Painful Joints? You Can Try a Treadmill in a Swimming Pool

Aquatic rehab works injured, painful joints without stressing them

Water Therapy

If you need rehabilitation to heal from an injury, surgery or to address chronic pain, consider aquatic therapy. Experts say being weightless in the water can addresses the pain and tedium of working through these issues.

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Aquatic therapy speeds the healing process by reducing compression on irritable, swollen joints. In some cases, this can involve riding a treadmill in a swimming pool. Other exercises that can help patients in the water include squatting, sit-to-stand exercises and going up and down steps, says physical therapist Todd Lewarchick, Regional Clinical Rehabilitation Manager for Cleveland Clinic’s Lorain Institute in Avon.

“We use the buoyancy of the water to ‘unweight’ someone,” Mr. Lewarchick says. “Any time you have an irritable joint or swelling, whether post-surgery or injury-related, it helps to unload that joint.”

Working in water restores the joints to optimal function more quickly and with more ease. This can help different types of patients, from those acutely injured to those with chronic pain.

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Mr. Lewarchick says a patient immersed waist deep in the water is approximately 50 percent unweighted. Shoulder depth immersion correlates to 75 percent unweighting or 25 percent weight bearing stresses in the submerged joints.

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With this benefit, using a pool for rehab is ideal. The only types of patients who cannot be rehabilitated in the water are those have cardiac restrictions, people with a fear of water, a current infection or incontinence issues, he says.

“Anyone exercising (whether in the pool or otherwise) needs a stable cardiovascular system,” he adds.

Warm pool, cool pool

Mr. Lewarchick has two pools he keeps at very different temperatures for patients at the Richard E. Jacobs Health Center in Avon, Ohio.

The warm pool is kept at a bathwater-like 92 degrees for those with arthritis, chronic pain, some neurological issues, those with difficulty walking, balance disorders, and other conditions that benefit from the soothing heat.

On the other hand, the cooler pool works well for those who have symptoms from certain conditions like multiple sclerosis and acute rheumatoid arthritis, which may worsen in warmer water. Athletes — from professional, college and high school teams to “weekend warriors” — benefit from the cooler pool as well because they can work out more aggressively and at a higher intensity in a protected environment, Mr. Lewarchick says.

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“The premise of being in the water is to stay moving,” he says. “Generally speaking, you can do much more volume of exercise in the water than you could do on land. You can do more using less energy because you weigh less. You want to keep your heart rate up and take short breaks as needed.”

Building strength in the water

“We really try to promote function — even though there’s a core weakness, we can do strengthening in the water,” Mr. Lewarchick says. “We can get patients in the water soon after an operation, which allows us to protect the joint and promote early function. Depends on incision healing, within one to two weeks after surgery, we can get that patient in the water.”

Athletes can use aquatic therapy to do jumping, cutting or moves specific to their sport, he says.

“How can a runner benefit? Patients don’t realize there’s technology out there to get them running on a treadmill in the water. A basketball player who has a sprained ankle, they don’t think about doing drills on land, however in the pool, we may introduce early functional movements to speed recovery. We can use pools to serve the athlete or other high-functioning patients in addition to those with debilitating conditions,” he says.

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