If land based exercise flares your joints, or you have been told to strengthen but everything you try hurts, water changes the rules enough to make it possible. That is the whole proposition of hydrotherapy, and it is why I have spent years training in it and now tutor other physiotherapists on the APA aquatic courses.
Most people have no real idea what an aquatic physiotherapy session involves. So rather than list benefits, let me walk you through one.
Four properties, each doing a different job.
Buoyancy reduces the effective load through your joints. In chest deep water you are carrying roughly a quarter to a third of your body weight. Someone who cannot tolerate walking down a corridor can often walk comfortably up and down a pool.
Hydrostatic pressure is the gentle compression the water applies from all sides. It helps reduce swelling and gives your nervous system a constant stream of sensory information, which has a settling effect on painful joints. People often describe feeling held.
Resistance comes at you from every direction rather than one plane, and it scales with speed. Move slowly and it is easy. Move fast and it pushes back hard. That makes it self regulating, which is enormously useful when you are working with pain, because you cannot accidentally overload yourself the way you can with a dumbbell.
Temperature. Hydrotherapy pools run warmer than lap pools, usually somewhere in the low thirties. Warm muscle relaxes, and stiff joints move more freely.
It is not swimming. Your head stays above water the entire time. You do not need to be able to swim and a good number of my clients cannot.
Before you get in. Your first session follows a land based assessment, so I already know your diagnosis, your restrictions and your goals. We are not working it out in the pool.
First few minutes. Walking. Forwards, backwards, sideways, in chest deep water. It looks trivial and it is doing a lot: warming you up, letting me watch how you move, and letting you feel what the water does to your balance before we add anything.
Next. Range of movement work. Whatever joint is the problem, moved through as much range as it will comfortably give, with buoyancy taking the weight. Post surgical knees and stiff shoulders make particularly rapid gains here.
The main block. Strength. Squats holding the pool edge, step ups on a submerged step, resisted arm and leg work using floats and paddles, and single leg work that would be impossible on land at this stage. Turbulence from your own movement adds a balance challenge on top.
Toward the end. Balance and confidence work. This is where the water is genuinely irreplaceable for older adults, because the fear of falling disappears. You can push someone right to the edge of their balance and the worst outcome is that they get wet.
Getting out. Sessions run around 30 to 45 minutes. People are often more tired than they expect, which surprises them given how little it felt like work.
Worth saying plainly. Hydrotherapy is not appropriate if you have an open or unhealed wound, an active skin or urinary infection, uncontrolled cardiac conditions, uncontrolled epilepsy, or a fever. Incontinence needs a conversation first, though it is often manageable. If you have a serious chlorine sensitivity, tell us before booking.
This is the part I want people to understand before they start.
For most people, hydrotherapy is a way through a period when land based exercise is not possible. The aim is to build enough strength, range and confidence in the water that land work becomes tolerable, and then to move you across.
Bone and tendon need weight bearing load to adapt properly, and water by definition removes some of that. So water alone will not get you all the way. For some people, particularly those with significant arthritis or complex pain, it remains a valuable ongoing part of staying mobile, and that is a legitimate outcome too.
Either way, I will tell you at the outset which of those two I think you are, and we will revisit it.
If you are not sure whether the water is the right place to start, book an assessment and we will work it out on land first.
No. Every exercise is done standing with your head above water, and you are supervised the entire session.
Swimwear, a towel, and thongs or sandals for the pool deck. A robe or something warm for afterwards if you feel the cold. If your balance is limited, let us know beforehand and we will arrange the right support getting in and out.
Usually yes, under physiotherapy extras cover, since sessions are delivered by a physiotherapist. Rebates vary by fund and level of cover, so check with yours directly.
An aqua class is a general fitness class run to a set routine. Hydrotherapy is individually prescribed following a physiotherapy assessment, with exercises selected for your specific condition and stage of recovery, and progressed as you improve. Both have their place. They are not substitutes for each other.
Once the wound has fully healed and your surgeon has cleared you for immersion. That is commonly around two to three weeks, but it varies considerably by procedure, so follow your surgeon's advice rather than a general rule.
It depends on what you are recovering from. Post surgical clients often do a block of six to eight while weight bearing is restricted, then transition to land. Ongoing arthritis management can be a longer term arrangement.
Almost certainly, eventually. We generally use both, weighted toward whichever one your body currently tolerates.
If pain is the reason you stopped exercising, or if you have been told to strengthen but cannot find a way to do it without paying for it the next day, hydrotherapy is worth an assessment. It regularly opens a door that felt firmly shut.
Book an assessment at our Elsternwick clinic, or get in touch to ask about pool locations and session times.
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