In Europe hydrotherapy treatment is

expanding as doctors see the benefits.

Spa waters at Casciana Terme, Italy

Exercising in hydro pools is beneficial for cancer survivors, those with muscular and neurological problems, lymphoedemia and many, many other conditions.  It just needs to become better used.

Italy has come up with good ideas for Acqua Aerobics (exercising in water); I tried this out in Casciana Terme over three years ago, but in the UK we are just hearing about them now. Italians are used to visiting one of their marvelous spas for targeted medical treatment; and this really works. Same in Germany, and all over Continent patients are prescribed hydrotherapy exercise as a fun and efficient way of aiding recovery.

On the Continent it is regarded as ‘normal’ to include hydrotherapy exercise;  in the UK we seem almost scared, but I have found it incredibly helpful.  My only caveat is to make sure you protect you face.  The heat and moisture are incredibly drying, and with our compromised skins we MUST protect them: I find the best way is to put on a moisturising mask before I enter the pool.  It won’t drip off into the water, but it sinks in so you don’t itch when you come out!

Britain has many hospital hydrotherapy pools – why does NHS neglect them?

When it was Government policy to increase funding for the NHS, hydrotherapy pools were installed in many hospitals.  But these pools needed maintenance and trained staff – so NHS has let many close as a way of saving money.  What a waste!

There is no reason why we can’t adapt Italy’s ideas to improve our health and wellbeing – just sad we don’t have their massive hospital pools and heated mineral water springs!  Believe it or not, the pool above was part of the clinic I went to for treatment in Italy, where warm water gushes out of the ground for free!

However, a pool doesn’t have to be enormous to give tremendous benefits and help with rehabilitation.

Where to find Hydrotherapy

Now that some hospitals are thinking of closing their pools, NHS hospitals often ‘hide’ theirs;  in one major London hospital my Consultant said she had heard there was a pool in her hospital, but couldn’t find anything about it – could I? !!!   I kid you not!  Another hospital is always changing its mind – sometimes their pool is open, and sometimes not, depending upon their whims.

Pools, I have found,  range from basic ones, with bad disability aids, up to superb private hospital pools where celebrities go for exercise after hip operations  (Molton Brown shampoo and shower gel in all the changing rooms!)  I saw Craig Revel Horwood in one, during his Strictly stint.

Prices vary from free NHS sessions for a limited time, up to £95 for 30 mins. in the most expensive private pool   So ask around once you discover your nearest NHS hydro pool, as many offer sessions at a small charge.  Best are those that offer 3 in a pool half hour sessions, with one physio;  this seems most effective and helpful ratio.  You can get sessions with no physio present, but I do find having someone watching you do the exercises correctly is the most effective.

Initially the NHS will offer you  4 – 6 sessions for free – then if you are lucky you can pay (around £6 – £20) for follow-up sessions.  One NHS hospital offers one-to-one sessions with a physio – alone in the pool – for £60.  But you might find this too intensive, and the cheaper sessions (at £20) where you share a pool with two other patients might be more suitable.  At Guys Hospital in London I paid £20 for a half-hour session along with two other patients, and a wonderful Irish physio who keeps us in fits of laughter.

There are private health and fitness clubs, many of whom offer Aqua Aerobics.  However, ASK what is the pool temperature before you plunge in.  Most club pools are kept at 29°,  which is too cold for many with disabilities. Hospital pools are kept at around 33°-34°.  This is the usual temperature at European medical centres, and they are the experts. (Temperatures are reduced in UK to save money; UK fitness clubs will tell you it is healthier – try telling that to the experts in Europe!).


The anti-Brexiters are all be-moaning the fact that we are leaving the EU, yet did nothing to copy what was being done in European hospitals.  Arrogance personified!

At Charing Cross Lymphoedema clinic I was interviewed by a bright young doctor, who mentioned Paolo Zamboni’s research into aqua aerobics, describing the benefits of Acqua Aerobics.  He promised to send over the paper, and when it arrived, I realised I had had one of his aqua aerobics classes when I was treated at Casciana Terme, over three years ago.

