The role of hydrotherapy in MS

Hydrotherapy offers a range of benefits for people living with MS. Hydrotherapy is usually suitable for people of all abilities with different levels of function and mobility. Hydrotherapy pools provide increased accessibility allowing people to use hoists, ramps and water wheelchairs where required to enter the pool. Hydrotherapy pools are usually equipped with a range of different equipment options to help support individual mobility requirements including railing for additional support and safety. 

The buoyancy that water creates allows people with walking and mobility difficulties to walk and mobilise with increased ease. This can be especially helpful for those with impaired mobility, falls risk and/or experience muscle and joint pain. 

Hydrotherapy is a great low impact option that can improve strength, cardiovascular function and balance. Water creates a natural resistance and turbulence, challenging strength and balance. This allows individuals to practice and challenge their balance in a safe and controlled environment with reduced risk.

Just because it’s low impact, doesn’t mean it has to be low intensity. Working with an exercise physiologist or physiotherapist to develop an appropriate, individualised and safe water-based exercise program can be an effective way to reach your goals.

Hydrotherapy can offer pain relief for individuals that experience both neuropathic and musculoskeletal pain. Naturally, the buoyancy of water reduces the amount of body weight being distributed through joints, allowing individuals to move with greater intensity and range of motion without painful joint limitations. Heat and floatability of water can reduce the activity of pain receptors, effectively alleviating pain, whilst also enhancing muscle relaxation. This can contribute to improved function inside and out of the water. 

A thermoneutral environment supports an individual to maintain their internal core body temperature without expending extra energy to heat or cool. Exercising at a thermoneutral temperature can be an effective way to offset fatigue whilst still eliciting an effective exercise stimulus. This can be especially helpful for those that experience thermoregulatory dysfunction and fatigue. The ideal temperature is between 30 - 32 degrees, any warmer than this and it may be a bit hot and have the opposite effect! 

Water submersion is renowned for the positive calming effects it can have on the nervous system. The gentle pressure of the water on the body helps stimulate sensory nerves in the skin, which signals the brain to shift toward a more relaxed, ‘rest and recover’ state. At the same time, buoyancy reduces the effects of gravity on the body, easing muscle tension and lowering stress signals. 

Hydrotherapy can effectively reduce spasticity. The warmth of the water promotes muscle relaxation, which facilitates a greater range of motion and improves the ability to perform voluntary movements. 

Edema is swelling caused by excess fluid trapped in the body's tissues.  

Immersion in water, combined with the gentle pressure it exerts on the body, can help to reduce swelling, in turn helps to reduce edema. This is achieved by supporting venous return and promoting the movement of excess fluid from the tissues back into circulation.

An MS study found that an intensive eight week hydrotherapy intervention improved participants’ reported fatigue levels. The exact reasons for this are not fully understood, but it is believed to be related to the well-established positive effects of exercise on fatigue. 

Specific and individualised exercise is the most effective therapeutic approach to manage and improve symptoms associated with MS. Regular exercise helps to slow disease progression, prevent relapses, slow and reduce progressive mobility declines and reduce disability.

Exercise stimulates and promotes positive physiological adaptations including facilitating neuroplasticity which is the brains’ ability to rewire itself, creating new connections and pathways, promoting muscle re-activation and the ability to relearn movement patterns.

Regular exercise is positively associated with improved cognition, including mood and memory. 

Whether it is your first time trying hydrotherapy or you have had plenty of practice, there are a few tips and considerations to keep in mind to ensure you have a safe, effective and enjoyable experience. 

• Pool environments are wet and slippery – be careful and watch your step!
• Whilst the water temperature may be thermoneutral, the outside ambient temperature may be hotter. Being in a hot environment may temporarily exacerbate symptoms, this is not something to worry about but be cautious and mindful of. Pre-cooling may help offset this.
• Jump in a cooler pool before and after
• Wear an ice vest on the drive to the pool
• Stay hydrated throughout the session, keep an icy bottle of water by the pool side
• Intensity can be deceptive in the pool – start with a short session to determine what you can tolerate, slowly increase.
• Take it slow when getting out of the pool – you may have worked harder then you realise, and the legs might be a bit wobbly!
• Work with an exercise physiologist or physiotherapist initially to develop an appropriate hydrotherapy program that is going to address your needs and achieve your goals.
• Look into group classes – working out in a group can be more enjoyable and fun, plus it’s suitable for many different levels!  

MSWA offers both individual and group hydrotherapy sessions, delivered by physiotherapists, exercise physiologists, and physiotherapy assistants. Services are provided across a range of locations, utilising partnerships with local community pools. 

If you feel that hydrotherapy may be right for you, or would like more information, please get in touch with our friendly team!