Aquatic Therapy

Pain Relief and Increased Mobility

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Aquatic Therapy: Quick Facts

  • Aquatic therapy is a form of physical therapy performed in a therapeutic pool, using the natural properties of water to reduce stress on the joints while improving strength, flexibility, balance, and mobility.
  • The buoyancy of water helps support body weight, making movement less painful and allowing patients to perform exercises that may be difficult or impossible on land.
  • Aquatic therapy is commonly used for patients recovering from spine surgery, orthopedic injuries, chronic back or neck pain, arthritis, sports injuries, neurological conditions, and balance disorders.
  • Treatment is individualized and guided by a licensed physical therapist, with exercises designed to improve strength, range of motion, endurance, posture, and functional movement before transitioning to land-based therapy when appropriate.
  • Most patients do not need to know how to swim to participate. Therapy is performed in a controlled environment using the support and resistance of the water to promote safe rehabilitation.
  • Aquatic therapy is often combined with traditional physical therapy as part of a comprehensive rehabilitation program to reduce pain, improve function, and help patients return to their daily activities more comfortably.

What Is Aquatic Therapy?

Aquatic therapy is a form of physical therapy performed in a pool or other water environment under the guidance of a trained physical therapist. It uses the properties of water, such as buoyancy, resistance, hydrostatic pressure, and warmth, to help patients recover, manage pain, and improve mobility.

This highly-effective form of therapy is used at VSI Physical Therapy in Reston, often used for post-surgical recovery, injury rehabilitation, and athletic training. Aquatic therapy has the ability to improve strength and flexibility, helping patients achieve their goals and recover faster.

VSI Physical Therapy is proud to offer the only HydroWorx underwater treadmill in Northern Virginia.

Not all outpatient physical therapy clinics offer aquatic therapy. If aquatic therapy is available, it is most often performed in a pool setting where the height of the water is not adjustable and the water is not heated. In most circumstances, the therapist is supervising multiple patients at once in a pool setting. Our treatment model allows one-on-one supervised care with a therapist that provides specific exercise instructions to maximize your time in aquatic therapy.

Aquatic Therapy Benefits

Benefits of Aquatic Therapy After Surgery

For spine surgery patients, aquatic therapy supports healing and bridges the gap between early rehab and return to full activity by providing a low-impact rehabilitation environment. Here’s why it is impactful:

  • Natural resistance is provided by the water in all directions, which exercises the muscles without use of heavy weights. This can be beneficial early on after an injury or procedure.
  • Reduced load on healing tissues and improved circulation allows aquatic therapy to be introduced earlier in the rehab process than land-based exercises, promoting faster recovery. Patients can begin practicing walking, jogging, or sport-specific drills in water before safely returning to land-based versions.
  • Balance is often improved by the challenge of an unstable water environment, which is especially valuable after lower extremity injuries or surgeries, where re-learning body control is crucial.

Benefits of Aquatic Therapy for Athletic Performance

Water provides multi-directional resistance, requiring muscles to work harder with every movement. Resistance can be scaled by speed and surface area (e.g., using paddles, boards, drag equipment). The height of the water and the jet in the HydroWorx treadmill affect the resistance as well.

Plyometrics, direction changes, and sprint training in water deliver the neuromuscular benefits of explosive work without the repetitive impact of land training.

High-intensity aquatic interval training enhances aerobic and anaerobic capacity with lower injury risk.

athlete running in aquatic treadmill rehab

Benefits of Aquatic Therapy for Injury Recovery

Aquatic therapy offers unique advantages that make it an ideal option for patients recovering from an injury. The properties of water create a therapeutic environment that supports healing while allowing for earlier and safer movement than traditional land-based rehabilitation. Here’s how:

  • Warm water relaxes muscles, improves blood flow, and reduces pain sensitivity.
  • Hydrostatic pressure from the aquatic treadmill decreases swelling and inflammation, which further assists with pain management.
  • Buoyancy decreases the effect of gravity, reducing the load on joints, bones, and soft tissues. This allows safe movement and exercise to be implemented earlier in recovery.
patient using weights in aquatic treadmill

Conditions Treated Using Aquatic Therapy

At VSI Physical Therapy, we use aquatic therapy to treat these and other conditions:

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What to Expect During Your Aquatic Therapy Session

Sessions are personalized and catered to each individual patient, with intensity varying depending on tissue irritability, phase of rehab, and goals of the patient. Sessions can range from simple activities like walking at a comfortable pace for the duration of the session to more intense workouts incorporating sprint intervals and plyometric training. The challenge of functional movements such as squats, lunges, and step-ups can be modified to suit each patient by altering the water height and incorporating the use of free weights.

