Aquatic Therapy

Jump in the pool for faster recovery. By Christina Hefley, DPT.

Water provides the safest and fastest way to begin the recovery process for most orthopedic injuries, especially those involving the ankles, knees and back. How many times have you heard from friends and doctors, “ Stay off of that sprained ankle until the swelling goes down.” Or, “Just elevate and ice it for a few days.” What you may not be aware of is that the scarring process begins within 7 hours of an acute injury, which usually involves tearing of soft tissue fibers. The most common injuries involve muscles, tendons and ligaments. A “strain” is considered tearing of muscle fibers or tendons, a “sprain” is considered injury to a ligament. There are three basic categories of strain/ sprains. Type I - overstretching of the tissue, which results in small tears within the muscle belly, tendon or ligament. Type II - partial tearing , which can often be the most painful of the three and can take months and sometimes years to completely heal. And Type III - a complete rupture or tear of a muscle, tendon or ligament, often a significant amount of swelling or deformation is present in the absence of severe pain.

If not properly diagnosed and rehabilitated correctly, a simple Type I strain/ sprain can lead to an early end to a sports season, chronic pain, chronic instability and pre-mature arthritic changes in the involved joint. Because weight bearing on the involved part is often painful or unstable, the athlete is advised to “stay off of it.” Water provides the ideal environment for accelerated healing. Gentle range of motion (ROM) should begin within hours of acute injury. If delayed more than 48 hours, scar tissue can quickly over produce, leading to tightening of the joint capsule and/ or weakening of muscle fibers. Additionally, if the injured part is over stressed by load bearing, the healing tissue can re-tear, thus prolonging recovery and resulting in chronic pain and inflammation.

The properties of water that accelerate the healing process include:

Buoyancy - This is one of the key features of aquatic rehab. Buoyancy decreases the load on painful, inflamed joints. It allows for movement of the rest of the body so strength, endurance and speed are not lost during the recovery process. It also allows for more normal movement patterns, such as running, while decreasing the gravitational pull.

Hydrostatic pressure - Water pressure increases with depth, resulting in significantly improving blood flow and decreasing swelling. A body in water produces a different physiological response than it does on dry land. For instance, warm water will increase the cardiovascular demand and improve respiratory function. That means you can keep up your cardiovascular endurance, without over stressing the injured part during the recovery process.

Fluid Dynamics - Water provides a unique environment for strengthening in all planes of motion with heightened proprioceptive feedback from surrounding muscles, tendons, ligaments and joint surfaces. Increasing speed of movement in water directly increases the resistive push and pull without putting weight through the injured joint.

There are many experienced physical therapists that can help you quickly recover from just about any sports injury. So jump in the water and get wet!

#health #sports