So, you have been referred for a hydrotherapy programme…

  1. What is hydrotherapy?

Hydrotherapy is a type of exercise-based therapy that is conducted in a water-based setting as a treatment for many conditions including exercise rehabilitation.

  1. What are the benefits of hydrotherapy?

Hydrotherapy is a great starting point for someone who has had a significant injury and is reporting high levels of pain, is unable to weight bear or has an extremely limited range of movement within a joint. Many moderate to high quality-based evidence supports benefit for hydrotherapy in reducing pain symptoms, joint strength and mobility, balance and self-efficacy in adults with arthritis, knee and chronic lower back conditions.

  1. If I am referred for hydrotherapy, can I still complete land-based exercise?

Yes. If you are referred for a hydrotherapy programme with an AEP at Absolute Balance, you will still complete an initial assessment on land to get functional starting points for your programme. This will measure your baseline capacity in terms of the physical critical demands of your job role. A hydrotherapy programme can commence following this if the findings in the initial assessment support it, however, we only want to complete pool-based exercise until symptoms have stabilised and overall exercise tolerance has improved. Following this, your treating exercise physiologist will progress your programme to gentle land-based exercises and begin to gradually increase the load and exercise difficulty. Typically, exercising non-injured areas of the body is also safe to complete on land- however, check with your treating AEP first for their recommendations and tips.

  1. Why do programmes need to progress to a land-based setting?

At Absolute Balance, we aim to get the injured worker (IW) back to a level of capacity where they can return to their pre-injury job role in a timely manner. All job roles involve some aspect of weight-bearing for prolonged periods, moving in certain postures and lifting loads, all of which can only be accomplished by completing a land-based programme. A land-based programme can be tailored more efficiently to address each individual’s job role so we can more accurately monitor and assess the IW’s competence and tolerance with these specific tasks in which we measure as the Total Work Output (TWO). All hydrotherapy programmes have a TWO of 0 as it is impossible to measure load in the pool.

  1. Is there an alternative to both hydrotherapy that is still lower intensity than a conventional landed based programme?

Yes. At Absolute Balance, we offer Neural Fx, which is an adaptation of dynamic neuromuscular stabilisation, based around five key interacting principles: respiration, core stabilisation, quality of support, body movement awareness, and joint-segment centration. This type of training begins with learning diaphragmatic breathing patterns and low-intensity movement and progresses to incorporate functional movement patterns (for more information regarding this, see our previous blog –Lift with your Spine).

Tayla O’Halloran (Bsc. Exercise Physiology)

Senior Accredited Exercise Physiologist (AEP) (ESSAM)



  1. Martin, D. and Kukuh Noertjojo, K. (2004). HYDROTHERAPY. Review on the effectiveness of its application in physiotherapy and occupational therapy. Hydrotherapy.
  2. Geytenbeek, J. (2002). Evidence for Effective Hydrotherapy. Physiotherapy, 88(9), pp.514-529.