How Soon is Too Soon? The Best Time Frame for Beginning Aquatic Rehabilitation
Getting athletes or patients into the water as soon as possible is an integral part of providing an enhanced and speedy recovery. The earlier the individual can begin their rehabilitation, the sooner they are able to return to what they need and love to do. The ability to get an injury or repaired joint moving early provides four significant benefits:
- Increase mobility – Getting an affected joint moving after surgery helps to increase the mobility of the joint in the long run. It is important to keep it mobile even when it seems impossible. Depending on the restrictions prescribed after surgery, it is difficult to do this on land. Many times it requires manual manipulation that can be painful and stressful. Getting into the warm water can make increasing mobility easier and less painful, because the buoyancy and warmth of the water assist in movement.
- Reduce scar tissue – Scar tissue builds up quickly when a joint is immobile, thus making it even harder to increase the movement of the joint later. Again, aquatic therapy is an extremely beneficial way to increase mobility early. Additionally, the hydrostatic pressure of the water can work to maintain blood flow to the affected area and decrease scarring.
- Maintain fitness levels – When surgery causes an athlete or patient to reduce their normal activity levels, it can be detrimental to their cardiovascular fitness and strength. By getting them into the water early, they are able to do things they couldn’t do on land and can continue some level of activity. This makes returning to their previous fitness levels much easier and they can do so much sooner.
- Increase compliance – Many times, the pain and frustration of solely land-based therapy can leave patients and athletes less than eager to return for further sessions. By reducing the pain and providing quick improvements, aquatic therapy is often more tolerated and leads to better compliance, with patients returning more regularly than for land-based therapy appointments.
But how soon is TOO soon?
A major concern about getting patients or athletes into the water early is exposing the wound to the water. There is plenty of research and anecdotal evidence to show that this should not be a concern when handled properly. According to a meta-analysis published in the Archives of Physical Medicine and Rehabilitation in 2013, early aquatic physical therapy improves function and does not increase risk of wound-related adverse events for adults after orthopedic surgery. The most common way to keep a wound safe is to use bio-occlusive dressing to ensure the incision stays dry.
We have found many forward-thinking clinicians who put patients and athletes into the water as early as 2-3 days post-op! They see impressive results and work hard to make sure they can continue to do so.
Watch this waterproofing demonstration by Randy Cohen, ATC and Associate Athletic Director for Medical Services at the University of Arizona for an example on how to safely and effectively cover a wound to prepare for aquatic rehabilitation: