It makes up most of the Earth’s surface. Our bodies are filled with it and sustained by it. Children, young and old, are drawn to its strength and buoyancy. It’s no surprise that this element, so necessary to our survival, is also a healing aid.

Artist Norm “Pete” Sturdy discovered the power of water not long after his back was broken in an automobile accident. Soon after back surgery, he began traditional or “land” therapy, but after six months he saw no improvement. “I was very discouraged,” says Sturdy. “I kept saying to my doctor, ‘Can’t we do something else?’”

As it happened, there was something else: water therapy.

For three months, Sturdy participated in water, also known as aquatic therapy, at Barnes-Jewish Hospital in St. Louis. “On the first day, I walked in with a cane,” he says. “After it ended, I no longer needed one.”

This was quite a feat for Sturdy, who at one point after his accident wasn’t even able to dress himself without his wife’s assistance.

Another benefit of water therapy for Sturdy was that it helped him gain strength without pain, something he experienced a great deal of after his surgery — particularly during land therapy. “The water therapy pushed me; it challenged me,” he says, “but it didn’t cause more pain.”

Ruth Sova, president of the Aquatic Therapy and Rehab Institute, a Florida-based national nonprofit educational organization dedicated to the professional development of health care professionals, says that water therapy is ideal for people with pain because it aids recovery without causing additional pain. It also assists in reducing overall pain.


Water work is a very potent form of physical therapy, and there are a number of ways it helps heal and strengthen, says Sova, who is also the author of BackHab—The Water Way to Mobility and Pain Free Living. Here are the primary ways in which it helps:

Weightlessness. When you’re lighter, there’s less of a load on your body. This is beneficial in exercise, particularly for people with joint pain. “When you’re neck-deep in the water, you have an apparent weight loss of about 90 percent, and when you’re waist-deep, you have an apparent weight loss of about 50 percent,” explains Sova. “When the load isn’t so painful, you can relearn functional, correct movement.”

Sturdy says he found this aspect of water therapy particularly helpful. “I loved the weightlessness and buoyancy,” he says. “Since I don’t have much of a disc, just bone on bone, I can do things I couldn’t do with land therapy.”

Hydrostatic Pressure. Water exerts pressure, known as hydrostatic pressure, against your body, which creates a massage-like effect. “It’s like a gentle squeezing,” says Sova. “It increases circulation, which assists in getting some of the toxins out of the body.”

Diaphragmatic Breathing. This is a lesser-known way that water can help you with your pain. “It’s been shown that diaphragmatic breathing — or what we call ‘belly breathing’ — decreases pain,” says Sova. “Being in water helps you breathe that way a little more naturally.”

Strengthening. The stronger your muscles and joints are, the more you will be able to do in your everyday life without pain — or, at least, with less pain. “It really strengthened my legs a lot,” says Sturdy. “The water therapy built up my leg muscles so that walking was easier and less painful.”

“You have more strengthening benefits in water because the water is heavier and thicker than air,” explains Sova.“When you do start to move, the muscles strengthen without putting the load on the joints. And a lot of people with pain have joint pain.”

The “Ahhh” Effect. “So many times, a person gets in the warm water and just goes ‘ahhh,’” says Sova. “It elicits a parasympathetic, or calming, response. And if you can get that, you can start to get changes in function. When people are tense and tight they can’t make changes.”

One key to achieving the advantages of the water is the pool’s temperature. “If you’re in cold water, it probably isn’t any better for you,” says Sova. “In cold water, muscles will contract and you’ll have more pain. So find a warm-water pool. And by warm, I mean 84-92 degrees.

“If people are able to move to warm up, they can get away with an 84-degree pool,” continues Sova. “If they are very limited in function, the therapy pool should be 92 degrees.”


Before beginning water therapy, visit with your doctor. Sova explains that it’s important to get your physician to write a prescription for the therapy for you because insurance may cover some of the program’s cost.

