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How Aquatic Therapy Can Help With Reconstructive Surgery

Reconstructive surgery, whether elective, medically-recommended or absolutely required, sometimes involves quite a bit of physical therapy upon completion. For instance, a patient recovering from ankle surgery, shoulder surgery, hip surgery or knee surgery must relearn how to walk and/or make use of his or her body. Hundreds of thousands of reconstructive surgeries occur each year in the United States and will continue to grow in the near future, which means clinicians must be equipped to effectively help patients recover.

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The problem with physical therapy comes when a patient with a partially or completely reconstructed limb or joint cannot comfortably continue physical therapy sessions. The forces of gravity may pull to such a degree that the patient feels any kind of therapeutic treatment is too uncomfortable to continue. The patient may also begin to rely less on the reconstructed area, creating an awkward and sometimes unhealthy walking, sitting or standing pattern.

To combat the realities and inherent difficulties associated with reconstructive surgery therapy, many patients and their prescribing doctors turn to aquatic therapy using a specialized, technologically-advanced HydroWorx therapy pool.

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7 Advantages of Aquatic Therapy for Reconstructive Surgery

Aquatic therapy includes the same movements as traditional physical therapy performed on land, but the natural properties of water provide healing and are more forgiving. The buoyancy of the water can make a patient up to 80 percent lighter. For example, a 200-pound man submerged into a therapy pool would feel as if he were 40 pounds. This tends to have a calming, and even relaxing, effect on patients. It also takes the innate stressors off of the affected bones, muscles and tendons.

Aside from the buoyancy factor, there are numerous other advantages provided by aquatic therapy to individuals needing ankle, hip, shoulder and knee rehabilitation:

  1. Aquatic therapy reduces pain and muscle spasms.The hydrostatic pressure of the water creates what could be considered a compression band effect on the limbs of the submerged patient. Because of this compression, muscle spasms tend to be reduced during aquatic therapy activities.In essence, the muscles are constantly stimulated during underwater therapy. The constant stimulation reduces the discomfort associated with some reconstructive surgery therapy exercises, and relaxes the body. Many patients have noted that they feel rejuvenated after aquatic therapy, and their reconstructive surgery spots are less sore than they expect.
  2. Aquatic therapy increases circulation and decreases swelling.If a reconstructive surgery site becomes swollen, any kind of physical activity can be difficult. When limbs and joints are unable to bend, such as during knee surgery rehab, the patient cannot move easily. In water, the hydrostatic pressure and increased mobility discourages swelling incidences.This solves two major concerns for both the patient and the physical therapist: discomfort and healing. With the level of discomfort kept to a minimum, the patient will comply more easily with his or her knee rehab exercises. In addition, the improved blood circulation speeds the healing of the reconstructed ankle, knee, hip or shoulder area. The HydroWorx massage hose can help to additionally manipulate any scar tissue.
  3. Aquatic therapy shortens rehabilitation time.With so many people concerned about the future of healthcare and insurance plans, it is important to note that reconstructive surgery aquatic therapy has been shown to shorten the time it takes to rehabilitate a patient. Though the exact amount of time varies depending upon the procedure, the age of the patient, the health of the patient and other factors, it can be less than if the patient experienced land physical therapy alone.This is good news for patients who may be paying out of pocket, or whose healthcare dollars afford only partial reimbursements for any kind of physical therapy. It is also a positive advantage for the physical therapist, as he or she can assist more patients in a month or year.
  4. Aquatic therapy reduces the risk of joint trauma.After undergoing reconstructive surgery, the last thing a patient wants to face is the possibility of causing additional trauma to his or her joints. This can be either the joint that has been operated upon or other joints that are now bearing the brunt of his or her weight during daily activities, such as during ankle surgery rehab.Aquatic therapy offers an atmosphere of lowered stress on all body parts, including sensitive joints. Because the joints are not dealing with the stress of gravity in addition to the stress of rehabilitation, they are less likely to swell, become injured or ache. There is also a reduced risk of falling, which in turn removes added risks of joint trauma.
  5. Water rehabilitation can be done sooner post-op.Many patients are surprised at how quickly they can begin aquatic therapy after they have had reconstructive surgery. As long as any open wound areas are completely covered and waterproofed, patients can get into the therapy pool within a few days after being released from the medical facility.By speeding up the initial physical therapy sessions, the patient is also likely to speed up his or her return to normal physical functioning. Increasing mobility during early stages of rehabilitation also decreases swelling and increases function.
  6. Water therapy is easier for those suffering from comorbidities.Often, patients who have undergone reconstructive surgery and need shoulder surgery rehab — or hip, ankle and knee rehab — have other conditions such as chronic pain, arthritis, obesity or respiratory issues. By exercising in a forgiving environment surrounded by warm water, it can be much easier for them to begin and continue their physical therapy. This also helps physical therapists avoid the common problem of patients refusing to come to physical therapy sessions because of pain or difficulty.
  7. The warm water of a therapy pool makes patients more receptive to performing exercises.From a psychological perspective, it‘s much easier for patients to perform physical therapy exercises if they have an optimistic mindset. Anecdotal evidence culled from aquatic therapy professionals and their patients indicate that a warm water pool tends to reduce the emotional stressors of physical therapy.While the initial session may incur a bit of trepidation, due to getting into the pool and worrying about balance issues, the following sessions are generally met with high levels of positivity. As medicine has shown, the state of the patient‘s mind can make huge differences on the outcomes of their physical therapy sessions.Aquatic therapy patients are notoriously happy to continue to their shoulder surgery aquatic therapy treatments; many have indicated in studies that the therapy pool has helped them deal with their disabilities and it is more enjoyable than land therapy. This is an unintended, but positive, consequence of aquatic therapy.

