1. What is Concussion?
2. How Long Does a Concussion Last?
3. Concussion Signs and Symptoms
4. What are the Physical Signs of a Concussion?
5. How Harmful is a Concussion?
6. What are the 3 Stages of a Concussion?
7. How Long is Concussion Recovery?
8. How to Speed up Concussion Recovery?
9. Conclusion
10. References

Concussions are a significant concern in sport, affecting athletes of all levels. Understanding the intricacies of concussions, from causes and symptoms to treatment and recovery, is crucial for athletes, coaches, and medical professionals. 

What is Concussion?

A concussion is a type of mild traumatic brain injury (TBI) that occurs when a non-penetrating head trauma, such as a blow to the head, or acceleration/deceleration forces, lead to a sudden jolt or shake of the brain. Subsequently, this causes temporary disruption of normal brain function [1]. It is classified as a brain injury that does not typically involve structural damage, such as bleeding or swelling, but instead can alter the brain’s chemical balance, disrupt cellular functioning and cause metabolic changes [2]. Concussions are common in contact sports like Football, Rugby, American Football, Boxing and MMA but can also occur in non-contact sports and everyday activities.

How Long Does a Concussion Last?

The duration of a concussion varies depending on the severity of the injury and the individual’s health. Generally, most symptoms of a concussion resolve within 7 to 14 days; however, some individuals may experience prolonged symptoms of more than 28 days [3].

Increased recovery time has been associated with a history of previous concussions. 30 % of collegiate football players with more than 3 concussions experienced symptoms lasting over 1 week compared with 14.6 % of those with 1 previous concussion [3]. Adults who reported higher scores on the Post-Concussion Symptom Scale (PCSS) (42.5 vs 19.2, p <0.01) and had a greater number of symptoms (13.9 vs 8.9, p = 0.008) had an increased likelihood of suffering concussion symptoms for more than 28 days [4]. 

Paediatric patients aged 10 to 17 years old demonstrated a median recovery length of 17 days. Similar to the adult population, higher symptom scores were associated with prolonged symptom effects. Furthermore, patients with more than 2 previous incidences of concussion also experienced an increased recovery time. Interestingly, females were at greater risk of prolonged recovery than males (odds ratio = 2.08, 95 % confidence interval = 1.49-2.89) [5].

Concussion Signs and Symptoms

Symptoms of Concussion

Concussions manifest through various symptoms that can be categorised into physical, cognitive and emotional/behavioural domains. General symptoms immediately following an injury include headache, dizziness and mental disturbance. These include mental clouding, general confusion or the feeling of being slowed down. Over the next 24 hours, further symptoms can manifest, including nausea, inhibited balance, visual disturbance, confusion, memory loss and fatigue [6]. As time progresses, additional symptoms, including tiredness, irritability, nervousness, anxiety, sleep disturbance and sensitivity to light or even noise, have been reported [7]. It is important to consider that not all symptoms are present in each concussion case; furthermore, athletes with a history of previous concussions display a more varied presentation of symptoms [8].

Do symptoms vary depending on age/gender?

Male and female high school and collegiate athletes experienced different outcomes following a concussion. High school athletes performed worse on both verbal and visual memory tests after a concussion. Furthermore, female athletes performed worse than their male counterparts on visual memory and reported greater post-concussion symptoms [9]. 

Concussion Causes

Concussions can be caused by any significant impact to the head or body. The rapid acceleration and deceleration of the brain within the skull are what leads to a concussion [1]. A study of more than 2000 athletes across 27 high school sports indicated that 62.8 % of concussions were caused by player contact. Player contact also accounted for a larger proportion of concussions in males compared to females (59.1 % versus 39.8 %). Equipment contact was the second largest mechanism of injury, with 66.8 % of these concussions coming from contact with the ball. American Football had the highest overall rates of concussion with 9.21 per 10,000 athlete exposures (AE,) which is significantly higher than a rate of 3.89 per 10,000 AE across all high school sports. The rate of concussion increased during competition for most sports, with 19.87 per 10,000 AE. Interestingly, concussion rates were higher in females vs males in sex-comparable sports [10].  

