Hydrotherapy

Water has been used therapeutically for thousands of years. From ancient Roman baths to modern-day aquatic physiotherapy, the healing properties of water are well established, and for good reason. Hydrotherapy – the use of water as a medium for physical therapy and rehabilitation – offers a unique set of benefits that other types of treatment simply cannot replicate.

At Flex Health, we are proud to be Yorkshire’s leading provider of physiotherapy and occupational health services, and we understand that for some patients, land-based physiotherapy alone may not always be the most effective path forward. While we do not operate our own standalone hydrotherapy pool, our experienced team has access to specialist facilities where aquatic therapy sessions can be carried out with clients when clinically appropriate.

Combined with our expert musculoskeletal (MSK) and physiotherapy services, we are well placed to develop a comprehensive treatment plan that supports your individual recovery goals.

Below, we explore what hydrotherapy is, how it works, the conditions it can help treat, and what patients can expect from aquatic physiotherapy sessions.

What Is Hydrotherapy?

Hydrotherapy – also known as aquatic therapy or aquatic physiotherapy – is a form of physical therapy that takes place in water, typically in a purpose-designed hydrotherapy pool. Unlike standard swimming pools, a hydrotherapy pool is carefully controlled in terms of water temperature and depth, and is designed to support therapeutic movement rather than recreational swimming.

The water temperature in a hydrotherapy pool is usually kept warmer than in a regular pool – typically between 33°C and 36°C – because warmth plays an important role in the therapeutic process. The heat helps muscles relax, promotes blood flow, and can significantly reduce pain and stiffness before exercises begin.

Hydrotherapy is not the same as swimming, and patients do not need to be confident swimmers to attend sessions. The focus is on guided therapeutic exercises carried out by a trained physiotherapist or aquatic physiotherapy specialist, rather than on swimming lengths.

How Does Hydrotherapy Work?

The benefits of hydrotherapy come from the unique physical properties of water. Understanding these properties helps explain why aquatic therapy can make such a meaningful difference for so many patients.

Buoyancy

When the body is submerged in water, buoyancy reduces the effective weight placed through the joints. This makes movement easier and less painful, particularly for patients who are unable to carry full body weight on land due to injury, surgery, or a painful condition. The reduction in weight bearing allows patients to begin rehabilitation exercises earlier in their recovery – often before they would be able to manage the same movements on land.

Resistance

Water provides natural resistance in all directions of movement, meaning that muscles work harder without the need for heavy equipment. This resistance supports the development of muscle strength and improved range of movement in a controlled and graduated way. Because the resistance is proportional to the speed of movement, patients can progress at their own pace without the risk of overloading muscles or joints.

Hydrostatic Pressure

The hydrostatic pressure of water – the pressure exerted by the water on the body – has a gentle compressive effect that can help reduce swelling, improve circulation and support joint stability. This pressure can also reduce muscle spasm and contribute to overall pain relief during and after sessions.

Warmth and Relaxation

The warmth of the water encourages muscles to relax and improves blood flow throughout the body. Heat is a well-known tool for managing pain and stiffness, and the sustained warmth of a hydrotherapy pool means that this benefit is maintained throughout the session. Many patients find that the combination of heat, pressure, and buoyancy allows them to relax more deeply than they would during a land-based treatment session, making it easier to engage with therapeutic exercises.

What Conditions Can Hydrotherapy Help Treat?

Aquatic physiotherapy can be used to support recovery and manage symptoms across a wide range of musculoskeletal, neurological, and chronic health conditions. Our team at Flex Health may consider hydrotherapy as part of a broader treatment plan for patients experiencing the following conditions:

Osteoarthritis and Rheumatoid Arthritis: The warmth and buoyancy of the water can relieve pain and improve range of movement in patients with both inflammatory and degenerative joint conditions.
Back and Spinal Conditions: Reduced weight bearing in water allows patients to work on core strength, posture and mobility with less discomfort.
Post-surgical Rehabilitation: Patients recovering from orthopaedic surgery, including joint replacements, can often begin aquatic physiotherapy earlier than land-based exercises, supporting a faster recovery.
Neurological Conditions: Aquatic therapy supports balance, gait retraining, and movement re-education for patients living with stroke, multiple sclerosis, Parkinson’s disease, and other neurological conditions.
Muscle and Soft Tissue Injuries: The resistance and buoyancy of water make it an effective environment for rebuilding muscle strength and restoring range of movement following injury.
Fibromyalgia and Chronic Pain: The warmth and relaxation properties of hydrotherapy can help manage widespread pain and improve general fitness and function.
Ankylosing Spondylitis and Other Inflammatory Conditions: Warm water can ease stiffness and support mobility in patients with conditions that affect the spine and joints.

It is important to note that hydrotherapy is not a cure for any of these conditions. However, as part of a well-designed treatment plan, it can play an important role in managing symptoms, supporting recovery and improving quality of life.

Who May Not Be Suitable for Hydrotherapy?

While aquatic therapy is safe and beneficial for many patients, it is not appropriate for everyone. Your physiotherapist will carry out a thorough assessment of your medical history before recommending hydrotherapy, and will take into account any medications you are currently taking and any underlying health conditions that may affect your suitability.

Patients may not be able to attend hydrotherapy sessions if they:

Have an open wound or skin condition, such as an active infection, that could be worsened by water exposure or affect the hygiene and safety of the pool.
Have recently had surgery and are not yet cleared by their doctor or surgeon for water-based therapy.
Have a serious cardiac or respiratory condition that may be adversely affected by changes in pressure or water temperature.
Are unable to maintain safe positioning in the water, even with support.
Have a significant fear of water that would make them feel uncomfortable during sessions.

