Dive In! -- Aquatic Therapy for People With Disabilities

From the WebMD Archives

July 19, 2000 -- Water. Not only is it essential for life, it provides far-reaching benefits to the body and mind. Just ask Penny Linder, who was diagnosed with multiple sclerosis (MS) 26 years ago and has been using aquatics, or water exercise, to help relieve chronic pain caused by the neurological disease.

Although Linder may not be able to jump freely into the pool like she did as a child, she values aquatics for what it can provide her both physically and mentally -- a chance to feel healthy despite a disability that has gradually curbed her energy.

"I don?t feel disabled in the water," she said. "I feel stronger and more healthy in the pool because I can do things there that I couldn?t dream of dong on land."

Because water eliminates the effects of gravity on the body, pain and stress on muscles and joints are greatly reduced. As result, Linder and others like her, can stretch and strengthen weakened arms and legs within their full range of motion. While standing in a pool, they can also use the weight of water to help correct problems in gait and balance with less effort than on land.

Aquatics are particularly recommended for people with MS because water is more efficient in drawing heat away from the body than is air. This helps keep the body from overheating, which often causes MS symptoms to worsen temporarily.

The soothing effects of the water can also benefit other people with disabilities, according to experts at Shepherd Center, an Atlanta-based hospital that specializes in treating people with MS and brain and spinal cord injuries.

Therapists at Shepherd often supplement a patient?s rehabilitation program with aquatic therapy because warm water has been shown to help increase flexibility, decrease pain, relieve muscle spasms, and improve circulation.

"With aquatics, individuals can improve their mobility in the water, then take what they've learned and practice it on land," said Margo Howell, aquatics specialist at Shepherd Center. "Plus, it's just fun and a nice change of pace from many other forms of exercise and therapy."

Getting Started

Whether taking a class or working independently, talk with your doctor about starting an exercise program. Shepherd Center aquatic therapists also recommend the following:

  • Look for a community pool that is easy to get in and out of. Many public pools have lifts or ramps with handrails for greater accessibility. If not, ask if a portable lift can be added.
  • Check the water temperature. For people with MS, cooler is better -- 78-82? F is ideal for exercise, but warmer temps of 85-86? F degrees are fine for stretching. For people with spinal cord injuries who may get chilled easily, warmer water -- 92-94? F -- is best.
  • Start slowly. Try exercising or stretching for 15-20 minute sessions, until your body gets used to it. Remember, it?s easy to over exert yourself in the water.
  • Never exercise to the point of pain.
  • Drink plenty of water after exercising.

Exercise Options

Any movement that provides resistance against the water is good for stretching and strengthening muscles. Shepherd Center recommends the following exercise options:

  • Swim laps, using a ski belt around the hips (if necessary for floatation) and hand paddles for added resistance. An inflatable collar can also help keep water out of the face.
  • In shallow water, use foam dumbbells to help build upper-body strength, or ankle weights to strengthen leg muscles.
  • Wear lightweight webbed gloves for added resistance in the water.
  • For people with disabilities, practice doing transfers from chair to pool deck to pool or on pool steps.
  • Exercise arm and leg muscles in deep water using an inner tube or "noodles" under arms.

If you need a more structured exercise program, aquatic classes are available at many community and fitness centers. Examples of classes to look for, include:

  • Watsu -- a therapeutic relaxation technique where the therapist moves the participant through the water. The movement allows for complete relaxation and can be very beneficial for people with disabilities and for those who experience chronic pain.
  • Ai Chi -- similar to Tai Chi but it?s done in the water, using a combination of deep breathing and slow broad movements.
  • Water yoga -- Using the same concepts as yoga on land, water yoga is designed to relieve stress, but movements help build internal energy and strength. Techniques are also designed to help with balance, flexibility, and coordination.
  • Low impact aquatic classes -- provide an aerobic workout and strength training without putting pressure on joints.

Additional Information/Resources:


  • Swimming for People With Disabilities; Association of Swimming Therapy (1992); London: Bedford Row Publishing.

  • Watsu: Freeing the Body in Water; Dull, H. (1993); Harbin Springs publishing.

Internet Sites

Shepherd Center in Atlanta is a private, not-for-profit hospital specializing in the care of people with spinal cord injury and disease, acquired brain injury, multiple sclerosis, and other neuromuscular disorders and urological problems. The Center houses the largest model spinal cord injury program in the country, the largest brain injury rehabilitation program in Georgia, and an official Multiple Sclerosis Center, designated by the National Multiple Sclerosis Society-Georgia Society. Serving the Southeast since 1975, the 100-bed specialty hospital offers a continuum of health care services, from intensive care through rehabilitation, transitional care, day program, and outpatient services.