I have always loved being in water. Over the years I have enjoyed it for different reasons; playing, swimming, life saving, water polo (briefly), I can’t remember when some sort of swimming was not part of my life. It therefore followed that I would be drawn to the pool as a physiotherapist.
My career turned towards neurology and particularly paediatric neurology fairly quickly. Due to a combination of having access to a pool and supportive colleagues I was able to work with some children in a hydrotherapy pool form the very beginning of my paediatric career. And you know what? There’s no-where better. Physiotherapy for a child with complex physical difficulties can be a challenge (as I am sure you all know) so it has to be fun otherwise it becomes a battle for all concerned. To be a physiotherapist you have be a salesman, you have to sell the exercises and activities you want your clients to do and the reasons why you want them to do it. If you haven’t got the gift of the gab life as a physio is a bit disappointing. Paediatric physios have to be able to find the ways and means to give the best intervention possible with out it being boring or a trial and at the same time giving the children control.
Sounds difficult? Not if you have a pool. In a pool all sorts of things can happen and you don’t even know it! Sneaky? No, I don’t think so, its just taking full advantage of the inherent properties of the water.
The properties of water mean that we have to work hard to control the way we move. Firstly the effect gravity has on us is much less when we stand in water than when we stand on dry land. Gravity ‘sticks’ us to the ground so when that’s reduced we feel lighter and less of our body weight goes through our joints. Secondly there is another force that acts on us in water, buoyancy. Buoyancy pushes upwards from the bottom of the pool towards the surface. Buoyancy makes us float. Thirdly, water is thick. It is much thicker (more viscous) than air so it takes much more effort to move through it. The combination of gravity, buoyancy and ‘thickness’ means that it is much more difficult to control our body movements and much more difficult to balance. BUT in a pool we are supported by the water in all directions and so we can lie down and move and do somersaults (!) much more easily than we can out of the water. Although it is harder to balance in water everything happens in slow motion so we have time to practice movements and we don’t fall over and hurt ourselves.
It is a place where we can be independent movers even if we are not when on land. Moving in water, eg aquatic physiotherapy and learning to swim, improves our core stability, our ability to balance, our co-ordination, our stamina, our strength and increases the stability of our joints. It improves our gross motor skills which directly has a positive influence on our fine motor skills. AND because we can’t breath in water we learn to control our breathing AND the thickness of the water creates a pressure all around us so that the muscles which make us breathe work harder, but that’s great for improving ‘lung fitness’. Aquatic physiotherapy can work on all the same physical goals as conventional land based physiotherapy. There are obvious differences, gravity being the biggest one and so pool work is not an alternative to all other physio but it most definitely compliments land based programmes. There are massive pluses to being in a pool, fun and independence at the top of the list – and you can get your physiotherapist really, really wet…me!
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