Ryan Aquatic Therapy Hydrotherapy By Ryan Berube The Benefits

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					Aquatic Therapy

    Ryan Berube
The Benefits for Athletic Injuries

• Increased Mobility and strength
• Maintain fitness levels
• Decrease swelling
• Pain relief
• Removes weight from joints and bones
Mr. Palmer
• Began jogging at an
    earlier stage of rehab
•   Buoyancy allowed Carson
    Palmer to run neck deep
•   underwater cameras
    allow Bengals athletic
    trainers to observe
    movements and diagnose
    any gait irregularities
History of Aquatic Therapy
• Hippocrates used hydrotherapy
  extensively around 400 B.C.
• Was Commonly used in Europe.
  – Treated diseases and maintained health.
• Aquatic based rehabilitation was not used
  in the U.S. until early 1900’s.
• This form of rehabilitation has evolved
  considerably throughout time.
Properties of Water

• Archimedes’ Principle
• Buoyancy- The upward thrust acting on in
  the opposite direction of gravity
• Specific gravity- The ratio of the mass of
  one substance to the mass of the same
  value of water (Andrews,2004).
Properties Continued
• Hydrostatic Pressure
  – Pascal’s law
  – Control effusion in an
    injured extremity
  – Increases blood flow
  – Increase lymphatic
• Viscosity
  – Resistance to all fast
    movements in water
Physiological Effects
• Physiological changes occur when a person is
    immersed in water, both at rest and during
•   Changes that occur during water immersion are
    the result of hydrostatic pressure.
    – Because of the increase in blood flow and volume, the
      heart distends and myocardial wall tension increases
      resulting in a Frank-Starling reflex and a increase in
      stroke volume (Andrews,2004).
Physiological Effects Cont’d

• Water temperature for rehab is
 recommended to be between 82 and 98
 deg F.
  – Decrease joint stiffness
  – Relieve muscle spasm
  – Increase blood flow
  – Assist in the inflammatory process

• Aquatic rehab offers advantages over land
 based rehab.
  – Buoyancy decreases weight bearing and joint
    compressive forces.
  – The viscosity associated with water provides
    accommodating resistance to exercise.
  – Water provides a good environment for
    cardiovascular training.
Rehabilitation (Cardiovascular
• Key component to the rehab program
• Should have the appropriate warm up and cool
    – Walking, jogging, bicycling motions
• Clinician can choose to rest the injured area or
    challenge the muscles specific to the sport.
•   Flotation vests may be used
•   25 minutes, 5 times a week is recommended
    – Intensity and duration should mimic the athletes
Rehabilitation (Stretching)
• Restore osteokinematics and joint
•   The buoyancy of water supports the extremities.
•   Warm water can provide a relaxing environment
    which may allow for increased soft tissue
•   The duration of the stretch can vary.
•   Stretching should be performed throughout the
    rehab process.
Rehabilitation (Upper Extremity)
• The program should
    be sport specific.
•   Shoulder
    exercises that are
    performed on land
    can be performed in
•   Overhead activities
Rehabilitation (Lower Extremity)
• Must consist of
    Open/Closed chain
•   Open chain exercises
•   Closed chain exercises
•   Balance and
Rehabilitation (Core Strengthening)

• Core Body strength and postural control are
    critical for any athlete (Andrews,2004).
•   Most extremity exercises also train the core
    – Standing leg kicks
    – Shoulder flexion/extension
• Dynamic exercises
    – leg lifts, straight leg lifting
• Eccentric exercises
    – Can use a buoyant ball for exercises
Return to Sport
• An extensive aquatic rehab program will
    challenge the athlete while allowing him/her to
    train and condition along with providing
    adequate recovery time (Andrews,2004).
•   Clinician should rely on subjective input and the
    athlete’s response to functional testing to
    determine readiness.
    – Athletes should be able to complete any testing with
      proper form and without any increase in pain or
      swelling before resuming land activities
Special Conditions
•   Arthritis
•   Orthopedic
•   Chronic pain
•   Neuromuscular and
•   Pediatric
•   Weight Loss
• Andrews R., James, M.D., Gary, Ed.D.,ATC
    Harrelson L., and Kevin, PT Wilk E.
    Physical Rehabilitation of the Injured
    Athlete. 3rd ed. Philadelphia:
    SAUNDERS, 2004.
•   Hydrotherapy. 20 Nov. 2006. 29 Nov. 2006
    .html>. Path: Aquatic Rehabilitation.
•   Hydroworx. 29 Nov. 2006. 24 Nov. 2006

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