What are the Physical Signs of a Concussion?

As a coach, athlete, official, or spectator, identifying a concussion promptly is critical to ensuring swift treatment and recovery. The Sport Concussion Assessment Tool, 3^rd Edition (SCAT3) is a standardised tool used by medical professionals to evaluate concussions in athletes and can be used for athletes 13 years and older. Furthermore, pre-season SCAT3 baseline testing is often utilised by professional clubs and organisations to aid the interpretation of post-injury scores. In a study of concussions in Ice Hockey [11], they investigated the prevalence of five on-field signs of a concussion using the SCAT3.

1. Disorientation (68 %)
2. Postural Instability (44 %)
3. Vacant Look (41 %)
4. Amnesia (27 %)
5. Loss of Consciousness (24 %)

Additionally, almost two-thirds of subjects displayed more than one on-field sign of concussion. Despite being the most common on-field sign, disorientation was not associated with cognitive defects. Other signs of concussion include emotional liability, which is often displayed through behaviours such as uncontrollable or inappropriate laughing or crying [8]. 

How Harmful is a Concussion?

As previously discussed, most symptoms of a concussion resolve within 7 to 14 days; however, some individuals may experience prolonged symptoms of more than 28 days, particularly individuals with a history of previous concussion [3]. 

It has been hypothesised that repetitive neurotrauma sustained in boxing is associated with chronic brain damage. This has been described as having a neurological syndrome referred to as ‘punch drunk syndrome’, traumatic encephalopathy, dementia pugilistica, chronic traumatic encephalopathy (CTE) and chronic progressive traumatic encephalopathy. In brief, repetitive head injuries can cause long-term cognitive and emotional difficulties for the athlete [12].

In recent years, there has been much publicity around the long-term effects of heading in Football. According to research [13], former professional footballers are 3.5 times more likely to suffer from dementia than people of the same age range in the general population. Further research [14] found that neurodegenerative disease varies by position and length of career but is not impacted by which decade players competed.  Although footballers have a greater risk of experiencing neurodegenerative disease, it is important to consider there are wider physical and psychological health benefits to playing football.

This research led to The Football Association’s decision to adopt the International Football Association Board trial to remove deliberate heading in grassroots football matches at U12 and below. 

What are the 3 Stages of a Concussion?

Understanding the three stages of concussion can help in managing and monitoring recovery:

Acute Phase

The acute phase is typically the first 24 to 72 hours following a concussion, where symptoms are most pronounced. As previously highlighted, symptoms include headache, dizziness and mental disturbance. As time progresses, further symptoms include nausea, inhibited balance, visual disturbance, confusion, memory loss and fatigue [6]. Prompt recognition of a concussion and appropriate management are crucial to facilitate recovery. 

Recommended management during the acute phase includes immediate removal from activity and physical and cognitive rest. Light physical activity, such as walking, can be reintroduced within the acute phase, providing it does not exacerbate symptoms [15]. Furthermore, continuous monitoring during the acute phase is essential. 

Subacute Phase

The subacute phase is the period that commences immediately following the acute phase and typically lasts around 3-weeks [16]. This phase is characterised by an ongoing recovery process that may not be immediately evident through standard clinical assessments. Specifically, concussed individuals may exhibit decreased activation in the right hemisphere attentional networks shortly after injury, followed by improved activation in these areas as recovery progresses. Subsequently, symptoms often begin to improve for the individual; however, as the brain is still vulnerable, a gradual reintroduction to physical and cognitive activity is important. 

Chronic Phase

The chronic phase of a concussion refers to the period extending beyond the initial weeks following the injury, during which some individuals continue to experience persistent symptoms and cognitive deficits. While many recover within a few weeks, some patients may develop prolonged issues, often termed post-concussion syndrome (PCS) [17].

