Aquatic Physical Therapy for Athletes

When it comes to healing an athlete from injuries sustained on the field or following surgery, there’s a timetable. An important one.

When athletes arrive in a physical therapy clinic, often the first thing they wonder is how quick can they return to their fields and courts of play. Safely.

And by athletes, we’re talking about everyone from a professional basketball player to a mother of four training for a half-marathon.

That’s where aquatic therapy and sports physical therapists come in.

Aquatic therapy is prescribed exercises performed in a pool as directed by a physical therapist as part of a total treatment plan.

Clinicians across Tidewater Physical Therapy’s more than 30 locations and five aquatic therapy centers use therapeutic pools to treat patients.

“For an acute sports injury, the pool is beneficial because we can continue to exercise the rest of the patient’s body, while the injured area is healing,” said Mike Satterley, PT, DPT, SCS, CIMT, CSCS, CMTPT and the Sports Physical Therapy Program Director at the Oyster Point location in Newport News.

This isn’t just foam noodles and scissor kicks in the water. In the last decade, the equipment and techniques used to support aquatic therapy have advanced to include paddles, adaptive devices and submerged treadmills.

To be true aquatic therapy, therapists work with the trifecta benefits of water pressure, buoyancy and temperature.

As obvious as it may sound, the buoyancy of water is often considered the first most beneficial aspect of aquatic therapy.

Water allows patients to exercise the rest of their body while still building up the strength of an injured area. Bodyweight and supporting it on, say, a knee that’s recently been operated on, can be too much. In the water, though, the stress of just standing and walking on your own bodyweight can be reduced by nearly 20 percent because of the buoyancy.

By using the pool to unweight the body so much, patients can practice exercises and activities earlier than on land. Then, when it is safe to load the full bodyweight on land, the patient has already been practicing in a heated pool.

Note that we said HEATED pool. The temperature of the water also makes a difference.

“What sets aquatic therapy apart from the typical recreation center aquatic aerobics, is that the pool is heated, and it’s very, very comfortable to get into a heated pool,” said Paul Reed, PT, DPT, Clinical Director of the First Colonial location in Virginia Beach.

Therapeutic pools, including those at Tidewater Physical Therapy clinics, are generally large enough for multiple patients to work out at one time, but small enough to be able to control the temperature. A therapeutic pool is set several degrees higher—usually around 92 degrees—than most swimming pools, but cooler than a hot tub, which is generally set between 100 and 104 degrees.

The comfortable, warm temperature often decreases muscle guarding and pain for early therapeutic exercise and can improve range of motion and flexibility.

“Also,” Reed added about this treatment option, “the programs that physical therapists develop are very individualized and specific for that person, so you feel that you have a say in the goals that have been established and set.”

Physical therapists, when working with patients in the water, can determine how intense prescription exercises as part of a treatment plan are — the harder a patient pushes against the water, the harder the exercise will be.

The underwater treadmill is among those exercises physical therapists use to work on that resistance benefit. It has the ability to treat low-level performing athletes and high-level performing athletes, at the same time.

It can start very slow—at half a mile an hour for walking—and can go all the way up to 12 miles per hour for running, making it suitable for multiple levels of recovery.

“Having someone walk in the water versus walking on land is totally different,” Reed said. “Often times, following a lower extremity injury or surgery, there is a period of time where you can’t walk on land either due to increased pain or postoperative restrictions, so aquatic therapy really helps.”

Reed has seen it happen. In the past year alone, Reed has treated several athletes, including a runner with a broken foot, to football players with strains in their backs.

Water therapy is being used to treat not only athletic patients, but also those with total joint replacements, children with cerebral palsy, autism, and Down syndrome, and adults with, among other ailments, joint pain, stiffness, muscle spasms, back pain, osteoarthritis, rheumatoid arthritis, fibromyalgia, lymphedema and systemic lupus.

Many of Tidewater Physical Therapy’s clinicians hold Direct Access Certifications, meaning patients can make physical therapy appointments without a referral from their physician. For more information about aquatic therapy, find a clinic near you and make your own appointment.