When you think aquatic therapy, a picture of an older woman with a flower swim cap and floats is probably what comes to mind. However, aquatic therapy today is considered a safe and effective option for a wide variety of physical therapy patients. From high-functioning, independent patients returning from a sports injury, to 100-percent-dependent, wheelchair-bound patients recovering from a spinal cord injury, and even people living with multiple sclerosis, the “type” of person who may benefit from aquatic PT is endless.
Water’s unique environment enables patients to work on endurance, joint mobilization, stretching, balance, strengthening, gait training and the list goes on – oftentimes with more independence than what he or she may find on dry land. Therapy in the water challenges a patient’s core and stabilizing muscles in a way that may not be activated on the ground.
With the Rio Olympic Games kicking off, and the heat wave to end all bearing down on us, we spoke with Cathy Kramer, PT, an outpatient physical therapist at The Shepherd Center, and Lisa Ruger, the aquatics coordinator at The Shepherd Center, to discuss how patients find relief and recovery in the pool.
Lisa paints a picture of the pool facility at the Shepherd Center, complete with accommodations for nearly all patients and equipped to treat those with huge physical impairments, as well as with adaptive equipment to provide support for the various conditions and wide range of functionality treated.
The pool doesn’t discriminate. From day to day, Cathy may treat a patient who is 100-percent-dependent, hoping to find relief from chronic shoulder or neck pain from sitting in a wheel chair, followed by a teen with a goal of returning to his football team for his senior season.
Aquatic therapy also allows for flexibility in ways many patients or caregivers may not think of – like temperature control. The Shepherd Center’s pool varies in temperature, allowing physical therapists to treat conditions that are temperature sensitive and have different needs, as some patients have conditions that are sensitive to heat and some need the heat to reach their goals.
For patients who are considering PT in the pool, your first appointment likely won’t look too different from another’s – although your treatment plan will be tailored to your specific needs and goals. For example, Cathy explains that she holds the first appointment on land because that is the world we live in, and understanding patients’ limitations on land is key to developing a treatment plan as effective as possible for their everyday lives.
Once in the water, Cathy assesses a patient’s comfort-level as the pool may bring out anxiety in some patients. This may stem from the origin of the injury – a neck injury from diving into the pool, for example – or a drastic change in functionality in some who no longer know how to function in the water.
To prevent over assistance and impairment of natural movements, Cathy starts without equipment. She assesses the patient’s functionality and ability, and from there may add weights to increase ground reaction force or floats if necessary. Sessions and equipment are individualized to each person’s needs.
After determining the best treatment plan to reach a patient’s goals and help him or her gain functionality, Cathy’s focuses on helping the patient feel comfortable enough in the water to work their program on their own or with the assistance of a caregiver.
After reaching their PT goals, patients can continue their time in the pool with community classes. Lisa explains how continuing progress after your PT is “complete” is possible with open swims, community classes and other programs offered at The Shepherd Center. Who knows – you may see a former aquatic therapy patient in Tokyo for the 2020 Olympics.