Hydrotherapy in Physiotherapy


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As the name suggests, hydrotherapy quite simply refers to techniques involving water for therapeutic purposes. This method is an important tool in physiotherapy, and a number of different and more specific techniques come under this umbrella term.

Why water therapy?

Temperature is an important component in the mechanism of hydrotherapy. As the body is immersed in water, its temperature will undoubtedly affect it. Your physiology alters according to temperature, immersion in cold water for example results in constriction of blood vessels which can be of use to a physiotherapist when trying to reduce swelling or bruising. Similarly using warm water can relieve tension and stiffness, while also improving blood flow by causing the dilation of blood vessels. Appropriate hydrotherapy can also stimulate the release of an anti-stress hormone called endorphin, affectionately dubbed the ‘happy hormone’ for its positive effects on mood and pain.

The water supports anywhere from half to about 90% of your weight, making it an ideal medium in which to begin rehabilitating injuries and restoring movement. Injuries to the lower body are difficult to effectively treat without overworking them as they are load bearing in nature, and ideally your therapist will want to ease weight back on to them as slowly as possible. The fact that while supporting body weight, water also provides some resistance means that you can strengthen the affected area without the risk of overloading.

Different methods of hydrotherapy in physiotherapy

As discussed above, the early stages of hydrotherapy might simply rely on immersing the body in a temperature which encourages recovery. When your physio decides it is appropriate, they may move you on to performing under water exercises, often supplemented by a light regime of exercise and stretching out of the water as well. The course of action is determined by your physio in their assessment of your condition upon referral.

The term ‘hydrotherapy’ encompasses any means of water based treatment, however there are more specific media for this therapy. Swimming pools are an easily accessible and cheap option for under water exercises, but do not provide a controlled or constant temperature for therapy. Similarly a warm bath might be recommended for up to 30 minutes, perhaps supplemented by aromatherapy oils or sea salts.

Saunas are a tried and tested environment for hydrotherapy, relying on the heat and moisture to dilate blood vessels, relax muscles, stimulate endorphin release, and hence facilitate healing. Steam baths and Turkish baths operate on a similar principle, although they are perhaps less accessible than saunas, which can now be found in most gyms and spa facilities. A Sitz bath is another alternative, in which you would be in one tub with warm water, while your feet lie in another filled with cold water, you would move between them regularly.

Some hydrotherapies are not immersive, meaning that water is used as a tool for treatment without full body immersion. These bring the benefits of other hydrotherapies on to a smaller scale that can be more convenient and suitable for some people. Examples including a hot or cold water compress, which can quite simply be a towel soaked and then applied to the site of injury. Similarly larger towels can be used to cover you, warming you and achieving the aims of certain forms of hydrotherapy.

Receiving hydrotherapy

Your physiotherapist will be the one who decides whether or not hydrotherapy is the method for you. The NHS can provide hydrotherapy to some extent, while you can also go privately for around £35 for basic sessions. Private hydrotherapists are available as well. As some methods, as discussed above, are basic and can be conducted at home, your physiotherapist may offer you instruction on how to perform the procedure properly and, if you are able, let you conduct the treatment in the privacy and comfort of your own home. Discussing your options with your physiotherapist is undoubtedly the best way to address any issues or questions you may have, as well as tailor the treatment to suit your specific needs.


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