Zamboni and other have produced a paper (extract in the magazine Phlebology (Oct. 18th 2016), on a specifically designed aquatic exercise protocol to reduce chronic lower limb edema, exploring advantages of basic aqua aerobics; this mentions sources including work at University of Ferrara.

Italy of course has an enormous advantage in that warm mineral spring are to be found all over the country, making it easy for every hospital and medical centre to have gallons of warm mineral waters gushing up (only I am not too keen on the sulphur-smelling ones around Tivoli – phew!)

Some hydrotherapy pools are run by Physios who use exercises developed in the thermal pools at Bad Ragaz, Switzerland (recently featured in a TV programme on luxury hotels), and others have been to the fantastic Clinic Bad Sulza (part of University of Jena, Germany) where their Olympic sized pools are state of the art – as is the physiotherapy

What does Lymphoedema Support Network advise?

They sent me a link

which provides invaluable advice: from temperature of water, advice on exercises and wearing compression garments whilst exercising.

Pretty well any exercise in a pool is good – but those on the website seem the same as I was being taught in, in Italy.

Talk to your Physio and see if they can offer help with specific exercises for ‘your’ lymphoedema.  They may well want to read Zamboni’s article to learn more.Work Starts on New Children's Hospital Hydrotherapy Pool

Why does exercise work?

The lymphatic system is made up of a network of vessels that carry a clear fluid called lymph throughout the body. Lymph fluid serves the important purpose of carrying nutrients to the cells that bathe in the fluid. The lymph fluid then delivers cellular waste to the bloodstream, which carries it to the kidneys, colon and lungs for elimination. If your lymphatic system is blocked or clogged, you may experience a number of symptoms, including back pain, constipation, fatigue, depression and weight gain. However certain exercises can help release blockages and promote healthy movement of nutrients and waste throughout the body.

What exercises

Settle yourself standing in the water.   As you inhale, slowly turn your head to the right to a count of five. Pause for one second and then exhale, bringing your head back to centre for a count of five. Repeat on the left side. Do five repetitions on each side.Stand or sit in a comfortable position. As you inhale, draw both shoulders up toward your ears and then exhale, releasing your shoulders to a neutral position. Repeat five times. Stand.  Flex the ankle and extend the ankle six times, flexing and pointing the toe like a ballerina. Repeat on each side.Stand and hold onto side rail.  Get up on tip of toes. Stand.  Flex the ankle and extend the ankle six times, flexing and pointing the toe like a ballerina. Repeat on each side. Stand and hold onto side rail.  Get up on tip of toes for count of 30.  Then down.Once you are warmed up, you can then go on with exercises using  the ‘toys’ that surround most pools, and HAVE FUN!

Have a pool at home

.  Thanks to a firm called Endless Pools, this is no longer a far-fetched idea.  If you have the space, you can install your own pool in the garden, and cost is from £19,000 for a heated pool with equipment.  The Brownlee Brothers,  Triathlon medal winners in the Olympics, have installed one in their back garden;  theirs includes a Treadmill – ideal for weight-bearing exercise.

More details:

Hydrotherapy Pools

It is important to realise that a hydrotherapy pool must be kept at a higher temperature than one used for sport.  For best results the pool should be kept at a temperature around 33-35 degrees.

NHS Pools in London

  • Charing Cross Hospital
  • Chelsea and Westminster Hospital
  • Guys Hospital
  • St. Thomas’ Hospital

Private Pools in London

  • Chelsea Health Physio
  • King Edward VII Hospital
  • Parkside, Wimbledon

H  N.B.  It’s worth repeating. You will probably find the hot water makes you skin itch.  I slap on a good cream mask such as Antipodes Aura Manuka Honey Mask.  The heat helps this penetrate, so you are having a skin treatment as well as exercise, and this does wonders for your face!

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