Aquatic Therapy and CRPS: Should you fear to tread...water?
By Melanie E. Swan, OTR/L
What is aquatic therapy?
Aquatic therapy is therapeutic exercise performed in a body
of water-generally a lap pool or a deep water pool. Aquatic
therapy often occurs in a group/class setting, though it may
also be part of an individual treatment session with a therapist.
Aquatic therapy may be used for people with CRPS who
have limited movement and/or have low tolerance for resistive
Why do you use water for therapy?
Water provides a combination of buoyancy and resistance/challenge.
The buoyancy of the water supports your body weight differently,
making you feel lighter and taking some of the pressure off
joints so you can move more freely. The movement of the water
during exercise challenges balance, helping to strengthen
core/abdominal muscles. Moving faster or slower changes the
resistance of the water, making it harder or easier to complete
the exercises. Aquatic equipment, such as kickboards, foam
noodles, webbed gloves, or aqua fins, can also increase the
resistance of exercises.
What is an aquatic therapy session like?
An occupational therapist or physical therapist designs a
series of exercises to promote increased strength, balance,
and range of motion or weight bearing. Some programs may even
involve floatation for relaxation of muscles. These exercises
are tailored to meet the needs of the patient and the aquatic
What should the temperature of the water be?
There is no specific water temperature that is ideal for everyone.
Most indoor pools are kept between 78 to 82° if they are
used for vigorous swimming or exercise. Temperatures of 83
to 88° are optimal for moderate exercise. Temperatures
warmer than 88° promote increased relaxation and circulation
but can increase muscle fatigue more rapidly during exercise.
Will the water harm my CRPS if it feels cold?
Many people with CRPS prefer slightly warmer water during
exercise, as often they are more sensitive to cold. Cooler
water may initially produce some constriction of blood vessels;
however, this is not harmful as it is your body's natural
mechanism to conserve body heat. This response can be reduced
by performing a few minutes of vigorous exercise to increase
muscle activity and circulation. Neither heat nor cold has
proven to be more effective in the progression of aquatic
exercise. Varying water temperatures during exercise is also
an excellent way to work on temperature desensitization.
Is there a difference between aquatic therapy in a lap
pool or deep water pool?
Lap pools are relatively shallow (approximately 3.5 to 4.5
feet deep) but offer a greater ability for patients to work
on weight bearing and balance exercises during ambulation
activity-walking, side-stepping, running, hopping, etc. Deep
water pools offer greater ability to perform exercises while
treading water or wearing a floatation device. This allows
a greater amount of the body to be submerged below the water
surface and provides greater resistance to upper body activity.
However, most exercises can be completed in either setting
with the use of aquatic equipment and modification or creativity.
Is there a difference between aquatic exercises and therapeutic
activities outside of the water?
The water provides a place to try new activities, to improve
ease of movement, to decrease muscle guarding and begin working
on strength and balance. However, these activities need to
be transitioned into a land-based exercise program to improve
daily function. Aquatic therapy may be a good place to start
therapeutic exercise; however, it should not be the only therapeutic
exercise used during the treatment of CRPS as the buoyancy
of the water prevents full weight bearing or loading of the
Should I have aquatic therapy for my CRPS?
You should consult your physician before beginning any exercise
program. Your physician or your Physical Therapist/Occupational
Therapist can help determine if aquatic therapy is the right
intervention for you.
If you have any ideas
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Updated Juiy 19, 2005