Hydrotherapy
And now for something a little bit different!
It is true that travelling has shown me some incredible ocean, pool and waterfront locations around the planet. Some balmy and warm and some icy and freezing, but that comes with the snow chaser territory I guess ;)
Let's talk for a moment about warm water....
These snow and other adventures have taken me from the sulphur hot springs and hot tubs of the Canadian Rockies to naked bathing in Hokkaido's Japanese Onsen and once diving into the crystal azure waterfalls and underground limestone cenote cavern's of Mexico's Yukutan Peninsula. I've worked in Bath, Somerset in the spiritual home of hydrotherapy with its Roman bathing rituals and travelled to the travertine terraces or "cotton castle" mineral compositions in Turkey's Pamukkale or ancient Hierapolis (Holy City). Similar areas have been drawing the sick, injured and inquisitive to their thermal properties since the time of classical antiquity.
When I'm not travelling, I'm a qualified Physiotherapist with Post-graduate training in Aquatic Physiotherapy, or hydrotherapy. I know a thing or two about the hydrostatic and hydrodynamic properties of water, how these impact the body systems and the implications for exercise and recovery. Think words like float, drag, pressure, turbulence and resistance; these are some of the physical principles of water that a hydrotherapist incorporates into their daily practise to benefit the client. Add to this the thermal properties of warm water and usual benefits of exercise and you have a potent remedy for health and healing.
So What About Arthritis?
We are hearing more and more in the scientific literature as well as mainstream media about how a conservative approach to things like osteoarthritic knee pain has been shown to be an effective and preferable alternative to arthroscopy or knee surgery. We read anecdotal evidence about the potent anti-inflammatory and cartilage rebuilding benefits of Fish Oil, Glucosamine, Tumeric and Curcumin and wonder if we are truly able to slow down or reverse some of the painful effects of joint injuries and ageing.
Recent research in rheumatology has found a crucial link between metabolism and osteoarthritis. While often put down to a natural part of the ageing-process or ‘wear and tear’, an expert review in Nature Reviews Rheumatology describes how the onset or progression of Osteoarthritis can potentially be delayed, slowed down or even prevented with a good diet and regular exercise. Newsflash; Joint pain isn't a normal ageing process and you don't have to just put up with it!!
We also know that regular exercise can reduce the risk of dementia, Type 2 Diabetes, depression, some cancers, heart disease and other chronic conditions by at least 30%.
So if exercise can help osteoarthritis, plus many other health conditions, what type of exercise should you do? One great option for many conditions is hydrotherapy, where you undertake a specific exercise programme in water, under the guidance of a physiotherapist.
The Benefits of Water
Philosophers and physicians like Plato and Hippocrates knew the value of warm water as a therapeutic medium. The ancient Romans and Greeks thought waters relieved conditions like rheumatism, arthritis and an over-indulgence in food and drink.
Over the years, water has continued to be used in the treatment of muscle spasm, joint pain and swelling, circulatory and lymphatic issues and various diseases by many – including an increasing number of allied health, medical and alternative therapy professionals.
As it turns out, the Romans and Greeks weren’t far off the mark! Water-based exercise can provide a realistic and enjoyable alternative to exercising on land, and when done correctly can provide you with similar strength and conditioning outcomes as a session in the gym.
Having to move against the resistance of the water (using it’s properties of drag and turbulence) promotes activation of deep stabilising and postural muscles, which are important in conditions like back pain, movement disorders and during pregnancy.
Among other things, hydrotherapy can help manage:
- Osteoarthritis
- Osteoporosis
- Rheumatoid and other Arthritis
- Back, neck or shoulder pain
- Hip pain or tendon problems
- Knee pain
- Pain or discomfort associated with pregnancy
- Rehabilitation after surgery
- Foot or ankle problems where weight-bearing is painful or restricted
The hydrotherapy environment can also address balance issues in a way that is safe and supportive. When standing in water, there is less pressure under our feet owing to buoyancy. Without our usual foot/ankle and lower limb strategies, other parts of the body like the vestibular system and core stabiliser muscles that help us to balance are called upon to work harder. If balance is a concern for you, exercising in water creates and provides a secure environment to challenge your balance, reflexes, righting reactions and confidence without risk of falls and injury.
Is Hydrotherapy Safe?
Modern pain science tells us that pain is an expression of perceived danger to the body. The pool environment is one of the few places where we can be more active while also feeling safer. This has powerful benefits for both rehabilitation and chronic or persistent pain.
For the larger weight-bearing joints like your hips, knees and spine, exercising in water is proven to be safe and can actually be more comfortable, particularly if you are dealing with a painful flare up or recovering from early orthopaedic surgery.
In water, there is less loading and compression of the joints which means less risk of injury. Standing in water up to your neck equates to a reduction in body weight of up to 90%, and a 100% reduction of joint load can be achieved if engaging in flotation or exercise off your feet; a way to experience true “weightlessness”!
Is Hydrotherapy Too Gentle?
While it feels great to be light on our feet, we shouldn’t underestimate the hidden circulatory benefits and increased cardiovascular and physical effort of working against water pressure and it's added viscosity, turbulence, drag and resistance.
The heart and lungs work harder when exercising in water, largely owing to an increase in circulating blood volume of 20-40%. This can be influenced by water temperature, depth and body positioning and can have positive cardiovascular health benefits.
A recent study showed that high drag forces in water result in greater muscle activity up to 300% of body weight. By choosing the right activity, varying speed of movement and using additional equipment like paddles or floats, joint forces, muscle resistance and overall effort can be modulated individually to meet your rehabilitation or fitness goals.
Exercise for Osteoarthritis
If you are overweight, suffering from health problems or already with osteoarthritis and painful inflammation of the joint cartilage, the prospect of starting an exercise programme may seem daunting.
The good news is; If you have pain, swelling or reduced mobility owing to osteoarthritis, exercise in water may be a preferable and safer alternative to help you get back on your feet. This is related to the unique properties of water including warmth, buoyancy and hydrostatic pressure.
How To Start Hydrotherapy
Sarah provides personalised hydrotherapy and Pilates services in Adelaide, South Australia. If you would like to investigate whether hydrotherapy would be appropriate for you, please get in touch.
In the meantime, happy splashing!!
N.B References can be provided upon request.
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