PCS is characterised by the persistence of concussion-related symptoms beyond three months post-injury. These symptoms can include headaches, dizziness, fatigue, irritability, anxiety, insomnia, and difficulties with concentration and memory. Studies have shown that individuals with PCS may exhibit cognitive deficits, particularly in attention, working memory, and verbal learning, even years after the initial injury. For instance, research indicates that patients assessed between three months to five years post-injury demonstrated reduced cognitive efficiency and increased fatigability, impacting their daily functioning [17].

How Long is Concussion Recovery?

Concussion recovery duration varies among individuals and is influenced by factors such as age, sex, injury severity, and pre-existing medical conditions. While many individuals recover within a few weeks, some may experience symptoms for several months or longer.

General Recovery Timeline

Adults – Research indicates that adults typically recover from a concussion within 14 to 30 days. A systematic review and meta-analysis found that collegiate athletes reported symptom resolution in approximately 6 days, with cognitive recovery occurring around 5 days post-injury [18].

Adolescents and Children – Younger individuals often require more time to recover. High school athletes, for instance, reported symptom recovery at an average of 15 days, with cognitive recovery around 7 days post-injury [18]. 

Factors Influencing Recovery

Age – Older adults may experience prolonged recovery periods. The Toronto Concussion Study observed that participants over 35 years of age took longer to recover compared to younger individuals [19]. 

Sex – Females have been found to experience more severe initial symptoms and longer recovery durations than males [19]. 

Pre-existing Conditions – A history of migraines is associated with extended recovery times. However, pre-existing psychological conditions, such as anxiety or depression, were not directly linked to prolonged recovery in the same study [19].

How to Speed Up Concussion Recovery?

Accelerating concussion recovery involves a combination of early, appropriate interventions and personalised management strategies. Emerging research highlights several approaches that may facilitate a more rapid and effective recovery:

Early Introduction of Controlled Aerobic Exercise

Recent studies suggest that introducing controlled, sub-symptom threshold aerobic exercise can expedite recovery. A randomised clinical trial demonstrated that adolescents and young adults engaging in early, monitored aerobic exercise experienced faster symptom resolution and returned to normal activities approximately four days sooner than those who performed stretching exercises. The exercise regimen involved activities such as walking or stationary cycling at intensities below the threshold that would exacerbate symptoms [20]. 

Phased Return to Play

Implementing a structured reintroduction physical activity is beneficial. The Consensus Statement on Concussion in Sport recommends a phased return-to-play protocol, which involves progressively increasing exercise intensity and complexity, ensuring that each stage is symptom-free before advancing.

Nutritional Support

Adequate nutrition supports brain healing. Research suggests that certain nutrients, including omega-3 fatty acids and antioxidants, may play a role in brain recovery post-concussion [20].

Sleep Management

Quality sleep is essential for recovery. A study highlighted that sleep disturbances are common after a concussion and can impede recovery, underscoring the need for effective sleep management strategies [20].

Individualised Management

Recovery trajectories can vary based on factors such as age, sex, injury severity, and pre-existing conditions. Personalised treatment plans that consider these factors are crucial. Collaborating with healthcare professionals experienced in concussion management ensures that interventions are tailored to the individual’s needs, optimising recovery outcomes [19].

Conclusion

Concussion management is a critical aspect of sports medicine, given its impact on athletes’ health and performance. While most individuals recover within a few weeks, factors such as age, sex, and injury history can influence recovery duration. Understanding the three stages of concussion helps in implementing appropriate treatment strategies. Emerging research supports early controlled exercise, nutritional support, and individualised management to optimise recovery. With increasing awareness and evolving guidelines, sports organisations and medical professionals continue to refine concussion protocols to enhance player safety and long-term well-being, ensuring a balance between athletic participation and brain health.

The post Concussion Recovery in Sport: A Comprehensive Guide appeared first on Science for Sport.