Watch this Canadian football player’s story how aquatic therapy helped him recover quickly from an ACL surgery so he could get back on the football field ready for his next season:

Common Aquatic Therapy Exercises

It’s helpful to compare some of the exercises that are most often used for reconstructive surgery aquatic therapy in a HydroWorx pool. Each of the exercises can be modified as needed.

Knee Bends

Performing several knee bends on land may be virtually impossible for a patient who needs knee rehabilitation. However, in the water, knee bends are much easier because of the buoyancy and feeling of “instant weight reduction.” As the patient is instructed to bend his or her knees in the water, the physical therapist should make sure the healthier knee isn’t bearing the brunt of the work. If it is, the physical therapist can help the patient recognize the desire to compensate, and then overcome that desire.

Eventually, the patient may be able to perform knee bends in conjunction with other exercises, or to alternate between legs. If the patient feels he or she is going to fall, the support bars or side of the HydroWorx therapy pool can be utilized.

Shoulder “Rolls”


Patients who need shoulder surgery aquatic therapy can be encouraged to submerge themselves to the neck level, and then extend their arms to the front or the sides. By moving their hands from a “palms facing up” to a “palms facing downward” position, they essentially “roll” their shoulder joints. Though this activity may seem like a small step during shoulder surgery rehab, it has shown improvement in patients. Because there is no downward force to contend with, the patient can focus solely on the motions, not the effects of gravity.

Over time, handheld exercise “dumbbells” may be incorporated into this exercise. These water dumbbells can be slowly raised and lowered into the water, adding another dimension to the shoulder rolls.

Aquatic Therapy Works for Reconstructive Patients of Any Age

Perhaps one of the best aspects of aquatic therapy and its benefits is that it has been proven to work for individuals of all ages. No matter if it’s a teenager who injured a knee during a football scrimmage, or an older adult who needed to solve a years-old shoulder injury through surgery, therapy in a HydroWorx pool is always an option.

In fact, with more physical therapy clinics and facilities choosing HydroWorx as their water therapy partner, it’s becoming more mainstream than ever. That’s not only good news for patients who are considering reconstructive surgery, but it’s great news for the professionals who are dedicated to helping them recover.

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Page Updated on: November 23, 2020