydrotherapy services; however, their availability varies significantly between different trusts and regions.
- Referral Process: Usually, you need a referral from a GP or specialist to physiotherapy services, who will then decide if hydrotherapy is right for you.
- Eligibility Criteria: The NHS usually prioritises conditions with strong evidence bases, such as inflammatory arthritis, severe osteoarthritis, and certain neurological conditions.
- Waiting Times: Can be anywhere from 2 to 16 weeks, depending on where you are and how many people want the service.
- Session Allocation: Most NHS trusts only offer a few courses (usually 6–8 sessions), but if clinically necessary, they will reassess for more sessions.
Important Note: In some areas, the NHS has reduced hydrotherapy services due to insufficient funding. Some trusts have closed hydrotherapy pools or made them less available. Check with your local NHS trust to see what services are currently available.
Where Hydrotherapy is Typically Performed
Hydrotherapy sessions take place in various settings across the UK:
- NHS Hospital Pools: Hydrotherapy pools that were built specifically for physiotherapy departments.
- Private Rehabilitation Centres: Are special places with their own hydrotherapy pools and equipment.
- Community Leisure Centres: Some have separate hydrotherapy pools that aren’t part of the main swimming pool.
- Special Schools: A lot of schools for children with physical disabilities have pools for hydrotherapy.
- Specialised Spas: Some spas have trained staff who can give you therapeutic hydrotherapy.
When choosing a facility, think about things like the water temperature (it should be between 33 and 36 degrees Celsius for therapeutic purposes), how easy it is to get to, whether there are changing rooms, is there a hoist for access and the qualifications of the staff who will be supervising the sessions.
Next Steps for Getting Started with Hydrotherapy
The first step to getting good hydrotherapy treatment is to talk to a qualified professional
These steps will help you start hydrotherapy treatment on the right path:
- Consult with a Healthcare Professional: Ask your GP, specialist, or physiotherapist if hydrotherapy is right for your condition. They can give you a referral if you need one and tell you how to do things in a certain way.
- Seek Proper Assessment: A qualified physiotherapist who has worked with hydrotherapy should do a full assessment to get baseline measurements and make a treatment plan that is right for you.
- Research Facilities: Look into nearby hydrotherapy options, taking into account things like pool temperature, accessibility features, qualified staff, and the number of sessions available.
- Check Insurance Coverage: If you’re using private health care, make sure you know what hydrotherapy services your insurance covers, including any referral requirements or limits on how many sessions you can have.
- Prepare Appropriately: Before your first session, make sure you have everything you need (swimwear, towel, shower supplies) and learn the rules for using the changing rooms and pool at the facility.
Things to Ask Your Provider
These questions can help you get the most out of hydrotherapy:
- What exact benefits can I expect for my health?
- How many sessions will I need?
- What can I do at home to stay in shape between sessions?
- Are there any risks or safety measures that are unique to my condition?
- What will be done to keep track of and measure progress?
- What special tools could improve my treatment?
Who is qualified to provide hydrotherapy?
In the UK, chartered physiotherapists who have received extra training in aquatic therapy usually provide hydrotherapy. Seek professionals registered with the Health and Care Professions Council (HCPC) who, if possible, possess additional training in hydrotherapy or aquatic rehabilitation. Some specialised facilities may also hire aquatic exercise instructors who have been trained to lead group sessions.
What do I need to bring to my first hydrotherapy session?
You will usually need comfortable swimwear, a towel, shower supplies, and any assistive devices you normally use, like orthoses that can go in water. Some places have flotation devices, but you might want to bring your own if you have certain needs. Always check with the facility ahead of time, as rules may be different.
Is hydrotherapy good for everyone?
Hydrotherapy can help with a lot of different problems, but it doesn’t work for everyone. You shouldn’t use hydrotherapy for fever, infectious skin conditions, uncontrolled epilepsy, severe heart conditions, open wounds, and some respiratory conditions. Always seek a proper medical evaluation before beginning hydrotherapy to ensure its safety and suitability for you.
Make Your Hydrotherapy Experience Better
The StandSure Board is a simple but effective way for physiotherapists and patients to get the most out of hydrotherapy. It helps with common problems that arise in water-based therapy. Designed by physiotherapists to meet real clinical needs, it’s making a big difference in outcomes all over the UK.
Conclusion: What Will Hydrotherapy Look Like in the Future?
Hydrotherapy is one of the oldest forms of treatment we have, but it is constantly changing thanks to new research, methods, and specialised tools. Hydrotherapy is becoming more and more recognised as an important part of full rehabilitation programmes as more and more evidence shows that it works, especially for arthritis, neurological disorders, and chronic pain.
Water has special qualities that make it possible for healing and rehabilitation to happen in ways that aren’t possible on land. Hydrotherapy can help many patients not only physically but also mentally. It can help them regain confidence, independence, and enjoyment of movement that they may have lost because of an injury or illness.
There are still problems with access, especially in some NHS areas, but more and more research is showing that hydrotherapy works, which is helping to keep it a part of modern healthcare. The Standsure Board and other new ideas show how targeted solutions to specific problems can improve results and open up new possibilities in the therapeutic pool.
If you’re thinking about hydrotherapy for yourself or a patient, the evidence indicates that it can be very helpful when done correctly and tailored to each person’s needs. Hydrotherapy can be a life-changing part of recovery and long-term health management if you work with trained professionals and use the right equipment.
“Water has a memory that goes deeper than what we know about it scientifically. In the therapeutic pool, I’ve witnessed patients regaining movements and abilities they previously believed to be irreversible. There’s something deeply healing about the supportive embrace of water that goes beyond its physical properties to touch the human spirit.”