Why VSI Offers Aquatic Therapy

Aquatic therapy is more than just a treatment, it is part of our comprehensive philosophy on recovery. We believe recovery starts before your surgery even takes place and continues long after the procedure is complete. This forward-thinking approach is at the heart of the Recovery Revolution™, a movement created to transform how patients experience healing and restoration.

Aquatic therapy is one of the advanced tools we use to set the stage for optimal recovery. This therapy remodels damaged tissue, enhances your healing capacity, and accelerates your return to the life you love. It is part of our 5 Pillars of Recovery, which include cutting-edge technology, surgical precision, continuity of care, and specialized recovery modalities.

Frequently Asked Questions about Aquatic Therapy

Many patients wear bathing suits for aquatic therapy, but any clothes that you don’t mind getting wet are acceptable. Some patients prefer to wear shorts or compression shorts with t-shirts or sports bras. Most patients are comfortable being barefoot in the aquatic treadmill, though some choose to wear aquatic shoes. Please note that shoes with laces of any kind are not allowed in the aquatic treadmill for safety reasons.

Towels will be provided, but you’re more than welcome to bring your own if you prefer. The locker rooms are located adjacent to the aquatic treadmill and feature private showers for patients to use after their session. We recommend bringing a change of clothes and any toiletries you may need so you can freshen up comfortably after your aquatic therapy session.

At VSI PT, all of the sessions are booked for one hour regardless if it is scheduled as a land-based appointment or aquatic therapy appointment. Your physical therapist may recommend the entirety of the session be allocated to aquatic therapy or a blend of aquatic and land-based therapy.

No. In most cases, the purpose of aquatic therapy is to help retrain normal day-to-day functional movements, such as walking, jogging, running, squatting, lunging, and stair training, in an environment that is less stressful on the tissues of the body while it is healing.

Yes, it can be largely beneficial for people with back or joint pain.

Yes. Aquatic therapy can be highly beneficial for a wide range of conditions, but it is not appropriate for everyone. It is not indicated for those with uncontrolled cardiac conditions, open wounds or skin infections (without proper waterproof dressing), history of uncontrolled seizures, or those with urinary or fecal incontinence.

Those who have fear of water (aquaphobia) should use caution. Those with vestibular disorders should also use caution due to the increased risk of dizziness or disorientation in moving water. Aquatic therapy is generally safe for pregnant women, but they should avoid overheated pools and high-intensity activity as a general precaution.

The water for our HydroWorx tank is set typically around 98-100 degrees fahrenheit.

No, generally you do not need a referral to see a physical therapist in Virginia, thanks to Direct Access laws. However, some insurance plans still require a physician’s referral for coverage, and our dedicated New Patient Coordinators will guide you through your insurance’s specific requirements.

In most cases, the purpose of aquatic therapy is to help retrain normal day-to-day functional movements e.g., walking, jogging, running, squatting, lunging, stair training, in an environment that is more comfortable on the tissues of the body while it is healing. Regular swimming is a type of aerobic exercise for cardiovascular training that is not utilized in aquatic therapy.

Water exercise classes are not catered to an individual patient undergoing physical therapy. Some of the exercises may be appropriate for a patient, while others may not. Water exercise classes are appropriate for pain-free individuals who are seeking to maintain or improve their fitness. Aquatic therapy is indicated for patients who are rehabilitating from musculoskeletal injuries and neuromuscular conditions.

Your physical therapist will make a recommendation after your initial evaluation. This will be based on your particular injury or condition, goals, and evaluation findings.