Post Covid-19, hydrotherapy treatment could be the way back to fitness

As long as cost-conscious NHS Trusts don’t close hospital pools as an easy way to save money.

Image result for acqua termale matheldaHydrotherapy at Casciana Terme, Italy

Exercising in hydro pools is beneficial for cancer survivors, those with muscular and neurological problems, long-term muscular weakness after Covid-19, polio, lymphoedemia, osteoporosis,  arthritis and many other conditions.  
Sadly, UK hospitals often close their pools in cost-cutting exercises, unlike  Europe where patients are prescribed hydrotherapy exercise as an effective, fun and efficient way of aiding recovery.

In the UK we seem almost scared of using hydrotherapy, 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 drug-compromised skins we MUST protect them: I use 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!

Hunt the NHS pools

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!

Currenrly pools are closed during lockdown, but numerous studies prove it should be easy to operate them safely once life gets back to normal.

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 thermal 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!  At 8 am I joined a session for local OAPs with osteoporosis, and it was heaving with about 20 happy pensioners splashing around.

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

Where to find Hydrotherapy

Now that some NHS hospitals are thinking of closing their pools to save money, hospitals often ‘hide’ theirs;  in one major London hospital my Consultant said she had heard there was a pool in her hospital, but didn’t know where – did I? !!!   Another London hospital is always changing its mind – sometimes their pool is open, and sometimes not, depending upon their funding.

Pools can range from basic with few 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.  The best one I have found is the NHS one at the Nuffield Centre in Oxford.  Yet this is frequently empty, as patients are limited to a few sessions, then that’s your lot.  Meanwhile, this pool floats on, empty of patients.


Prices vary

  • from free NHS sessions for a limited time
  • up to £95 for 30 mins. in the most expensive private pools

So ask around.  I found best for me were those that offer half-hour sessions in a pool supervised by a physio.  You can get sessions with no physio present, but I find having someone watching you do the exercises is reassuring.

Initially the NHS will usually offer you  4 – 6 sessions for free – then if you are lucky you can pay (£3 – £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 £3 – £20) where you share a pool with other patients might be more suitable.

N.B. Ask If Towels are supplied, a big consideration when I can’t carry a heavy load, and make sure showers have correctly-placed grab rails (you would be surprised there are some that don’t!)

There are private health and fitness clubs, many of whom offer Aqua Aerobics.  However, check 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 seen by a bright young doctor, who mentioned Paolo Zamboni’s research into aqua aerobics, describing the benefits for those of us with this condition.  He promised to send over the paper, and when it arrived, I realised I had had one of Zamboni’s aqua aerobics classes when I was treated at Casciana Terme (above).

Zamboni and others 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 springs 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!)

Here, 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);  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 – and teeming from 8 am to 10 pm.  France has its share of hydro pools too, and I once turned up at one near Annecy to find it was full of muscular young men training for the Tour de France!

At the Circle Hospital in Reading there is a variant: an aqua treadmill.  This has glass sides, and my physio was able to take a video of my legs showing how jets of water were forcing the lymph glands to clear fluid. A Hydro Treadmill provides the benefits of treadmill exercise, but you are held up by the water, so no problems about falling over.

Why does hydro exercise work for lymphoedema?

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 hydro 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.

During lockdown they have been able to continue with training!

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.

For exercise, small can be beautiful;  although it is fun to swim up and down, for suitable exercise you just need enough space to stand in the water and swoosh your arms around.

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

Outside London, ASK – and be prepared to ask again.  Pools are available all over the UK.

So go and enjoy – and theoretically you don’t need to be able to swim, although I do prefer to know I can if necessary, as backstroke is particularly effective for helping relieve back pain.