1. What is Hydrotherapy?
2. What are the Benefits of Hydrotherapy?
3. Hydrotherapy for Recovery
4. Hydrotherapy for Rehabilitation
5. Does Hydrotherapy Work?
6. Conclusion

Hydrotherapy, derived from the Greek words “hydro” (water) and “therapeia” (healing), refers to the therapeutic use of water to treat various physical and mental health conditions. Hydrotherapy encompasses a range of treatments, including hydrotherapy massage, hydrotherapy pools, and hydrotherapy exercises, each utilising the properties of water to promote health and well-being.

What is Hydrotherapy?

Hydrotherapy is defined as the external or internal use of water in any form (liquid, steam, or ice) for health purposes such as pain relief, improved circulation, muscle relaxation, improved mobility, reduced stress, improved sleep quality, and fatigue reduction. It involves methods like thermotherapy, cryotherapy, contrast water therapy and thermoneutral therapy (1). Furthermore, aquatic exercise and underwater massage can be used with these methods.

Cryotherapy

Cryotherapy refers to the treatment of injury using extreme cold such as icepacks, or liquid nitrogen, and also includes cold water immersion (CWI) whereby subjects are immersed in cold water < 15 °C. A wide variety of techniques have been used to implement CWI including ice baths, ice bins, and plunge pools (1). More recently, portable ice bathtubs have become a popular and affordable alternative. An immersion duration of between 15-20 minutes has been suggested in research, however, the duration could be as low as 30 seconds due to individual tolerance to cold temperatures (1).

Thermotherapy

Thermotherapy, or hot water immersion (HWI) refers to immersion in warm water > 36 °C to increase core body temperature. This can be implemented using heated baths, spas and pools. An immersion duration of between 10-20 minutes has been suggested in research (1). 

Contrast Water Therapy

Contrast water therapy (CWT) refers to alternating between hot and cold temperatures. For example, an athlete may go from an ice bath to a hot shower. Protocols have varied widely, but often consist of 30-300 seconds at a hot temperature, followed by 30-300 seconds at a cold temperature. This is repeated between 3-7 times and lasts between 4-30 minutes (1).

Thermoneutral Therapy

Thermoneutral therapy is the simplest form of hydrotherapy to apply as temperatures typically range between 16-35°C. Immersion time ranges from between 5 minutes and 6 hours (1).

What are the Benefits of Hydrotherapy?

The benefits of hydrotherapy are multifaceted, encompassing both physical and psychological aspects of health and performance.

Physical Benefits

Reduced Muscle Soreness

CWI, HWI and CWT improved the recovery of maximal isometric squat force compared to a passive recovery group at 24, 48, and 72 hours following an eccentric leg press post-fatigue protocol. The hydrostatic pressure caused by water immersion is believed to displace fluids from the periphery to the central cavity. This causes physiological changes including increased substrate transport, cardiac output and a reduction in peripheral resistance. These changes may increase the removal of waste products, possibly enhancing recovery from exercise-induced muscle soreness. However, only CWI and contrast water therapy enhanced the recovery of squat jump power and post-exercise swelling. This demonstrates that water temperature also appears to affect recovery using hydrotherapy (2).

Improved Strength

Foley et al. (2003) investigated the effects of a 6-week intervention comprising three 30-minute thermoneutral water or gym-based training sessions per week on the strength and function of osteoarthritis patients (3). The same progressive loading strategy was utilised for both water and gym-based interventions. Both interventions successfully improved the physical function and strength of participants, however, gym-based sessions were more effective in improving the muscular strength of the quadriceps. Increased muscle strength around affected joints can improve shock absorption capacity and joint stability. Water resistance can therefore improve physical function and muscular strength without the load associated with land-based weight-bearing physical activity. 

Injury Rehabilitation

Mixed-level athletes suffering from femoroacetabular impingement underwent a hip arthroscopy as they were unable to perform their sport due to debilitating pain and restricted range of movement. Following surgery, the athletes were allocated to a control group comprised of land-based exercises or a hydrotherapy group including thermoneutral water and land-based exercises. The same progression principles and exercises were employed, regardless of group. The hydrotherapy group returned to play at 15 weeks, while the control group took 22.3 weeks, demonstrating an improved return. Furthermore, the athletes’ hip-specific scores and patient satisfaction scores improved considerably, suggesting that hydrotherapy is beneficial in post-operative injury rehabilitation (4).

