Aquatic Physical Therapy

by Barbara Foster

Aquatic physical therapy has benefited many different people across the United States and beyond. This low-impact therapy is preferred for patients with neurological, skeletal, and muscular diseases or anyone who may have difficulty with land-based exercise. Aquatic physical therapy is meant to help facilitate functional recovery in a safe setting. Find out how aquatic therapy works, who it benefits, and how it can help many different people with chronic illnesses.

What is Aquatic Physical Therapy?

Aquatic physical therapy, or aqua therapy, as it has been called, is the evidence-based practice of physical therapy but in an aquatic setting (most often a pool). The practice gives physical therapy patients the opportunity to rehabilitate and develop functional muscles when land exercises are too painful or even impossible. Because of the body's natural buoyancy, gravity's pull on the body can be reduced while submerged. The body bears only half of its weight when submerged to the chest and about 90 percent when submerged to the neck. This can cushion stiff or painful joints. And yet, water has a natural resistance, forcing patients to use their muscles in gentle, slow, sweeping movements. Water has about 12 times more resistance than air, so that translates to a more valuable exercise routine. Water pushes up, in the opposite direction of gravity, which can help to prevent potential falls for those with dangerously brittle bones or fragile joints. The aqua therapy setting can be freeing for those struggling to rehabilitate themselves with normal, land-based physical therapy practices. Several different techniques may be used within aquatic PT, such as Ai Chi, the Halliwick Concept, Watsu, and the Burdenko Method. The aim of aquatic therapy is often to create less pressure on areas such as the spine, to reduce swelling, and to decrease overall pain.

Aquatic Physical Therapy Vs. Aquatic Exercise

Swimming is a great way to get regular aerobic activity and can be done by almost anyone, but it differs from aquatic physical therapy in several key ways. Firstly, this form of physical therapy doesn't necessarily translate to swimming. It might include walking, lifting limbs, or going about normal, everyday motions, but in water. But there is a more important, key difference: Aquatic exercise can be practiced on one's own at a local pool, whereas aquatic physical therapy must be done in the presence of a certified physical therapy professional. That professional may support, direct, or instruct the patient to go about different motions and exercises. Because the physical therapist will know their patient, they'll know which exercises to use as a treatment for pain. For patients already in a program, aquatic exercises may be practiced on one's own, but it's very important to get clear instructions from the physical therapist first. Note that aquatic physical therapy also differs from hydrotherapy, which describes many different medical practices that use water. Sometimes, even simple submersion in a bath may have certain benefits to certain patients. While hydrotherapy is interesting, it does not often describe aquatic physical therapy.


While most people can benefit from simple water exercises like swimming, specific groups benefit a great deal from aquatic therapies. Many people choose aquatic therapy, but the people who are often the most positively impacted are the ones who suffer from some form of chronic pain. This form of therapy seems to be most beneficial to those with osteoarthritis in the hips or knees, as it frees patients for more easy movements and cushions them from any potential falls. As such, aquatic therapy is often appreciated by older patients with low mobility. Those with neurological disorders and diseases, such as cerebral palsy, Parkinson's disease, fibromyalgia, brain injuries, and multiple sclerosis, also seem to benefit from it as well. This is because aqua therapy has been known to reduce muscle spasms and, again, provides a safe environment where patients can exercise calmly and freely, without the pull of gravity. When it comes to the effectiveness of the treatment, the therapist's skill and the accuracy of the diagnosis both play an important role.