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Water-Based Therapy for Exercise

By: Andrew J. Cole, MD

The techniques used in water therapy exercise for back pain include spa therapy, standingor floating pool exercises, swimming, and conditioning using specialized equipment,

such as surgical tubing, flotation devices and resistive devices for the hands or feet.

Spa treatments complementing water therapy back exercise typically involve relaxing in

warm, agitated water such as that found in whirlpool baths. This form of hydrotherapyrelaxes muscles, improved muscle blood flow and increases general blood circulation,

which make the body more flexible and can prepare it for water therapy or land-based

exercise.

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Active techniques for water therapy back exercise are diverse and should

be tailored to the individual. Exercises range from simple routines performed in a shallow

pool to conditioning using underwater treadmills and other high-tech equipment.

Water therapy exercises muscles and joints, as well as

the back

Some of the basic techniques for pool therapy exercises are as follows (they can bemodified for varying degrees of difficulty):

Knee-to-chest exercise. This movement is performed with one hand on the side

of the pool or with back to the wall. Alternating between legs stretches the lower

back, as well as the gluteus (buttocks), quadriceps (front thigh) and hamstring(back thigh) muscles.

Leg raise exercise. This movement is performed with one leg outstretched and

the supporting leg slightly bent while one hand holds onto the side of the pool. It

strengthens and stretches the muscles in the leg, hip and lower back. Wall-facing leg stretch exercise. In this stretching exercise individuals assume a

Superman position with hands resting on side of pool and the body and legs

outstretched into and supported by water. This extends all regions of and joints in

the back as well as stretching shoulder muscles. Pool walking exercise. Walking both forward and backward in chest-high water

works the leg muscles while exerting no impact of the knees or hips, particularly

important for people who have arthritis in those joints. The walking exercise canbe made more demanding with the addition of hand floats or light weights, so a

stroll in the pool becomes an aquatic version of power walking.

Quadruped activity and exercise. This exercise works legs and arms and is

performed while floating on ones back (sometimes achieved with a therapist

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supporting the trunk or using a flotation jacket). The individual makes paddling

motions with his/her arms and legs.

Combined water therapy for back exercise with land-

based methodsWater therapy for back exercise can be a short-term exercise option if back pain or a back

injury makes land-based exercise too difficult. Or it can be adopted as part of an ongoingexercise program if land-based methods worsen symptoms or if the person prefers water

exercises. If their functional status or competitive goals require it, people may transition

to exercise in a dry environment once they are successfully performing exercises inwater.

Some people may find mixed use of wet and dry exercise therapy environments most

beneficial.

There is a small but growing body of scientific studies demonstrating the benefits of

aquatic exercise in the management of spine pain. Although more scientific evidence forthe specific benefits of water therapy exercise in treating back pain will be helpful in

creating specific programs for particular spine problems, the value of appropriate aquatic

exercise programs is well established overall and has been beneficial in many thousandsof individuals. The aquatic medium is ideal for patients for whom land-based options for

back exercise are limited, and may provide a safe and effective method of managing

spine pain while improving function.