Synapse Physiotherapy | Physio Center | Rehab Malaysia



Aquatic therapy encompasses treatments and exercises conducted in water to facilitate physical rehabilitation, relaxation, fitness, and therapeutic benefits. It is widely embraced across all age groups with various disabilities or disorders, offering numerous advantages.

Within aquatic therapies, warm water promotes muscle relaxation and peripheral circulation. Water resistance enhances muscle strengthening, while the alleviation of gravitational forces and joint pain facilitates the performance of range of motion or stretching exercises. Furthermore, regular swimming can improve respiratory functions and thoracic mobility. Swimming has been found to enhance pulmonary functions, aerobic capacity, and quality-of-life parameters in patients with AS (ankylosing spondylitis).


Physiotherapists often integrate aqua hydrotherapy into rehabilitation programs. The water offers a secure, low-risk, and supportive training environment, especially beneficial for older individuals participating in fitness programs without worry of falling. This enhances client satisfaction and adherence to hydrotherapy exercises. Furthermore, the social atmosphere of the sessions often amplifies the therapeutic benefits.

Properties of Water 

Hydrostatic pressure 


Hydrostatic pressure plays a crucial role in aquatic therapy, representing the static force exerted by water against a person or object. This force also generates the upward thrust we know as buoyancy, which significantly influences therapeutic exercise. For instance, during standing hip abduction, buoyancy assists the limb, while returning to neutral position requires increased hip adductor force to overcome buoyancy. Thus, buoyancy can act both as an aid and a resistance.

Moreover, hydrostatic pressure enhances heart efficiency by aiding venous return and applies compression to joints, muscles, and soft tissue, facilitating swelling reduction and lymphatic drainage. Buoyancy unloads the body, with greater depth of submersion leading to reduced gravitational effect on body weight. A basic breakdown of buoyancy’s unloading effect relative to body weight includes: waist deep – 50%; chest deep – 75%; neck deep – 90%.


The conditions helps by hydrotherapy 

 Chronic pain 


Hydrotherapy is recommended as a course of treatment for various chronic pain conditions. It helps to promote normal movement, increase muscle length, and enhance muscle strength and control. Conditions such as fibromyalgia, complex regional pain syndrome, and longstanding musculoskeletal issues can benefit from hydrotherapy.

Hydrotherapy is particularly effective for chronic pain because it addresses multiple symptoms simultaneously. It offers several key benefits. First, heat stimulates thermo-receptor nerves, thus relieving pain and increasing soft tissue extensibility. Additionally, heat promotes fluid movement within the body’s joints and induces muscle tissue relaxation, thereby calming the mind. Next, buoyancy reduces direct pressure on joints as the body floats in water, resulting in less pain and enabling freer movement. This effect can be adjusted easily by changing water depth. Finally, water resistance provides gentle yet variable resistance according to movement speed, aiding in improving muscle tone and strength. Moreover, the constant resistance of the surrounding water stabilizes movements, boosting confidence in pain-free movement without the risk of injury.

Neurological conditions

For individuals with neurological conditions, hydrotherapy offers opportunities to perform activities that may be challenging on dry land. It can also help reduce muscle spasms in severe traumatic brain injury patients and enhance strength in various neurological conditions.

The warm water in hydrotherapy sessions facilitates increased movement by reducing joint stiffness, normalizing muscle tone, and promoting muscle relaxation, collectively contributing to pain relief. Water also offers resistance, aiding in the strengthening of weak muscles. Additionally, the buoyancy effect of water enables passive stretching. Furthermore, water provides a safe environment for practicing balance and walking, and it enhances ease of handling for physiotherapists. Moreover, buoyancy decreases weight bearing, allowing for easier walking. 

Cardiovascular condition

In cardiovascular and pulmonary conditions, hydrotherapy aids in improving muscular and cardiopulmonary endurance, particularly in the elderly or in rehabilitation following chronic heart failure or respiratory disease exacerbations.

Musculoskeletal injuries

Musculoskeletal injuries, whether from sports or aging, can be improved with hydrotherapy. Commonly treated conditions include osteoarthritis, rheumatoid arthritis, ankle sprains, muscle tears, and low back pain.

Water offers a unique and supportive environment for muscle and joint rehabilitation, providing numerous benefits. The buoyancy effect experienced in water reduces the weight that bones, muscles, and joints have to bear, while the heating effect helps decrease swelling, increase blood flow, and alleviate pain. This combination creates an ideal medium to aid in your return to full function.

Moreover, water provides accommodating resistance, meaning that the resistance increases with the speed of movement. This feature is especially advantageous in musculoskeletal injuries as it reduces the risk of excessive resistance. In hydrotherapy, you can experience this concept firsthand and practice common functional movements relevant to your daily life.

By varying the depth, you can gradually increase the amount of body weight borne by the affected joint. Once mastered, these skills can be transitioned to land-based functional exercises. Hydrotherapy is particularly effective in the early stages of lower limb rehabilitation, before full weight bearing is feasible. Starting a hydrotherapy program early in the rehabilitation process helps preserve joint range of motion and facilitates a smoother recovery journey.


Hydrotherapy accelerates recovery for patients undergoing back, abdominal, or lower limb surgeries, aiding joint movement and muscle strength. It is beneficial for clients recovering from surgeries like anterior cruciate ligament surgery, Colles’ fracture reduction, and lower limb joint replacements.

The buoyancy from the water alleviates stress on weight-bearing joints, providing patients who are unable to bear weight with an opportunity to do so much earlier without concern for exacerbating their injuries. Additionally, the resistance offered by water can be utilized to build strength, with the level of effort modulated by the individual through adjustments in speed. Furthermore, the warmth of the water aids in relaxing tight muscles, facilitating easier range of motion exercises and reducing pain sensation. This combination of factors makes water-based therapy an effective and comfortable option for rehabilitation.

Pediatric condition

In pediatric care, hydrotherapy is commonly used for children with neurological or orthopedic conditions, or post-surgery. Conditions such as Rett syndrome, cerebral palsy, spina bifida, infantile spinal muscular atrophy, and post-surgery recovery can benefit from hydrotherapy.

Children often find water-based rehabilitation more enjoyable than traditional land-based methods. The playful environment of the pool makes exercise enjoyable, leading to greater enthusiasm and participation. Consequently, children are more willing to engage in water-based exercises, resulting in improved compliance with their rehabilitation regimen.

How long for a session

The duration of a hydrotherapy appointment typically varies depending on client tolerance and therapy objectives, but it usually lasts between 45 to 90 minutes.

What happens during the first session

During your initial hydrotherapy session, your therapist will ensure your safe entry into the pool. They may utilize aquatic equipment such as floats, paddles, or pool noodles to aid in exercises or provide additional resistance. The session may take place in shallow or deep water depending on your therapy goals.

How many session is needed

The number of hydrotherapy sessions required depends on factors such as your diagnosis, the severity or chronicity of your injury, your medical history, and other considerations. Hydrotherapy sessions often complement in-clinic therapy well and can effectively help achieve therapy goals.

Hydrotherapy plays a crucial role in physiotherapy by offering effective rehabilitation and pain relief through water-based treatments. Synapse Physiotherapy provides tailored hydrotherapy sessions, harnessing the benefits of water to enhance mobility, reduce pain, and improve overall well-being. With specialized expertise, we ensure patients receive personalized care to achieve optimal outcomes in their recovery journey.

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