building up strength

By Wendy Hughes

Since September last year my week has began with a visit to the hydrotherapy pool at Worthing Hospital, and I am often asked if it is beneficial to me, and do I swim a certain number of lengths in the pool?  The answer to the first question is a resounding yes, and the answer to the second is no I don’t swim, but I do a series of exercises that alleviate the problems I have experienced that week, therefore receiving tailor made exercise to meet my needs. Over the last 12 years I have had two total knee replacements, a total left hip replacement and received a diagnosis of spinal stenosis. This is a narrowing of the open spaces within the spine, which can put pressure on the spinal cord and the nerves that travel through the spine to your arms and legs.  All these problems affect my ability to do gentle exercises and to walk any distance without discomfort, although like all chronic illnesses some days are better than others.

knee exercises


Hydrotherapy has helped me in many different ways because the warmth of the water allows my muscles to relax, thus easing the pain in my back and joints and helping me to exercise, and because the water supports my weight, it helps to relieve pain, builds up confidence, and increases the range of movement. The water can also be used to provide resistance to moving your joints by pushing your arms and legs against the water which in turn improves your muscle strength.

exercise equipment

There are usually 3-4 patients in the pool as well as the physiotherapist, giving everyone the room they need to do their individual exercises.  The session lasts for half an hour and we are all encouraged to do only what we feel comfortable with.  The emphasis is on building up strength and confidence slowly without causing any damage to existing problems. We start the session with a few warm up exercises, such as walking around the pool and lifting our legs up as high as we can, then we walk backwards and sideways before the physiotherapist comes around to each of us individually asking how our week has been and if we have any problems, then exercises are suggested that will help that particular problem. For example if my back has been particularly painful then I am given an exercise where I hold on to a bar and slowly ‘walk’ up the wall of the pool, then walk down and stand on tiptoe, before walking backwards, but still holding on the bar.  If the hips have been painful, then I am told to hold on the bar  and lift my leg up as high as I can, open up the hip joint and taking one hand off the bar turn my body, very much like a ballet exercise but much easier in water, before returning to my starting position.  For the knees I do squats, similar to sitting in a chair then using my knee to put myself up.  There are also some core muscle-strengthening exercises where we sit on a long roll of foam and cycle in the water. So far this is the most difficult exercise for me and even with two pieces of foam I still find it hard to balance, but the physiotherapist is always on hand to encourage and help me.  We also do upper arm and shoulder strengthening exercises using floats or plastic dumbbells to pushing through the water, forwards and sidewards.

exercising in a hydrotherapy pool

Hydrotherapy sessions are available on the NHS, and most hospitals have access to hydrotherapy pools. Any member of the healthcare team should be able to refer you to an NHS physiotherapist if they think you might benefit from hydrotherapy. In some parts of the UK you can also refer yourself to a physiotherapist, who’ll assess whether hydrotherapy would be suitable for you. Check with your GP or call your local rheumatology department to find out if an NHS physiotherapist in your area will accept self-referrals.

You can also choose to use private healthcare, but make sure that the physiotherapist is registered with the Health Professionals Council (HPC), and it is recommended that you see someone who’s a member of the Chartered Society of Physiotherapists (CSP) and who’s accredited by the Aquatic Therapy of Chartered Physiotherapists (ATACP).

Exercising wwith foam rolls

Before you start hydrotherapy, you’ll be seen by the physiotherapist in your hospital’s physiotherapy department, on the hospital ward or possibly in the physiotherapist’s own surgery. They’ll ask about your general health, and assess your individual needs. Using this information and the information provided by your doctor, the physiotherapist will advise on whether hydrotherapy is appropriate for you. This initial assessment normally takes about 30–45 minutes, and if a course of hydrotherapy is recommended you will usually have five or six NHS 30-minute sessions, and if it is felt that you need more sessions then you will be advised where you can go locally.  In Worthing we are very lucky because after your NHS sessions there is a hydrotherapy group that we can attend if your physiotherapist feels it will benefit you.  This happened to me, and now for the price of £8 per session I am able to go once a week for as long as it helps me to gain more mobility.  However not all physiotherapy departments have a hydrotherapy pool, so you may have to travel to another hospital.

As you can imagine I come home totally exhausted, but the next day I do feel the benefit, so if you have mobility problems, then do think about the talking to your GP or locally physiotherapist.

hydrotherapy pool