Wade a while

Moving in the water can provide pain relief and offer a safe alternative to exercising on land

Humans are roughly 60% water, so it makes sense that exercising in water, in the form of aquatic therapy, could play a part in our health.

“Everyone can benefit from aquatic therapy,” says Alison Bonnyman, physiotherapist and founder of Canadian Aquatic Rehab Instructors (CARI), which provides training for aquatic therapists across Canada. “Patients with total joint replacements, arthritis, Parkinson’s, multiple sclerosis and stroke, dementia and sports injuries can benefit,” she says, as can patients with complex conditions like tracheostomies or Guillain-Barré syndrome. Aquatic therapy has even been used to facilitate bonding between neonatal intensive care unit infants and parents.

Gaining strength, reducing pain

“[Aquatic therapy is] a good option for gaining strength, because buoyancy makes it easier to exercise in the water,” says Costco member Dr. Albert Recio, a physician in the paralysis restoration program at the International Center for Spinal Cord Injury at the Kennedy Krieger Institute. Buoyancy supports patients, and hydrostatic pressure, the force of water against the body, helps circulation. “Hydrostatic pressure promotes muscle relaxation and helps decrease swelling,” explains Recio.

Aquatic therapy increases blood flow, strengthens muscles, improves balance, boosts memory and reduces stress, explains Bonnyman. “People feel more relaxed.” The relaxation and pain reduction can last for hours, says Costco member Audrey Collins, a certified CARI instructor based in Ontario. “Water supports the body and makes it easier to move and exercise,” she adds. Patients get stronger over time while experiencing less pain.

Recovering from injury

Costco member Michael Murray, president of the American Physical Therapy Association Academy of Aquatic Physical Therapy, sees a wide spectrum of patients, from injured athletes to people for whom aquatic therapy is a last resort.

Murray and his colleagues at Duke Health, in North Carolina, studied healthy people walking in shallow water, demonstrating how buoyancy lessened impact on lower extremities and resistance increased strength and some joint mobility. “If you have a condition that’s degenerative, aquatic therapy helps strengthen you to live more independently on land,” says Murray. He notes that high-intensity aquatic exercises can help maintain bone density, but osteoporosis patients also need weight-bearing exercise on land, adding that many patients do a combination of aquatic and land therapy to get stronger and functionally independent.

Meeting special lifestyle needs

Recio works with patients of all ages with mild to severe neurological, rehabilitative or developmental needs, and has published groundbreaking research on aquatic therapy for patients with tracheostomies, colostomies and pressure injuries, where activities of daily living, such as personal care and hygiene, improved. “We’re trying to demonstrate we can eliminate barriers for patients with complex medical conditions. We have developed policies and procedures allowing patients with ventilators and diaphragmatic pacers in the pool for skilled therapies,” Recio explains, adding that these patients hadn’t previously been considered for aquatic exercise. Aquatic therapy gives them more independence.

Aquatic therapy participants should continue water exercises after discharge from therapy by joining an aquatic exercise program at their local fitness centre or YMCA. “Remember,” says Collins, “if you don’t move it, you lose it.”

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