- Hydrotherapy, or aquatic physiotherapy, uses water-based exercise as part of a treatment plan.
- Buoyancy and warmth may make movement more comfortable for some people.
- Swimming ability is not always required, but confidence, access and support must be assessed.
- It can be useful when land-based activity is difficult, including some rehabilitation programmes.
- The water does not remove all risk. An assessment comes first.
Treatment, not a swimming lesson
Hydrotherapy is exercise in water, usually guided by a physiotherapist as part of rehabilitation. Instead of swimming lengths, you work on movements chosen for your condition and goals.
Hydrotherapy pools are often warmer than ordinary swimming pools. For example, South Tees describes water kept at around 34–35°C. Exact temperature, depth and access arrangements vary between facilities; Richard’s pool arrangements need to be confirmed before you book. South Tees Hospitals: What is hydrotherapy?
Why does water make a difference?
Buoyancy provides support. Water reduces the amount of weight borne through the body. How much support you receive depends on your immersion depth and position; there is no single unloading percentage that applies to everyone.
Warmth may make movement more comfortable. Some people find it easier to move a stiff or painful area in warm water, although this varies.
Water provides resistance. Moving against it can form part of a strengthening programme. Speed, body position and equipment change the load, so it still needs to be prescribed and progressed sensibly.
Support can help confidence. A supervised setting may feel less intimidating when movement on land is difficult. But it is not risk-free: balance, access and supervision still matter. Guy’s and St Thomas’: Hydrotherapy
Who might benefit?
Water-based rehabilitation may be considered for musculoskeletal or neurological problems when an individual assessment suggests it will help. It may be useful after some operations or injuries, or when exercising on land is painful or difficult. University Hospitals Plymouth: Hydrotherapy patient booklet
Arthritis, joint replacement, persistent back pain, neurological conditions and widespread pain are possible topics to discuss at assessment—not a promise that hydrotherapy suits every person with those diagnoses. Ask Richard whether his service is appropriate for your particular needs.
The useful question is: does exercising in water help you work towards your goals safely? Some people will be better served by land-based exercise or another approach.
What actually happens in a session?
Assessment comes first. Your physiotherapist discusses your symptoms, relevant health history and what you want to get back to, then checks whether pool-based treatment is appropriate.
A session may include walking patterns, controlled joint movement and strengthening adapted to you. NHS services describe different session lengths; there is no universal half-hour appointment. Confirm Richard’s appointment length, pool location, access, supervision and charges in advance. Guy’s and St Thomas’: Hydrotherapy appointments
You may also have exercises to do outside the pool. Water can support a stage of rehabilitation, while the wider plan helps you manage the activities you need on land.
Who needs extra screening or may need to wait?
Tell your physiotherapist before attending about an unhealed wound, infection, recent diarrhoea or vomiting, uncontrolled heart or breathing symptoms, seizures or blackouts, continence problems, a recent operation or any other change in your health. Facility rules and the individual assessment determine whether treatment can proceed, needs adapting or should be deferred. University Hospitals Plymouth: Hydrotherapy patient booklet
After surgery, wound healing, infection risk and the surgeon’s restrictions must be checked. You should not enter the pool simply because a set number of days has passed.
Tell the therapist immediately if you feel dizzy, unwell, unusually breathless or in pain. Ask what assistance is available for getting in and out. Follow the pool’s safety instructions and do not practise alone where supervision is required. Guy’s and St Thomas’: Hydrotherapy appointments
Is hydrotherapy the same as swimming?
No. Swimming is a form of exercise; hydrotherapy uses selected movements to address agreed rehabilitation goals. Neither automatically replaces the other, and regular swimming does not prove that an individual problem has been assessed.
You do not always need to be able to swim. Some programmes use supported standing in shallow water. Tell Richard if you cannot swim or feel anxious so the setting and level of support can be checked; do not assume every pool has the same depth or assistance.
Frequently asked questions
Do I need to be able to swim?
Not necessarily. Explain your swimming ability and confidence before booking. The therapist must check the pool, access and supervision arrangements are appropriate for you.
Does it help arthritis?
Some people find water-based exercise more comfortable and useful for working on movement and function. It does not cure arthritis, and benefits differ between individuals.
How many sessions will I need?
That depends on your goals, assessment and progress. Richard should discuss a review point with you; a specific improvement within a handful of sessions is not guaranteed.
Is it safe after a knee or hip replacement?
It may be suitable after clearance and appropriate healing. Your wound, infection risk, surgeon’s restrictions and pool requirements need checking first.
Can I combine it with ordinary physiotherapy?
Yes, where appropriate. Pool and land-based work can complement one another; the balance should follow your individual needs rather than a fixed formula.
Wondering whether the water could help you move?
Talk to Richard about an assessment and the right next step for you.
Enquire about an assessment info@richardjonesphysio.co.ukWritten by Jacqui Cox. General information only; not individual medical advice. Do not delay urgent care because of this article.
Sources & further reading
References checked 10 November 2026. External guidance supports the information; it does not endorse the practice or replace individual assessment.
