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by Michael J. Velsmid, DPT, MS

Aquatic therapy is one of the oldest forms of treatment, dating back to Roman times.  Bathing in hot mineral springs was used in classical medicine as an effective means to treat disease and injury, since the time of Hippocrates.  Today, physical therapists continue to use and develop aquatic therapy principles and techniques for the benefit of a wide range of injuries and conditions.

How can aquatic therapy be an effective choice for physical therapy treatment?  The physical properties of water can assist in pain relief and expedite the return to an active and healthy lifestyle.  Temperature is one of the most important factors that contribute to the effectiveness of an aquatic rehabilitation program.  The optimal therapeutic temperature should approach 90 degrees.  The warmth and pressure of the water assist in pain relief, swelling reduction, and ease of movement.  The buoyancy of water minimizes the stress on joints. Water turbulence and viscosity are used to provide resistance.  Since resistance is a factor of the speed of movement through the water, the individual has the ability to control the level of resistance.  These critical factors allow the opportunity to exercise at a level appropriate for the injury and stage of recovery.

The physical therapist is able to take a more aggressive approach with aquatic therapy, without the negative effects of early, aggressive, land-based therapy.  Patients are able to begin moving within days of an injury with little or no risk of reinjury.  The warm water desensitizes and serves as a counter-irritant to pain, resulting in decreased muscle guarding and spasm and increased flow of oxygen and nutrients to injured tissues.

Recent technological developments have brought aquatic therapy into the 21st century.  With the advent of therapeutic pools in the clinic setting, therapists now have the opportunity to utilize an effective treatment modality that can benefit a multitude of patients.  These pools have amazing versatility in that they have variable-speed underwater treadmills, adjustable water resistance jets, adjustable temperature, variable depths, massage jets, and continuous currents for swimming.  Unfortunately, the expense of such technology limits its availability at the present time.  Boston Sports Medicine, in Allston, is one of the few aquatic physical therapy centers in the Boston area that offers all of these features.

Dr. Velsmid is a Physical Therapist at Boston Sports Medicine