If any of these apply to you, your physiotherapist will discuss alternative treatment options and ensure your rehabilitation continues safely through land-based physiotherapy. Please do not be discouraged if hydrotherapy is not suitable for you at a particular stage of your recovery – your experienced physiotherapist at Flex Health will always tailor your treatment plan to your individual circumstances.

What to Expect from Aquatic Physiotherapy Sessions

If your physiotherapist at Flex Health identifies aquatic physiotherapy as appropriate for your recovery, they will arrange access to suitable facilities and guide you through what to expect at each stage.

Before You Attend

Before your first session, your physiotherapist will complete a full clinical assessment, reviewing your medical history, current symptoms and rehabilitation goals. This assessment informs the design of your personalised treatment plan and ensures that the water-based exercises you carry out are safe, appropriate and targeted to your specific needs.

You will be advised to bring a swimming costume and your own towel. Hydrotherapy facilities generally include a changing area and showering facilities. Your physiotherapist will talk you through the specific arrangements at the facility being used for your sessions.

During Your Session

Sessions are led by a trained physiotherapist who will guide you through a series of therapeutic exercises in the water. These may include:

Walking and gait retraining exercises to improve balance and coordination
Range of movement exercises for specific joints
Strengthening exercises using the natural resistance of water
Stretching and relaxation work supported by the warmth and buoyancy of the pool
Functional movements designed to replicate activities from daily life

Sessions are designed to progress gradually over time as your strength, mobility and confidence develop.

After Your Session

Following a hydrotherapy session, it is common to feel pleasantly tired and relaxed. Your physiotherapist will advise you on frequency – most patients attend one or two sessions per week, although this varies depending on the condition being treated and the stage of recovery.

As your rehabilitation progresses, your physiotherapist will review your treatment plan and adjust your programme accordingly, increasing the challenge of exercises in line with your recovery and introducing complementary land-based physiotherapy to consolidate the gains made in the water.

Is Hydrotherapy the Same as Swimming?

This is a question we are often asked, and it is worth clarifying. Hydrotherapy takes place in a pool, but it is not swimming. Standard swimming pools are not the same as dedicated hydrotherapy pools – they are typically cooler in temperature, are not designed for therapeutic use, and do not offer the same level of clinical supervision and structure.

A hydrotherapy session is a clinical treatment delivered by a qualified physiotherapist. It is structured around your specific rehabilitation goals, and the exercises are carefully chosen to address your individual symptoms. While general fitness swimming can be beneficial for many people, it is a different activity and does not provide the same level of targeted therapeutic benefit.

That said, once rehabilitation is underway and your physiotherapist is satisfied with your progress, they may recommend that you complement your treatment sessions with gentle swimming or an aquatic exercise class as part of your broader recovery and long-term maintenance of general fitness.

Hydrotherapy Alongside Land-Based Physiotherapy

At Flex Health, aquatic therapy is never used in isolation. Our approach is to combine the benefits of hydrotherapy with our expert land-based physiotherapy and MSK services to create a truly comprehensive rehabilitation programme.

Land-based physiotherapy provides a range of complementary benefits that water-based therapy cannot replicate – including targeted manual therapy, specific strengthening work, and functional movement training carried out in environments that more closely reflect the demands of everyday life.

Your physiotherapist will work with you to determine the right balance of aquatic and land-based treatment for your individual needs, reviewing and adjusting your programme at regular intervals to ensure continued progress.

Why Warmth Makes a Difference

It is easy to underestimate the therapeutic role that warmth plays in hydrotherapy. For patients managing chronic pain, muscle spasm, or significant stiffness, the heat of a hydrotherapy pool can reduce the body’s protective response to movement, allowing muscles to relax and enabling a greater range of movement than might be possible in a cold water environment or in a standard gymnasium setting.

The warmth also supports circulation, helping to flush toxins from the muscles and deliver oxygen and nutrients to healing tissues more effectively. For patients with conditions such as rheumatoid arthritis or fibromyalgia, this can be particularly noticeable – the combination of heat, pressure, and therapeutic movement can bring about a level of comfort and ease of movement that patients may not have experienced for some time.

How Flex Health Can Help You

At Flex Health, our physiotherapists are experienced in assessing and treating a wide range of musculoskeletal and neurological conditions, and in determining when aquatic physiotherapy may offer additional benefit as part of a patient’s recovery.

While we are not an NHS physiotherapist service, we work alongside NHS teams, hospital consultants, and doctors to ensure continuity of care for our patients. Whether you have been referred by another healthcare professional or are self-referring, our team will carry out a thorough assessment and design a treatment plan that reflects your individual needs and goals.

If hydrotherapy is identified as appropriate for your recovery, we will arrange access to suitable facilities and provide the clinical oversight needed to ensure that your aquatic physiotherapy sessions are safe, effective, and properly integrated with your wider rehabilitation programme.

Our services are available from our clinics in Hull, Sheffield, Beverley, and Willerby, and through home visits where appropriate. We are committed to making high-quality physiotherapy accessible to patients across Yorkshire and beyond.

Get in Touch With Us Today

If you are living with a condition that is affecting your movement, causing pain, or limiting your quality of life, our expert physiotherapy team is here to help. Whether land-based treatment, aquatic physiotherapy, or a combination of both is most appropriate for your recovery, we will work with you every step of the way.

To find out more about our physiotherapy services, or to discuss whether hydrotherapy might be right for you, please contact our team today. We will be happy to talk through your options and arrange an initial assessment at a time that suits you.