Orthopaedic Rehabilitation

Image of patient receiving aquatic treatment for total knee replacementThis is possibly the most common use of hydrotherapy in current trends and includes post operative management of patients with:

  • osteoporosis (read more below)
  • total hip and knee replacement
  • post spinal fusion and laminectomy
  • many types of fractures (read more below)
  • tibial osteotomies
  • arthroscopies
  • post rotator cuff surgery
  • multi-trauma (read more below)
  • and more conditions.

Image of patient walking up pool ramp with knee braceBenefits

When it comes to orthopaedic care, the benefits of aquatic physiotherapy are clear:

  • weight reduction and buoyancy
  • warmth and other pain relief benefits
  • increased movement with less pain.

Whilst some patients are concerned about their wounds in the hydrotherapy pool, a number of studies have allayed these concerns about wounds. It is imperative that you don’t consider a public pool as a venue for hydrotherapy post operatively. A purpose built physiotherapy run pool will screen all clients and ensure pool chemistry and hygiene is appropriate for wounds. Read more about wound management.

As a result of good post-operative results doctors and health systems have often included hydrotherapy as part of their pre-operative program in order to:

  • maximize strength, movement and health
  • assist in reduction of waiting lists and avoid surgery
  • postpone need for surgery.

Read more about hydrotherapy before and after a total hip or knee replacement.

Hip fractures

Traumatic fractures hips (fractured neck of femur) occur usually in older adults after a fall. There is often an associated wait for surgery, pain and loss of confidence and independence. Many who have had a fracture will then move less and get weaker in an effort to avoid future falls. This creates a cycle that leads to decreased strength, reduced balance and response times and increased frailty and loss of independence. Hydrotherapy exercise is often recommended. The water is often the place where these clients will move more and incorporate more strength, endurance speed and challenge to their movement as their fear of falling is reduced when in the pool. This is not only good for the body but the mind and soul!


Our practice has had extensive experience with multi-traumas, including:

  • post motor vehicle accident
  • multiple fractures
  • pelvic fractures
  • work place injuries
  • after other traumatic situations.

Water can be the ideal place to begin rehabilitation, especially if the patient is non-weight bearing on one or both legs. With varying water depth we can progress weight bearing gradually from 0% to 10%, then 20-30% up to 100 % with much more accuracy than on land.

Goals and benefits include:

  • being vertical at the deep end of the pool
  • walking in water
  • trunk and arm strengthening exercise
  • core stability
  • gentle stretching of your back /other structures
  • pain management and relaxation.

Hydrotherapy can be included in fast track rehabilitation programs for multi-trauma.


Osteoporosis is another condition that we see in the pool both pre and post fracture. Balance and strength are important at any stage with osteoporosis but once a person has a fracture (or multiple fractures) it is less clear what our strength exercise programs should include. The water offers a safe environment where we are able to promote balance and falls prevention while aiming at a safe progressive strength component as well. Managing pain, posture, fitness and well-being are essential but all must be done with great care. Read more about use of aquatic therapy in treatment of osteoporosis.

Please contact us to find out if hydrotherapy may be useful in your situation.