Turn Up the Heat, Turn Down the Pain

November 1, 2013, Department, by Carrie Madren

Pools such as Fountain View offer a unique place for people with injuries or who need physical therapy to safely move and build strength.For thousands of years, people across the globe have turned to warm water for healing and restoration. From Roman, Greek and Turkish baths to hot springs around the world, warm water has soothed aches and pains as well as maintained good health.

In modern days, warm-water pools are regular venues for aquatic therapy — a type of physical therapy that helps people regain mobility and comfort. In warm-water pools, temperatures range from 88 to 94 degrees Fahrenheit to help relax muscles, relieve pain, increase blood flow and boost flexibility. In addition, water’s natural buoyancy eases the burden on joints, making it easier to exercise. 

 Warm-water therapy pools can especially help people recovering from injuries such as fractures, as well as those suffering from chronic conditions such as arthritis, fibromyalgia, advanced osteoporosis, back pain, obesity, muscle spasms and other problems.

As more people experience the benefits of using warm pools, the number of warm-water therapy pools around the U.S. has likely doubled in the last decade or so, according to Ryan Nachreiner of Water Technology Inc., which designs warm-water pools and other aquatic facilities.

As baby boomers age, Nachreiner continues, we can expect to see even more warm-water pools in recreation centers, YMCAs and health clubs.

Relief at Hand

Entering a warm-water pool is more like gliding into a bathtub than plunging into a cold lap pool. 

“In cold water, you tense up, but when the water’s warm, you’re comfortable and your muscles loosen up,” says Gina Gagliardi, a fitness instructor at Fountain View Fitness Center in the Carol Stream Park District in Carol Stream, Illinois. The center opened this summer and has a 24,000-gallon, 47-by-27-foot warm-water therapy pool that stays between 87 and 90 degrees Fahrenheit and ranges from two to five feet deep.

Pools such as Fountain View offer a unique place for people with injuries or who need physical therapy to safely move and build strength. In many cases, people with chronic conditions or injuries can’t safely exercise on land because of stress to their joints, muscles or spine. The warmth of the water helps reduce joint pain and warms muscles up — all of which means greater range of motion, improved muscle tone and increased overall flexibility. 

Though warm-water pools alleviate a range of conditions, many people with arthritis in particular use the pools regularly, and there’s even an Arthritis Foundation Aquatic Program offered around the country. 

Arthritis causes swelling and inflammation within the joints, explains Patience White, vice president of public health policy and advocacy for the Arthritis Foundation and professor of medicine and pediatrics at the George Washington University School of Medicine and Health Sciences. With that kind of swelling, the muscles surrounding the joints have a sort of spasm, tighten up and ache. To relieve the pain, “you want to get that joint moving,” White says, and break the vicious cycle of pain leading to inactivity. 

Submersion in water — in combination with medications that relax muscles — helps unload the joint from gravity’s force as the warmth relaxes the muscles further.

Water of any temperature, in fact, offers buoyancy that helps support the body, takes pressure off of joints and makes exercises — like leg lifts — easier. Water also provides a natural resistance that helps tone muscles. 

In addition, hydrostatic pressure — water’s pressure from all directions on the body — helps support joints and reduces swelling. 

Full Health Benefits

Once in the water, people can get moving to obtain the most health benefits. Common exercises for warm-water therapy include gentle aerobics, Ai-Chi exercises (which focus on breathing techniques, stretching and relaxation), aqua yoga, water movement for arthritis and more. Some classes use water weights, bands and foam noodles to create resistance for shoulders and arms as well as the core and legs. 

“The warm water allows you to move in ways that it would not be possible to move on land,” says Susan Quash-Mah, a nonprofit manager/consultant at Tamarack Aquatic Center in Eugene, Oregon. Tamarack’s 50,000-gallon, 30-by-50-foot warm-water pool opened in the late 1970s, but it was converted to a saltwater pool about five years ago. In addition to making the pool more ecologically sound by not requiring large amounts of chlorine, the change to saltwater makes it easier on people with chlorine sensitivities or allergies. “Also, the saline is just about the same level as in natural body fluids,” she explains, meaning swimmers won’t experience a burning sensation if they open their eyes underwater. 

A saltwater conversion is just one feature that can make warm-water pools stand out. These pools typically have alternative ways to ease into the pool other than a traditional ladder, which requires swimmers to put pressure on joints. Many have ramps leading into the water; others have special stairs, wheelchair lifts or other entry assistance. Additionally, since pools are typically three and a half to five feet deep, individuals can usually walk through the water without swimming.

Healing Waters

“Usually people experience relief immediately on their first visit,” says Quash-Mah, if they don’t overdo it. 

Gagliardi notices a difference in her students from the beginning of class to the end. “When they first get in, they’re a little hesitant, and then as the class goes on, they’re relaxed and using the weights,” she says. 

To experience extended relief even out of the pool, people should submerge themselves two to three times a week, says Quash-Mah, who points to a study of people with fibromyalgia who used warm-water pools for eight months and experienced a reduction in pain and increased functionality. 

Quash-Mah herself has had fibromyalgia — a disorder that causes muscle pain, extreme tenderness in certain points and fatigue — for more than seven years and reports that it was between four and eight weeks of warm-water classes when she began to notice increased flexibility, reduced pain, improved stamina, relaxation and a better mood. She still takes a warm-water class about two or three times a week.

“Exercises are important,” White says. “When you get better and muscles get stronger, slowly but surely, that will translate onto land without the water.”

Carrie Madren is a freelance writer in northern Virginia.