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Aquatic Therapy (Hydrotherapy) By Ryan Berube The Benefits for Athletic Injuries Increased Mobility and strength Maintain fitness levels Decrease swelling Pain relief Removes weight from joints and bones Began jogging at an earlier stage of rehab

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the benefits for athletic injuries
The Benefits for Athletic Injuries
  • Increased Mobility and strength
  • Maintain fitness levels
  • Decrease swelling
  • Pain relief
  • Removes weight from joints and bones
mr palmer
Began jogging at an earlier stage of rehab

Buoyancy allowed Carson Palmer to run neck deep

underwater cameras allow Bengals athletic trainers to observe movements and diagnose any gait irregularities (Hydroworx,2006).

Mr. Palmer
history of aquatic therapy
History of Aquatic Therapy
  • Hippocrates used hydrotherapy extensively around 400 B.C.
  • Was Commonly used in Europe.
    • Treated diseases and maintained health.
  • Aquatic based rehabilitation was not used in the U.S. until early 1900’s.
  • This form of rehabilitation has evolved considerably throughout time.
properties of water
Properties of Water
  • Archimedes’ Principle
  • Buoyancy- The upward thrust acting on in the opposite direction of gravity
  • Specific gravity- The ratio of the mass of one substance to the mass of the same value of water (Andrews,2004).
properties continued
Hydrostatic Pressure

Pascal’s law

Control effusion in an injured extremity

Increases blood flow

Increase lymphatic return


Resistance to all fast movements in water

Properties Continued
physiological effects
Physiological Effects
  • Physiological changes occur when a person is immersed in water, both at rest and during exercise.
  • Changes that occur during water immersion are the result of hydrostatic pressure.
    • Because of the increase in blood flow and volume, the heart distends and myocardial wall tension increases resulting in a Frank-Starling reflex and a increase in stroke volume (Andrews,2004).
physiological effects cont d
Physiological Effects Cont’d
  • Water temperature for rehab is recommended to be between 82 and 98 deg F.
    • Decrease joint stiffness
    • Relieve muscle spasm
    • Increase blood flow
    • Assist in the inflammatory process
  • Aquatic rehab offers advantages over land based rehab.
    • Buoyancy decreases weight bearing and joint compressive forces.
    • The viscosity associated with water provides accommodating resistance to exercise.
    • Water provides a good environment for cardiovascular training.
rehabilitation cardiovascular conditioning
Rehabilitation (Cardiovascular Conditioning)
  • Key component to the rehab program
  • Should have the appropriate warm up and cool down.
    • Walking, jogging, bicycling motions
  • Clinician can choose to rest the injured area or challenge the muscles specific to the sport.
  • Flotation vests may be used
  • 25 minutes, 5 times a week is recommended
    • Intensity and duration should mimic the athletes sport.
rehabilitation stretching
Rehabilitation (Stretching)
  • Restore osteokinematics and joint arthrokinematics.
  • The buoyancy of water supports the extremities.
  • Warm water can provide a relaxing environment which may allow for increased soft tissue extensibility.
  • The duration of the stretch can vary.
  • Stretching should be performed throughout the rehab process.
rehabilitation upper extremity
Rehabilitation (Upper Extremity)
  • The program should be sport specific.
  • Shoulder strengthening exercises that are performed on land can be performed in water.
  • Overhead activities
rehabilitation lower extremity
Must consist of Open/Closed chain activities.

Open chain exercises

Closed chain exercises

Balance and proprioception

Rehabilitation (Lower Extremity)
rehabilitation core strengthening
Rehabilitation (Core Strengthening)
  • Core Body strength and postural control are critical for any athlete (Andrews,2004).
  • Most extremity exercises also train the core body.
    • Standing leg kicks
    • Shoulder flexion/extension
  • Dynamic exercises
    • leg lifts, straight leg lifting
  • Eccentric exercises
    • Can use a buoyant ball for exercises
return to sport
Return to Sport
  • An extensive aquatic rehab program will challenge the athlete while allowing him/her to train and condition along with providing adequate recovery time (Andrews,2004).
  • Clinician should rely on subjective input and the athlete’s response to functional testing to determine readiness.
    • Athletes should be able to complete any testing with proper form and without any increase in pain or swelling before resuming land activities (Andrews,2004).
special conditions


Chronic pain

Neuromuscular and Neurological


Weight Loss

Special Conditions
  • Andrews R., James, M.D., Gary, Ed.D.,ATC Harrelson L., and Kevin, PT Wilk E. Physical Rehabilitation of the Injured Athlete. 3rd ed. Philadelphia:SAUNDERS, 2004.
  • Hydrotherapy. 20 Nov. 2006. 29 Nov. 2006 <http://www.tuberosecom/Hydrotherapy.html>. Path: Aquatic Rehabilitation.
  • Hydroworx. 29 Nov. 2006. 24 Nov. 2006 <>.