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All You Need to Know about Hydrotherapy: Part 1

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HydrotherapyIn this special 2 part blog series, our Head of Orthopaedic Physiotherapy Emma McCabe reveals all you need to know about hydrotherapy and its benefits.

Hydrotherapy, or water therapy, is the use of water (hot or cold water, steam, or ice) to relieve discomfort and promote physical well-being.  Originally this therapy was known as ‘hydropathy’ but is now referred to as ‘hydrotherapy’ to encompass its therapeutic nature.

Hydrotherapy has been around for centuries and is thought to have been used initially by the physician Hippocrates in the 5th Century. The ancient Egyptians, Chinese and Japanese all used water for therapeutic reasons and there was of course the Roman tradition of building pubic communal baths over natural hot springs in places such as Bath, Harrogate and Matlock.  It is believed after the fall of Rome, nude communal bathing was not acceptable by the growing Christian population and as a consequence the public baths fell out of favour.

In the eighteenth century however, the popularity of hydrotherapy re-emerged, after the publication of several books including Psychrolousia. Or, the History of Cold Bathing: Both Ancient and Modern and Medical Reports, on the Effects of Water, Cold and Warm: As a Remedy in Fever and Other Diseases.  They promoted the benefits of water, not only to bathe in it but to drink too. Both of these books were extremely popular, running into several editions and were also translated into German.

Early in the nineteenth century a German priest, Sebastian Kniepp treated his parishioners with hydrotherapy and wrote about his techniques and findings.  He opened a number of hydrotherapy clinics and some of his techniques are still in use today.  In Austria a peasant farmer, Vincent Priessnitz, used cold water, air, and a good diet and exercises to treat his patients and is now considered to be the founder of modern hydrotherapy.

The UK still has some hydrotherapy centres dating from years gone by, but countries such as Germany, Austria and Italy have them in abundance. Following surgery or illness, clients attend these centres to rehabilitate and Germany has some of the best spas in the world.

Hydrotherapy is commonly used by physiotherapists in the treatment of patients with a variety of ailments. It is used to relieve pain, increase flexibility and strength, progress mobility and improve cardiovascular fitness. You may have already had a course of hydrotherapy (up to 75% of people with Fibromyalgia have). Hydrotherapy is used within hospitals, rehabilitation centres, football clubs and even specialist centres for animals.

How Does Hydrotherapy Work? 

A typical hydrotherapy pool is heated to 33-36 Celsius, so from the moment the patient steps into the water, muscles are more relaxed and so are you. Being in the water creates a sensation of weightlessness, as the water counteracts the effects of gravity.  Movements that you are unable to perform on land are easier to perform under water and by moving quickly in the water, you go against resistance, working the muscle more, thus increasing strength.

How Can Hydrotherapy Help?

Hydrotherapy helps in the following ways:

Reduced Pain

Due to the warmth and support of the water, muscle tension and spasms are reduced.  Stimulation of the skin reduces pain by activating areas of the brain that help to ‘turn off’ pain signals.

Reduced Muscle Tension

The heat helps to reduce tension in the muscles. Muscle spasms are reduced and there is increased circulation to the muscles

Decreased Swelling

The hydrostatic pressure (pressures exerted by the water) helps to gently massage, reduce swelling and increase circulation.


Being in water creates a sensation of weightlessness as the water buoyancy counteracts the effects of gravity.  Exercising in water is much easier, so increasing the range of movement of a joint or muscle becomes easier to achieve.

Increasing Muscle Strength

The hydrostatic pressure within the water acts as a resistance and so performing exercises in the water will increase muscle strength.  Water is 12 times denser than air.

Overall Fitness and Cardiovascular Improvements

Due to the temperature, your heart will beat faster and with increased circulation, you can work up a sweat in the water.


Carrying out gentle exercise in warm water will help to reduce your stress levels, bringing about a more relaxed state.

In part 2 of this blog series, published on Thursday 7th August, Emma describes a set of simple hydrotherapy exercises, which you can carry out at your own local pool.

Have you ever had hydrotherapy before?  Let us know what benefits you noticed in the comments section below!