Pain Relief

A 6-week intervention of one 30-minute thermoneutral hydrotherapy exercise session demonstrated a greater improvement in the Numeric Pain Rating  Scale ( NRPS) when compared with land-based exercises of the same volume and frequency. The hydrotherapy group demonstrated the maximum response compared to the land-based group. However, both interventions elicited a greater improvement in pain compared to the control group. This demonstrates that hydrotherapy offers a non-invasive, drug-free treatment option that can reduce pain and improve quality of life. The reduction in gravitational force allows for easier movement and pain reduction during exercise and therapy sessions (5).

Psychological Benefits

Reduced Anxiety 

Benfield et al. (2001) reviewed the use of hydrotherapy to decrease anxiety and pain during labour. The mean water temperature of the studies was 36 °C, however, temperature varied from 32-42°C (6). After bathing for 15 minutes the anxiety scores of all women in the hydrotherapy group decreased, whereas only 43 % reported a decrease in the control group. Furthermore, the hydrotherapy group demonstrated a mean decrease in anxiety, whereas the control group increased. This anxiety reduction is believed to increase relaxation, which is particularly beneficial during the physiological and psychological effects of labour. Therefore, during labour, immersion in warm water is hypothesised to decrease the production of stress-related hormones such as cortisol, whilst increasing the release of endorphins, which are natural mood enhancers.

Improved Sleep Quality

Patients with fibromyalgia completed a 2-month intervention consisting of 2 x 60-minute hydrotherapy sessions per week in a 32 °C pool. On completion of the intervention, patients reported an improvement in perceived physical function, work absenteeism, pain intensity, fatigue, morning tiredness, stiffness, anxiety, depression, sleep quality and daytime sleepiness. With regards to sleep quality, the Pittsburgh Quality Sleep Index (PSQI) was used to detect sleep disorders in the month leading up to the study. Prior to the intervention sleep disruption was scored at 39.5. Upon conclusion, 80 % of patients reported an improvement in sleep quality, with a mean reduction to a score of 33. It is stipulated that the physiological effects of hydrotherapy originate from the combination of the physical effects of water (thermal/mechanical) and exercise (7).

Improved General Health

A hot spring balneotherapy intervention was used for 30 minutes, 2-3 times per week for 5 months with 326 participants classified as ‘sub-healthy’ at two separate springs. The balenotherapy group bathed in a head-out immersion bath with naturally warm water (36-42 °C) mineral water. The research concluded that balenotherapy improved a range of factors including mental stress, women’s health problems, sleep quality and general health. Interestingly, despite mental stress being significantly relieved, bad/low mood, worry and irritability were not relieved. Symptoms of head pain, joint pain, leg or foot cramps and blurred vision were significantly relieved in the intervention group. 

Further analysis also revealed that increased bathing time increased relief and participants in the senior group (56-65 years old) had greater relief from insomnia, fatigue or cramps. Women’s health problems including breast pain, dysmenorrhea and irregular menstruation were significantly relieved in the intervention group possibly because of the thermal effects of spring water can regulate metabolism and blood circulation and metaboric acid can regulate the endocrine system (8).

Hydrotherapy for Recovery

Hydrotherapy has been found to improve the recovery of maximal force, power and swelling 24, 48 and 72 hours post-fatigue protocol (2). This could be particularly beneficial for athletes with short turnaround times between competitive fixtures. Examples include international football tournaments, tennis tournaments, basketball and baseball. 