Your next step should be to find a facility that offers an appropriate setting for the therapy: a heated pool. Many hospitals and clinics across the country have pools, much like the one Sturdy visited during his therapy. Ask your doctor; he or she may be able to recommend a place for you.

If your local health system doesn’t have any water therapy pools, you’re not out of luck. There may be other options in your community.

“YMCAs, YWCAs and Jewish Community Centers are other places to look; many of them sponsor water therapy classes,” says Sova. “Call any pools in your community —even fitness clubs — and ask if they have water therapy. You can also contact therapy clinics. Many will rent time at community pools.”

If you aren’t able to find water therapy, per se, start asking the people you call about their pools’ water temperatures, suggests Sova. If the water temperature is 84 to 92 degrees, you can start therapy on your own. “All you have to do is get in and walk around; you don’t have to have a specific program,” she says. “Just submerge whatever hurts and then start to move very gently. You should feel no additional pain when doing these movements.”

Sova does have one word of warning for people seeking a water therapy pool: Stay away from university swimming pools. “Any pool used for swim meets is going to be too cold for water therapy,” she says.


If you’re picturing water therapy as something akin to water aerobics, or even swimming, you should probably take your vision down several notches. Much like physical therapy on land, water therapy starts very simply and graduates from there.

Basic water therapy is walking. This simple action can help people improve strength, pain and posture. “The key is that it’s done very slowly,” says Sova. “The slower you go, the more challenging it is. Therefore you end up improving trunk stability and balance.”

Other types of therapy take their cue from popular fitness programs. “We have Ai Chi, which is like Tai Chi in the water,” says Sova, who has written a book on Ai Chi. “It involves very slow, fluid, large movements of the arms and legs. Pain patients love this program.”

There are also versions of yoga and Pilates that can be done in the water. A program called Watsu is the water equivalent of Shiatsu, a hands-on therapy term taken from the Japanese word shi, meaning finger, and atsu, meaning pressure. There is even water massage. “Massage therapists like it because they have better access to tissue, and the water relaxes the tissue and assists in the circulation,” explains Sova.

Swimming is usually not part of water therapy. “The regular strokes people do in swimming are pretty difficult for people who have pain, and the kicking has to be pretty vigorous to keep someone above water, which can also be too intense for people who have pain,” says Sova. “Some therapists will teach revised swimming strokes, floating skills or supine work in the water. It’s fine to be horizontal, but swimming would be a progression.”



Water therapy can benefit almost anyone. Sova says people who see the most relief tend to be people with orthopedic problems. “If you have pain in your hips, knees, back or shoulders, the water will work well for you,” she says. “The massaging and squeezing of the water also helps with muscle pain. Just about anyone can get in the water and do some degree of therapy and have it help.”

Sova points out, however, that people who have the following conditions need to take precautions before getting in the water:

Open Wounds. Because of the warm water and humid air, those with wounds can easily get infections. “There are bioclusive dressings you can place over a burn site, chemo port or other wound to protect it from water and bacteria,” says Sova.

Water Phobia. “Anxiety can create more pain and tension,” says Sova. “If you have a fear of water, you have to deal with that before getting in the pool. You could start by sitting on a step with your feet in the water or by standing near the edge.”

HIV or Skin and Pulmonary Issues. People with HIV often have compromised skin and lungs. The chemicals in the water and air of a pool area could exacerbate these problems. “People who have very fragile skin or pulmonary conditions need to be extremely careful,” cautions Sova.

If you’re unsure about whether you should participate in water therapy, ask your physician.

“It’s likely that you’ll see tremendous benefits,” says Sova. “Try it two or three times a week for about three weeks; the water will start to do its magic.”

Sturdy can attest to the power of water therapy. “With it, I could see progress,” he says. “I tell everybody to try it. You get the exercise without the excruciating pain. I say, ‘Don’t be afraid to try something new; it could be the thing that eases your pain.’ For me, that something new was water therapy.” {PP}