Calcific Tendinitis of the Rotator Cuff (CTRC)
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Take a dip!

Jun 18, 2024

Hydrotherapy, or aquatic based therapy, is a treatment method I have personally used with patients ever since first becoming an MSK physiotherapist. From my first ever exposure to the method in my early NHS, Junior Physiotherapist role, to using a pool with elite athletes competing in a number of different sports in my more recent career, I very rarely find that the patient doesn’t leave the session with some form of positive gain. Hydrotherapy is defined as the external or internal use of water in any of its forms (water, ice, steam) for health promotion or treatment of various diseases with various temperatures, pressure, duration, and site (Mooventhan and Nivethitha, 2014) (4). Like many good things, it has been used for 1000s of years to assist in the management of health conditions whether that be to aid movement or relieve pain. Today, we very much utilise the benefits of water to treat a variety of health conditions ranging from cardiovascular, to rheumatological, neurological and musculoskeletal injuries. So what are the benefits of hydrotherapy? Well, to break it into pointers, these are the reasons as to why we can find benefit from hydrotherapy:
  1. Pain Relief 
  • Immersion in warm water can help reduce pain and inflammation in muscles and joints. The heat increases blood flow, which can ease discomfort and accelerate the healing process. The pressure exerted by water also helps to reduce swelling and improve circulation
  1. Muscle Relaxation and Recovery
  • Warm water helps to relax tense muscles, reducing spasms and stiffness. It can also enhance muscle recovery after intense physical activity by promoting blood flow and reducing lactic acid buildup.
  1. Improved Circulation
  • Warm water immersion helps dilate blood vessels, improving circulation throughout the body. This can aid in delivering oxygen and nutrients to tissues and removing waste products.
  1. Stress Reduction and Mental Health
  • The soothing properties of water can help reduce stress and anxiety. The buoyancy and warmth create a relaxing environment that can promote mental calmness. This can have a direct positive correlation to improving a person’s ability to sleep due to the relaxed state they enter.
  1. Mobility
  • The buoyancy of water reduces the load on joints, making it easier to move and perform exercises. Water provides a low-impact environment for exercise, reducing the risk of injury. This makes hydrotherapy an excellent option for rehabilitation after surgery or injury.
It is easy to see how we can utilise hydrotherapy to benefit a variety of patients based on the benefits mentioned. Carere and Ore (2016) carried out a review which concluded that hydrotherapy has a positive effect on pain, quality of life, condition-related disability and functional exercise capacity. In fact, the perceived benefit of well-being was actually superior to land-based exercise protocols in cases where water temperature was within a thermoneutral range (33.5–35.5 °C). (2) Cikes et al. (2021) (3) looked specifically at the use of hydrotherapy as an alternative to dry land therapy for rotator cuff repair patients. Through their study they found that the use of pool-based rehabilitation was as effective as dry land rehabilitation at the 1 and 2 year follow up points but that Pool based rehab was in fact MORE effective than dry land exercise at the 3 month follow up point. This therefore suggests that the use of water in the early to mid stages of this particular recovery is beneficial. Then, away from rehabilitation, the pool can also be a useful tool in the role of optimizing recovery for athletes between heavier training sessions or competition. As such, the pool can be used as a recovery tool to support low load conditioning and accelerated recovery between training sessions or match play. This is particularly relevant following intense training days on the field and/ or in the gym, which are designed to load the athlete to develop their tolerance to increased training demands. (Buckthorpe et al 2019) (1) So, whether it be for: rehabilitation from surgery or an acute injury, pain management for a longer-term condition or as a tool in optimizing active recovery, hydrotherapy is another great string to our bow as physiotherapists and can be of great benefit to a large chunk of our patient population.

Reference List

 
  • Buckthorpe, M., Pirotti, E. and Villa, F.D. (2019). BENEFITS AND USE OF AQUATIC THERAPY DURING REHABILITATION AFTER ACL RECONSTRUCTION -A CLINICAL COMMENTARY. International Journal of Sports Physical Therapy, [online] 14(6), pp.978–993. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6878863/.
  • Carere, A. and Orr, R. (2016). The impact of hydrotherapy on a patient’s perceived well-being: a critical review of the literature. Physical Therapy Reviews, 21(2), pp.91–101. doi:https://doi.org/10.1080/10833196.2016.1228510.
  • Cikes, A., Kadri, F. and Lädermann, A., 2021. Evaluation of Three Different Rehabilitation Protocols After Rotator Cuff Repair, and the Effectiveness of Water/Pool Therapy. A Randomized Control Study. Journal of Shoulder and Elbow Surgery, 30(7), p.e421.
  • Mooventhan, A. and Nivethitha, L. (2014). Scientific evidence-based Effects of Hydrotherapy on Various Systems of the Body. North American Journal of Medical Sciences, [online] 6(5), p.199. doi:https://doi.org/10.4103/1947-2714.132935.