Twelve cyclists completed five consecutive days of cycling consisting of 105 minutes, including 66 maximal sprints. They then completed a 14-minute recovery intervention consisting of either CWI, HWI, CWT or passive recovery. Sprint and time trial performance were enhanced across the five day period following a CWI and CWT recovery when compared with HWI and passive recovery. CWI and CWT appear to improve recovery from high-intensity cycling and therefore allow maintenance of performance across a five day period (9). 

However, a systematic review investigating the use of CWI post-resistance training stated that less muscle growth was achieved compared to no post-exercise immersion (10). Therefore, it should be considered whether recovery or adaptation is the goal post-exercise.

Hydrotherapy Massage

Hydrotherapy massage involves heated water and mechanical pressure provided by jets or manual manipulation to massage the body. This type of therapy is typically performed in specially designed tubs, hydrotherapy pools, whirlpool baths, and hydromassage tables.

WATSU

WATSU is a passive form of hydrotherapy in chest-deep thermoneutral water (35 °C) combining myofascial stretching, joint mobilisation, massage and shiatsu. A therapist stands in the water, supporting the supine patient with their upper body, slowly moving the patient in circular motion sequences. Simultaneously, the therapist uses their hands to stimulate acupuncture points (11).  

In a systematic review, it was reported that WATSU was predominantly used as an intervention for pain, physical function and mental health with chronic conditions such as fibromyalgia, asthma, neurological conditions and geriatric care. The meta-analyses concluded that WATSU had a beneficial effect on acute and chronic pain, however, this was not statistically significant. Similarly, the analysis concluded that WASTU indicated beneficial mental effects but was not statistically significant. Interestingly, WATSU appears to have moderate effects on physical function, linking to lower muscular tone and stiffness, translating to fewer muscle spasms and increased range of motion (12). 

Hydrotherapy for Rehabilitation

Hydrotherapy has been found to accelerate the return to play time of athletes following a hip arthroscopy. It is stipulated that the buoyancy of water reduces the impact on joints and muscles, making it ideal for individuals in the early stages of rehabilitation (4).

Eighteen male professional athletes who incurred a grade I or II acute ankle sprain began thermoneutral hydrotherapy with hydrogen-rich water (HRW) intervention or a standard RICE (rest, ice, compression, elevation) protocol 24 hours post-injury. The HRW group received 6 x 30-minute ankle baths every 4 hours during the intervention period. The RICE group offloaded the injured leg, administering ice packs for 8 x 20 minutes every 3 hours. HRW was equally as effective for reducing joint swelling and pain while regaining range of motion and balance 24 hours post-acute ankle sprain. Therefore, HRW could be applicable to athletes and healthcare professionals requiring an alternative strategy to reduce swelling and pain (13). Further investigation is required to identify the effectiveness of HRW on other upper and lower-limb injuries.

Patients with osteoarthritis of the knee were allocated into a land-based or thermoneutral water-based exercise group for an 18-week period. Both groups completed similar exercises, consisting of gait training and strengthening and stretching the muscles of the lower extremities 3 times per week for 50 minutes per session. A similar progressive volume-loading strategy was also used by both groups. Both land-based and water-based exercises reduced pain and improved function, showing that water-based exercises could be a suitable alternative to land-based exercises (14). 

Knee and hip implants with telemetric data transmission were used to measure the joint contact forces of twelve elderly participants completing thermoneutral aquatic and land-based exercises. In chest-high water, the buoyant force led to decreases of 65-68 % in body weight. Specifically, a reduction of 58 % was identified in the hip and 62 % in the knee during a one-legged stance. Furthermore, both higher movement velocity and increased water resistance led to an increase in joint forces. This indicates that aquatic exercises can be used for effective muscle activation. Furthermore, these joint forces and muscle activation can be manipulated through exercise selection, movement velocity and utilising additional resistive devices, proving a useful tool in rehabilitation (15).

Hydrotherapy Exercises

Hydrotherapy exercises, performed in water, help improve strength, flexibility, and balance. They are a viable option for individuals recovering from sprains, fractures, or post-surgical intervention. 

