The Use of Aquatic Therapy for Treatment of Osteoarthritis (PART 2)

As the opening of our Freehold location, which will include aquatic therapy, draws closer, I would like to expand upon an earlier blog post concerning the use of pool-based physical therapy treatment for patients with arthritis of the leg joints.

Just as a refresher, remember that arthritis is characterized by a breakdown of the cartilage that covers the ends of bones, thereby creating bone-on-bone contact in joints and resulting in pain. Pain due to arthritis often makes land-based exercise difficult, and sometimes even intolerable, which is where the advantages of aquatic therapy are useful. Specifically, the qualities of water that help those with arthritis tolerate physical therapy treatment better are:

  • Buoyancy – an upward thrust against gravity created by water that unweights a person.
  • Hydrostatic Pressure – uniform pressure created by water around a body that can aid in swelling reduction.
  • Viscosity – the thickness of liquid that can be used to provide resistance.

Now that we’ve reviewed, I’d like to explore several specific ways that aquatic therapy can benefit those with arthritis. Realistically, anything performed during a standard land-based physical therapy treatment can be done in the pool, so the principles of treatment remain the same.

Therapeutic exercises are used to increase strength, improve flexibility, and enhance cardiovascular fitness. When designing exercises for a patient, a physical therapist will want to incorporate all body parts – not just the ailing body part. This includes both arms, both legs, and the trunk. Equipment may or may not be used, depending on the level of the patient. Some exercises that can be performed in the water are:

    • Quadriceps Stretch to improve the flexibility of the front of the thigh.


    • Hip Abduction / Adduction Swings to increase strength of the outer hip and inner thigh.


    • Push-Pulls to strengthen the chest, arms, and back.


Therapeutic activities are used to practice daily movements while emphasizing proper body mechanics and muscle activation. These may be simple tasks such as standing up from a chair or more involved activities like lifting boxes at home or at work. It is important that the physical therapist make therapeutic activities very specific to the patient so that he or she can return to all required and desired activities upon discharge. Some examples of therapeutic activities performed in the pool are:

    • Stair Training to ensure a patient’s ability to ascend and descend stairs properly.


    • Deep Water Running to improve running mechanics without the joint compression associated with repetitive landing on the feet that would occur when running on land.


Manual therapy is essential to any physical therapy program. Manual techniques, such as soft tissue mobilization, OSETOADmyofascial release, and joint mobilization, are used to improve a patient’s ability to move with greater comfort. When manual treatment is incorporated into the treatment, it makes it easier for the patient to perform therapeutic exercises and therapeutic activities. Examples of manual treatments performed in the aquatic environment are:

    • Spinal Traction to decompress the vertebrae and provide relief of spinal arthritis and sciatic symptoms.


    • Jet Hose Soft Tissue Mobilization to loosen tight muscles and break up tissue adhesions.


I hope that this article has provided you with better insight into how specific components of aquatic therapy are used and how it can truly benefit those with arthritis. So, for any of you out there suffering from arthritis that has not responded well to traditional land-based treatment, consider our upcoming Freehold clinic opening later this year for your aquatic therapy needs!

Dr. Rob Kohutanycz, PT, DPT

Posted in: Knee

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