Hydrotherapy Exercises

I have been meaning to write this post for years! When I was going through the 18+ months of hydrotherapy, I knew that I really should record the exercises that I did. However, I was always so tired and it felt like too much effort to try to describe each exercise. I guess I kept hoping I'd find pictures on the net at some stage and put together what the routine consisted of. Anyway, I am obviously feeling like I need to tidy things up, and tie up lose ends, so here we are with an outline of the hydrotherapy set I did religiously, week after week, for 18 months between April 2009 until November 2010 (before progressing to the NHS rehab gym class in December 2010).

I started with the 6 sessions at the hospital pool before going on to find a public pool which was warm enough for this kind of work.

During the 6 hospital sessions, there were 4-5 patients in the pool with 2 specialist physios who directed and helped with what we did. Each week, exercises got a little bit harder and/or the number of reps were increased. I think I probably started off doing 10 reps of each exercise. By the time the 6 weeks was up, I was up to 50 reps of each exercise. I was advised to stick to the 50 reps from then onwards.

Completing all exercises, at 50 reps, took me just under an hour. I sometimes added in more walking backwards and forwards, depending on how I felt. I also wore a ladies rash vest (which is what people wear under wetsuits) over my swimming costume . It provided some vital warmth whilst standing in the water. The physios encouraged me to make sure that, at all times, I was engaging my core muscles and keeping "good form" so as to activate the right muscle/nerve systems.

From start to finish then (50 reps of each exercise):

In waist high water:

• Stand by side of pool and slowly march on the spot, bringing knees up to hip height and back down again.
• Legs slightly wider than hip-width apart, slowly lower into squat position and back up.
• Take one or two kick boards. Hold them flat on the surface of the water close to the body in front of you (water preferably lower chest height). Stand up straight, engage core and placing hands onto floats, depress them under water until arms are straight, then control them as they slowly float back up.
• Take one or two kick boards. Hold them by their sides (one hand either side). With arms straight out, lay the floats flat on the water and then slightly submerged them, then, standing up straight and firm, slowly twist your trunk from side to side, dragging the float through the water with arms outstretched (essentially a trunk twist against resistance).

The next phase was done with my feet hooked under the metal bar which ran along the side of the pool, just below water level.

• Grab two woggles. Lying on your back, hook your feet under the bar. Put one woggle under the crooks of your knees, the other under armpits. Now perform a leg-press exercises - bending your knees, pulling your bum/body towards the bar and pushing it back out again (always remembering to keep your core strong)
• In same position, lying flat on the water, with a woggle under your neck as well, perform side-slide exercises (essentially lying on your back, engaging oblique muscles to slide your hand down one side and then the alternate side).
• In same position, take a light bar, with arms held straight, lift the bar from surface of water on thighs, up over head and then back again. Keep body straight and firm (do not over arch back)

Finally it was

• Step-ups using a submerged step block or pool steps, followed by some time walking forwards and backwards through water.

Additions I added later to target shoulder muscles:

• Standing in deep water so shoulders are submerged. Arms out to side, shoulder height, and perform small circles with hands (clockwise then anticlockwise)
  
• In same position, arms out in front, shoulder height, and perform small circles with hands (clockwise and anticlockwise).

Another addition to target hip adductors and abductors

• Stand by the side of the pool and, if needed, hold on lightly to the edge for balance. Stand on one leg and move the other leg out to the side and back in (both legs kept straight). Then change legs.

It's over 2 years since I did the hydrotherapy. It was an invaluable part of my rehabilitation process. The warm water was soothing to pain and the whole thing felt calming and constructive. It never felt punishing like gym work does. I believe it's what really helped get my muscles and nerves back online and open to change and rehabilitation.