All You Need to Know about Hydrotherapy: Part 2
In the final part of this special 2 part blog series, our Head of Orthopaedic Physiotherapy Emma McCabe reveals the evidence, which proves the effectiveness of hydrotherapy, and also some simple hydrotherapy exercises that you can even do at your own local pool.
In one systematic review, Perraton et al (2009) reviewed eleven studies of hydrotherapy as a treatment tool for people with fibromyalgia. Overall they concluded that hydrotherapy was most beneficial when attending 2-3 sessions of 60 minutes per week and getting the heart rate up to 60-80% maximum. The findings were reduced pain, increased confidence and general fitness and all participants in the study reported a reduction in anxiety and depression.
In another systematic review Langhorst et al (2009) compared ten randomised controlled trials and found that hydrotherapy seemed to be beneficial in patients, as there was a low drop out rate. They also found that people attending local spas reported reduced pain and their quality of life increased.
In a recent Spanish study by Segura-Jiménez et al (2013) they researched the effects of a warm water pool-based exercise program on the pain levels of female fibromyalgia patients. All reported reduced pain after their hydrotherapy session and improvements were higher in older women as well as those who were suffering more pain.
There is quite a lot of evidence with regards to the effectiveness of hydrotherapy and fibromyalgia. Hydrotherapy is very gentle so it causes a minimal stress to the body, but we advise that a qualified physiotherapist should always guide you. Speak to your healthcare professional and find out what services are available in your area. If you are not able to attend a hydrotherapy class locally, you could attend your local swimming pool to carry out some gentle exercises and/or treat yourself to a spa day near to where you are. Do bear in mind, that it may not be as warm as a hydrotherapy pool but exercising in the water is still a great way to strengthen, stretch and relax.
Here’s some exercises that you can perform in your local swimming pool at quiet times:
Walk in the water, either the width or if not possible part of the length 5 times.
Walk backwards x 5
Walk sideways in both directions x 5
Standing in the pool, with your arms straight out to the side and palms facing forward, push through the water bringing your hands together as if you were clapping. Then return to the start position and repeat 10 times.
No do the same exercise but with your palms facing behind you x 10.
Shrug your shoulders up and down x 10
Standing about a half a metre away from the edge of the pool, depending on the water height, pick a spot where the water height meets your shoulders. Place your hands on the edge of the pool (a little wider than shoulder width) and then bend your arms to bring your body closer to the edge without moving your feet and then straighten to push your body away. This exercise should resemble a standing push up. Repeat this 10 times.
March on the spot x 10
Standing with your legs straight, take one leg out to the side 10 times (this works your hip muscles).
Standing, with your legs straight, take one leg behind you 10 times (this works the bottom muscles).
Standing in the pool, keep your feet planted and gently twist your torso from side to side gently. Repeat this 10 times taking care not to twist into any discomfort.
Holding onto the side in the water, rise up onto your toes x 10
Sitting on edge of the pool, with your feet in the water and your knees bent, straighten your knees so your lower legs are moving in the water against resistance x 10 (this works the thigh muscles).
Standing in the corner of the pool, with your arms at 90 degrees and more than shoulder width apart with your feet about half a metre from the edge, lean forward and feel a stretch in the front of your chest. Hold this for 30 seconds.
Stand in the pool half metre from the edge with your feet shoulder width apart. With your arms extended and your back straight, place both of your palms on the edge of the pool. Put the calf you want to stretch behind you, being sure to keep your heel pressed to the floor and the leg extended without bending the knee. The other leg is in a lunged forward position in between the wall and the extended leg. Keeping your heel down, slowly bend your elbows and lean forward. Hold for 30 seconds
Standing in the pool, holding onto the edge, bend one knee and hold onto your foot with your hands. Aim to get your foot towards the bottom and feel a stretch on the front of the thigh. Hold for 30 seconds.
Standing, take one foot out in front, bring the toes up and feel a stretch in the back of the thigh. Hold for 30 seconds.
These exercises are just a guideline and if you are completing these for the first time, take it very easy and listen to your body. Simply attending the pool and doing some walking and gentle stretches may be enough for you.
Don’t forget the use of a hot water bottle, a hot bath at home, or the use of an ice pack can really help to ease your aches and pains. Remember if you have reduced sensation of your skin, check to ensure there is no skin irritation first. Using the hot water bottle or ice pack for 5-10 minutes may suffice.