Hydrotherapy

This information is for anyone with axial spondyloarthritis, including people with ankylosing spondylitis.

Hydrotherapy is exercising in water

The main issues associated with axial SpA are stiffness, pain, risk of developing a stooped posture and fatigue. Exercising in water helps with all these problems:

• The warmth and the buoyancy make stretches more effective
• It’s less painful
• It’s easier to stay upright because the effect of gravity is less
• It requires less physical effort
• Afterwards you usually have a really good night’s sleep!

Water supports your body

When you live with axial SpA, moving can be painful so it’s tempting to stay still. When you move less, your muscles become weaker, your joints stiffen, you become less fit and your balance is less reliable.

When you exercise on land you have to work against gravity. In water there is another force, which doesn’t pull you down like gravity does, but pushes you up. This force is called up thrust and it actually helps us move. Your body feels lighter.

In waist deep water you weigh around half of what you weigh on land.

With less strain on the joints, you can exercise more without pain and without doing damage to the joints. Because you can work longer and harder, fitness can be built up again.

Water is a shock absorber

The water provides shock absorption and makes aerobic exercise  safer and more enjoyable.

Water acts as resistance to help build muscles

The viscosity or thickness of the water as well as the turbulence, the buoyancy and the drag effect can be used as a resistance to help strengthen muscles. The effect of buoyancy can be enhanced by using different floats.

Water helps you relax

The water temperature in hydrotherapy pools is usually around 33-34 degrees Celsius – much higher than a swimming pool. The warmth of the water helps you to relax and tight muscles can be stretched more efficiently when they are relaxed.

Safety tips

• Check with your doctor or physiotherapist before you try exercising in water
• The area around the pool is slippery. Take care and don’t run or rush. You can wear flip flops or beach shoes and if you normally use a stick or crutch, it’s much safer to use a walking frame instead, as a stick can very easily slip when wet
• It’s possible to overdo things in the water because it feels easier. Begin gently and gradually build up the length of time you spend in the pool
• Only do the exercises shown by your physiotherapist. Do not perform your dry land exercise programme in water. It’s not effective, and could do more harm than good

Don’t use hydrotherapy if you have:

• Unstable blood pressure
• Uncontrolled diabetes
• Angina at rest or shortness of breath at rest

If you have lung function problems you may find the pressure of the water on the chest and ribcage too much in deep water.

If you suffer with asthma or angina, always take your inhalers and sprays with you and leave them on the pool side, so they are there if you need them.

You will need to undergo a health screening before being allowed to take part in hydrotherapy which will be conducted by your physiotherapist.

Where to find hydrotherapy

The best option is your local NASS branch, where you can exercise under the supervision of your physiotherapist.

You can use your local swimming pool once you know the exercises, but the temperature of the water will be lower. Keep moving so you don’t get too cold.

Lots of health clubs have pools with nice warm water. They may be a bit expensive to join, but once you are a member, you can go every day.