Say you were injured playing your favorite sport and had to have surgery on your knee. Now think of the countless hours of painful rehabilitation you face just to get your knee working again. What if there was a way to rehabilitate your knee in less time and with less pain?
Or maybe you suffer from fibromyalgia or some other disorder that makes even the lightest touch painful. What if there was a way to get your muscles back in working order without all the pain?
Well, there is. It's water therapy.
Using water to rehab injuries and ailments is both old and new. Greeks and Romans in ancient times used water to help them rehabilitate after sporting events, but it's only caught on recently in modern times. When NASA started doing research on weightlessness in water in the 1960s, people started realizing the scientific benefits of water therapy.
"Water can really help most patients," says Jan Pratt, physical therapist and owner of Aquatic Fitness Inc. in Creve Coeur and O'Fallon, Mo. "Using water is faster and better and offers less pain for the patient. For years physical therapists were referred to as physical terrorists or physical torturists. Water isn't that way - it's fun. And it has a powerful effect."
Just ask Steve Rainey, 45, of O'Fallon, Mo. After his third, and most invasive, back surgery, his doctor recommended water therapy.
"I just couldn't believe the difference it made," he says. "I'm farther along now (five months after the surgery) than I ever was at the end of the others. When I did regular land therapy it seemed like I hurt all the time."
With water therapy, many patients are able to get back to movement earlier, and with less pain and without stressing the parts that are healing. You can start treatment one or two days after a sprain or strain and two to 10 days after surgery; compare this with five to seven days for a sprain or strain and two to four weeks after surgery for treatment on land, Pratt says. Of course, an open wound would prohibit immediate water therapy, though in some cases a special bandage can be used.
"The thing that's good about water is that, whereas exercising on land requires weight bearing, in water, you can start water walking and not bear very much weight almost right away," says Bess Maxwell, who has a doctoral degree in exercise physiology and is executive director of Show-Me Aquatics & Fitness in St. Charles, Mo. "Water exercise is more comfortable. A person can gradually walk smoother, practice stepping up and down, a lot earlier on water than on land."
Water therapy with a different twist also worked for Susan Staat, 51, of Arnold, Mo.
Staat has suffered from fibromyalgia for years. Fibromyalgia, an arthritis-related condition characterized by generalized muscular pain and fatigue, affects different people in different ways; for Staat, the feeling was similar to flulike symptoms in her joints. "There were days I couldn't even put my feet on the floor, it hurt so bad."
She was in so much pain that the slightest touch affected her, and a traditional land massage, though beneficial, was extremely painful. Her husband read about a form of water therapy called Watsu.
Watsu is a sort of Shiatsu massage in the water, a sequence of gentle movements and stretches as you are held in warm water that relaxes your body, resulting in greater flexibility and freedom.
Staat thought she'd give it a try, so she called Kathleen Christ, who has performed close to 6,000 Watsu treatments at her St. Louis Aquatic Healing Arts Center in Creve Coeur.
"She puts me in a very relaxed state, and I'm just lifeless, and she gives me a deep, deep massage, the kind of massage I'm unable to do on a table," Staat says. "It would be just too painful. In the water, I don't feel the pressure."
After four years of therapy, Staat says she's noticed a huge change.
"I feel so good now. I was really in bad shape. I was in bed most of the time. Now, I'm very active. I cut the grass; I do a lot." In fact, she's been able to cut in half the number of pills she takes to control her fibromyalgia.
"She was almost not functioning before," says Christ. "Now she has her life back 100 percent."
Christ started the center in 1997 after reading an article about the benefits of Watsu. At the time she was a massage therapist, and Watsu "made so much sense to me."
After selling two of her businesses, she renovated the downstairs of her home into a Watsu area, a massage area and office. While that was going on, she went to California to study Watsu and came back a believer that it could heal people.
Watsu works for several reasons, she says. First, the warm water is hypnotic. "It's essential for anyone, especially a super Type A personality, because it gets the mind to relax. The body can heal itself when it's left to its own devices, but the mind gets in the way."
The warm water then allows Christ to stretch and move the body. "The greater freedom of movement it encourages creates a modality that can affect every level of our being," she says.
Freeing the spine in a weightless environment is the cornerstone of a Watsu session. The therapist supports the client in water while gently rocking and stretching the back and limbs. The head stays above water in Watsu; for greater effect, patients can try Wassertanzen - essentially the same thing, just with the head underwater.
During traditional water therapy and Watsu, the water is heated to body temperature. The warm water, says Christ, allows for a soothing of the mind as well as greater muscle movement.
Maxwell says warm water helps decrease pain, "kind of along the lines of a heating pad. It helps the tissues become more flexible."
Water is an ideal rehabilitation tool for several reasons, Pratt says.
First is buoyancy. When you are immersed in water there is less gravity and less compression on the spine and other parts of the body. "Thus, someone just standing in water often has zero pain level without even having to move."
Maxwell agrees: "The buoyant properties of water are what make it so special. So in essence, a 180-pound person can be in the water chest-deep and only be 30 percent of his weight. The gravity pushing against his joints just isn't there."
Water's hydrostatic pressure is also a reason it's a great tool. The body feels compression from all sides. The physiological effects of this include a decrease in swelling.
Finally, the ability to add movement adds a new dimension. Water is 12 times denser than air, Pratt says, so the resistance (if you move swiftly enough) is great for rebuilding muscles. Plus, you can use more functional movements, working specific muscles in the water.
In addition, therapists can also use the water for cardiovascular training. A patient may not be able to get on a treadmill just yet, but can "jog" against wave currents in the water and build up cardiovascular endurance.
"It's a way you can build endurance without any damage to the spine," says Jennifer Freeling, a physical therapist at Aquatic Fitness. "It's virtually impossible to get injured in the water."
And injury prevention and rehabilitation is the main goal for these therapists.
"In every case our role is to help that person get as much movement as possible to improve quality of life through exercise," Maxwell says. "We help them with functional ability - like walking, sitting, standing, things you count on to get around - and we count on everybody having fun."
Aside from injury and surgery rehabilitation, water therapy treatments are recommended for the following conditions:
Sources: Kathleen Christ, Bess Maxwell
(c) 2004, St. Louis Post-Dispatch. Distributed by Knight Ridder/Tribune News Service.