Aqua Therapy and Biokinetics

Fish & Field Biokineticists practicing Aqua Therapy techniques wearing floating device at Off Nicol in Bryanston in Johannesburg

We might be a bit biased when it comes to this form of therapy, but Fish and Field Biokineticists are firm believers in the benefits that aqua therapy holds for so many.  Whether you are recovering from back surgery, suffer a chronic illness or experience high pain levels, the water is the perfect place to start on your road to recovery.

The History of Aqua Therapy

Firstly, let’s have a look at how aqua therapy came about.  Aqua therapy, for the purpose of therapeutic and healing benefits, can be back dated as far as 2400 B.C with ancient Egyptian, Assyrian and Mohammadan cultures being some of the first to record such practises.  Through observation and trial and error over centuries, various healing traditions through water treatments have developed.

Dr Charles Leroy Lowman, the founder of the Orthopaedic Hospital in Los Angeles, made use of therapeutic tubs (the hospital’s lily pond was transformed into 2 therapeutic pools) to treat patients with cerebral palsy and other spastic conditions in 1911.  Dr Lowman was inspired after visiting Spaulding School for Crippled Children in Chicago, where they made use of wooden exercise tanks to treat patients who were paralyzed.    Leroy Hubbard developed a tank known as the Hubbard Tank, which launched the growth of modern aquatic therapy and the development of techniques such as Halliwick Concept and the Bad Ragaz Ring Method.  And it was during the 1930’s that a wealth of information, research and literature on spa therapy, pool treatment and aquatic exercise appeared in professional journals.

Different Aqua Therapy Techniques

There are many techniques that have been developed and are being used during aqua therapy sessions.  Some of these, and ones that we make use of in our practice, include:

Bad Ragaz

This method utilises floating rings to support the patient in a horizontal position in the water.  These rings are placed around the neck, arms, pelvis and legs.  In this position an aquatic therapist works one-on-one with their patient and guide them through specific patterns of movement and resistance. The aim is to enhance both active and passive range of motion through strengthening and mobilisation with the ultimate goal being to improve neuromuscular function.  Patients who can benefit from this method include orthopaedic, neurological as well as rheumatology conditions. 


Halliwick Concept is a technique that was developed to teach all people, particularly individuals with physical and/or learning disabilities, to engage in water activities, to move without any support in the water and to learn how to swim.  The concept is based on the physical properties of water for therapeutic interventions:

  • Turbulence, flow and resistance – Turbulence provide resistance, which results in one losing one’s balance slowly and in turn allows one time to react and learn motor control.
  • Buoyancy – Buoyancy allows for easy transition between positions, for example from floating on your back to standing up.  This influences the vestibular system and assists in sensory integration.
  • Buoyancy, gravity and rotation torque – Buoyancy forces counteract gravity forces which creates rotational forces (torque).  These forces can be used to increase the load on connective tissue (tendons, ligaments, etc.)

The aim of this technique is to improve postural control, normalise muscle stiffness and facilitate movement to achieve functional goals on land.


Watsu is a therapy used for deep relaxation and combines elements of muscle stretching, joint mobilisation, massage, Shiatsu and dance.  It can be defined as a one-on-one session in which the practitioner/therapist gently cradles, stretches and massages the receiver in chest-deep warm water.  Other than deep relaxation it also promotes quieting of the sympathetic nervous system (fight or flight response) and enhancing the parasympathetic nervous system (‘rest and digest’ function).  Physiological changes include reduced heart and respiration rates, increased respiration depth, and a decrease in muscle tone. 

The hydrostatic pressure enhances the function of the lymphatic system and helps to reduce swelling.  When used for orthopaedic rehabilitation, one can expect benefits such as decreased muscle spasm, reduced pain levels, improved soft tissue mobility and an increase in range of motion.  Individuals who can benefit from this form of therapy range from stroke victims, individuals suffering from fibromyalgia or even post-traumatic stress syndrome sufferers, to only mention a few.

Aqua Therapy and Biokinetics

Woman in water aqua therapy with Fish and Field Biokineticists offer pre and post-operative rehabilitation through aqua therapy technique Bad Ragaz in Bryanston, Johannesburg

So, why the combination of aqua therapy and biokinetics?  As described in one of our previous articles (Biokinetics – Everything you need to know) the word biokinetics is made up of 2 Greek words – ‘Bios’ which means ‘course of human life’ and ‘Kinetics’ meaning ‘to move’.  Put together, Biokinetics means Life through Movement.  We as Biokineticists’ primary function is to improve an individual’s quality of life through exercise and movement.  During our qualifications we study extensively the functions of the human body, what goes wrong and how to improve or fix that.  And therefore, we make use of all this knowledge that we have obtained and apply it to the water – allowing our clients the optimal environment if it is suited for their specific needs.  It allows them the freedom to move when they are restricted to a wheelchair, to learn how to walk again after being struck by an illness, be pain free when their back ache becomes unbearable and safely return to the sport that they love so much.


Bruce E Becker MD, MS, Aquatic Therapy: Scientific Foundations and Clinical Rehabilitation Applications.  CME [Internet].  2009 [Cited 2019 March 23]; 1(9): Available from:

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