Chesapeake Physical and Aquatic Therapy
  Columbia- Supreme Sports Club: 410-381-7000
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Owings Mills Physical Therapy: 410-654-2300
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Aquatic Therapy
Why Aquatic Therapy?
People with disabilities are often caught in a cycle of pain, depression, and stress. Disability can often lead to social isolation, and the belief that exercise and fitness is impossible for them. Aquatic therapy is often able to break this chronic pain cycle largely because of the unique properties of water. In addition, there are many physical properties of water that make it an ideal place for the rehabilitation of various injuries and conditions.

How Does it Work?
Individuals with varying diagnoses may be unable to exercise on land, but often can do so comfortably in the water. The buoyancy of water causes the individual to feel an upward thrust when submerged. This force acts in the opposite direction of gravity, therefore reducing the actual weight being transferred through the joints of the lower extremities. Buoyancy allows for a variety of exercises to be performed in the pool with minimal equipment. In addition, people with balance deficits may experience less fear of falling while walking and exercising in the pool.

Exercises performed in water can be adapted to resist the upward thrust of buoyancy, support the upward thrust of buoyancy, or to assist this upward thrust. Submersion decreases weight bearing by up to 90% when submerged in neck deep water, so an individual who is unable to support their body weight on land is often able to walk with minimal support in the pool. Other benefits of buoyancy are that the water supports weak muscles, enhances flexibility and range of motion, and increases the ease of handling for the therapist.

Hydrostatic pressure is another benefit of aquatic therapy. Hydrostatic pressure is the force exerted on the immersed body by fluid molecules. No movement is necessary by the individual in order to reap the many benefits of hydrostatic pressure. Hydrostatic pressure decreases pain and edema, which in turn increases range of motion. It also increases venous return and circulation by assisting the heart and decreasing blood pooling in extremities. Hydrostatic pressure turns down the body's reticular (activating) system (the brain's system of arousal), dampening tactile sensory input to the brain. This is partly why the water is such a calming environment for most people. Individuals who are tactilely defensive (having a negative response to touch) are often able to tune out their surroundings and focus on and enjoy being in the pool.

The benefit of being submerged in the water is that the individual experiences equal pressure everywhere. Healthy individuals will probably not even notice this slight "squeezing in" feeling, which is similar to the effects of wearing compression stockings. Submersion also places increased demands on the respiratory system, allowing for increased exhalation. Therefore, the respiratory muscles are forced to work a bit harder in the water, which causes these muscles to become more toned even without movement in the water.

Although there are many benefits of the water, patients should also be aware of the complications that water can pose in therapy or exercise. Buoyancy might cause stability problems for the individual. However, this buoyancy, when used properly, can provide individuals with an excellent core stability workout (building the trunk musculature to control the position of the lumbar spine). In addition, buoyancy can make it difficult for individuals to get balanced in the water because flaccid, weak extremities may float and spastic, flexed extremities may sink. An individual in the supine position will tend to roll toward the spastic or "heavy" side. Flotation supports, such as: "water noodles," lifejackets, or specially designed aquatic floatation devices can help compensate for stability problems, and your therapist will understand and know how to use these to effectively work with each patient.

owings-mills-maryland-physical-therapy-childrenThe water also provides excellent resistance for toning exercises. The higher viscosity of water makes muscles work harder when compared to the same exercises on land. Viscosity can be described as the way the water molecules stick together when you try to move through them. It is harder to move through the water than it is to move on land because the water molecules are sticking to each other and to you. This viscosity means that more muscle fibers are recruited for each movement through water. The heart must also work harder providing blood to the muscles, which results in cardiovascular fitness, as well as overall toning.
The resistance created by water workouts also creates muscle balance. Many orthopedic issues and many back pain problems can be relieved through developing both sides of the muscle. Since muscle fibers must be equally recruited during flexion and extension when moving through water, aquatic exercise provides the ideal environment for this type of workout.

Resistance can be used to create progressions for individuals at different levels of fitness. Decreasing the speed of movement decreases the resistance. On the other hand, increasing the speed of movements will make the exercise more difficult. Different types of aquatic therapy equipment can also create more of a challenge to exercises in the water, to the point that even the most fit athlete will reap benefits form an aquatic program.

Aquatic Therapy: Then and Now
The professional field of aquatic therapy is still in its relative infancy, but the use of water for therapeutic purposes is an ancient practice. The ancient Greeks and Romans bathed in hot springs thousands of years ago, enjoying the benefits of improved circulation and relaxation from immersion in the warm water. Swiss monks have long understood the curative properties of water.

In the 19th and 20th centuries, a therapeutic spa and medical center was developed in Switzerland, where people would come from many miles to experience the healing power of this special water. In 1957, a flotation support was developed and used in conjunction with exercises performed in this special spa. This method evolved into what is now known as the popular Bad Ragaz Ring Method of aquatic therapy. Using the Bad Ragaz Ring Method, our therapist creates progressions using passive and active exercises, moving the patient through the water in a supine position. This method uses the physical properties of water as a tool for muscle reeducation and uses specific patterns of resistance, relaxation, range of motion, and elongation to build endurance and reduce tone.

Many aquatic exercise methods that are currently en vogue, such as Ai Chi, Ai Chi Ne, aquatic yoga and Pilates also have ancient roots. These methods share the common objectives of focus, breathing, core stability and strength to improve posture, strength and flexibility.

.An Added Benefit
The physical benefits of aquatic therapy are astounding; however, an often overlooked aspect of aquatic therapy is the psychosocial benefits. Aquatic therapy can reduce stress and anxiety, increase one's ability to concentrate, enhance a feeling of well-being and confidence, and allow a person in pain to find their center of calm. The pool atmosphere often seems less clinical than a P.T. gym, and most people equate the swimming pool with fun!

To schedule an initial evaluation, or to learn if Aquatic Therapy is right for you, please contact Chesapeake Physical and Aquatic Therapy and speak to one of our therapists!

Doug Rosener, MPT
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