Throughout pregnancy, hydrotherapy exercises have also been found to help control heart rate and blood glucose levels, prevent excessive weight gain, and improve balance and mobility. These exercises can be adapted to suit individuals at different stages of recovery, rehabilitation or pregnancy (16). 

Walking or Jogging

Water walking or jogging is particularly beneficial for individuals recovering from lower limb injuries or surgeries. Additionally, it is an excellent method of reintroducing locomotion without the cost associated with equipment such as anti-gravity treadmills (14).

Water Squats

Water squats are performed by standing in the water at different depths, dependent upon the stage of rehabilitation. This exercise targets the lower body muscles and aims to improve strength and stability. The buoyancy of the water reduces the load on the lower limbs, making it easier for individuals with pain or injuries to perform (15).

Aqua Aerobics 

Aqua aerobics involves aerobic exercises performed in water, including jumping jacks, high knees, leg kicks, treading water and arm circles. These exercises can enhance cardiovascular fitness, strength and balance. Aqua aerobics is suitable for individuals of all fitness levels and ages (17,18).

Does Hydrotherapy Work?

There is still some speculation about the use of hydrotherapy for physical and psychological purposes. Furthermore, the method of hydrotherapy (thermotherapy, cryotherapy, contrast water therapy) applied will change the effect it has on an individual.

Cold Water Immersion (CWI)

CWI  has commonly been used to aid post-exercise recovery. A review including 27 studies measured the effects of various cryotherapy on delayed onset muscle soreness (DOMS). Analysis revealed that CWI significantly improves DOMS at 24, 48 and 96 hours post-exercise. It should be noted that CWI reduced DOMS more than cold air and ice packs. Furthermore, male participants responded better than female participants up to 48 hours (19). 

Thermotherapy

Despite its use in a physiotherapy setting, there is less research-based evidence to support thermotherapy. A review by Versey et al. (2013)  found that thermotherapy is unlikely to have a significant positive effect on the recovery of performance (20). However, studies have suggested there are a variety of psychological benefits to thermotherapy.

In labour, the anxiety of all women in hydrotherapy decreased, whereas only 43 % reported a decrease in the control group (6). A hot spring balneotherapy intervention improved a range of factors including mental stress, women’s health problems, sleep quality and general health (8).

Contrast Water Therapy

A review by Higgins et al. including 23 articles investigated the recovery effects of contrast water therapy with well-trained team sport athletes (21). Contrast water therapy did not enhance recovery of perceived muscle soreness 24 hours post-exercise; however, it appeared to reduce the detrimental effects of team sport on countermovement jump performance 24 hours post-exercise but had no additional benefit 48 hours post (21).

Thermoneutral Therapy

Hydrotherapy exercises completed in thermoneutral water have been used with individuals recovering from injury, surgical intervention or patients diagnosed with chronic conditions such as fibromyalgia (3). 

Although water-based exercise has been found to improve both physical function and strength, however, gym-based interventions have been more effective at improving the strength of osteoarthritis patients (3). Silva (2008) also found that hydrotherapy improved physical function and reduced pain similar to land-based exercises (14). Athletes recovering from femoroacetabular (hip) impingement returned to play at 15 weeks following a hydrotherapy intervention, while the control group took 22.3 weeks, demonstrating a significantly improved return to sport (4).

Patients with fibromyalgia reported an improvement in perceived physical function, work absenteeism, pain intensity, fatigue, morning tiredness, stiffness, anxiety, depression, sleep quality and daytime sleepiness (7).

Conclusion

Hydrotherapy offers a range of benefits, from physical and psychological improvements to aiding in recovery and rehabilitation. The method of hydrotherapy intervention seems to elicit different responses, therefore the individual’s goal should be considered before selecting a specific method. The therapeutic properties of water make it a versatile treatment option for various conditions. Whether used in clinical settings, sports facilities, or at home, evidence suggests hydrotherapy can enhance health and well-being. As research continues to investigate its efficacy, hydrotherapy remains a valuable tool in the arsenal of modern therapeutic practices.

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