Paediatric Hydrotherapy: Guide to Aquatic Therapy and Exercises for Children

17th February 2023

Many children need physical therapy for a wide variety of reasons, and hydrotherapy can be a good option too.

Paediatric physiotherapists provide a wide range of treatments for children according to their specific needs, and hydrotherapy can be used to treat many conditions.

In this guide, we look at what paediatric hydrotherapy is, the potential benefits and some common paediatric exercises.

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What Is Paediatric Hydrotherapy for Children?

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Paediatric hydrotherapy goes by several names, including paediatric aquatic therapy, paediatric pool therapy and paediatric water therapy.

It is similar to standard physical therapy on land, but the exercises are carried out in the water. It helps children develop strength, enhance flexibility, improve balance and increase endurance.

It is a specific type of physiotherapy that uses the natural buoyancy of water along with the warmth of the water and the resistance it provides, which have several benefits when combined.

The buoyancy of the water reduces the weight of the body, so the children receiving treatment can move differently from how they move on land.

Moving in water creates more resistance to help develop strength in the muscles. In addition, warm water helps to relax muscles and has a massaging effect on the joints, which can help with circulation and reduce pain related to inflammation.

Finally, many kids love being in the water. Paediatric aquatic physical therapy is fun and engaging for children, which can help stimulate their recovery.

Who Can Benefit?

Paediatric hydrotherapy can help children with a wide range of issues. For example, it is often used to assist children with conditions including cerebral palsy, Down’s syndrome, Freiberg’s disease, spina bifida, juvenile arthritis and muscular dystrophy.

It can also be used to treat more general problems, including injuries or helping with pain when recovering from surgery.

Key Benefits of Paediatric Hydrotherapy

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Hydrotherapy has several health benefits, and paediatric aquatic physical therapy can help children suffering from a wide range of conditions in many ways.

Increase Strength

Paediatric hydrotherapy can help to increase muscle strength, which is particularly useful for children who have suffered an injury like a broken arm or leg.

When a child cannot move their joints properly due to swelling or a lack of muscle strength, the combination of warm water along with the water buoyancy can make it easier to move affected joints and strengthen the muscles.

Improve Balance

Children with balance problems may be unable to carry out specific movements on land, like standing up from sitting.

But with the help of specific hydrotherapy exercises, they can improve their balance and coordination in the water and transfer this to land.

Improve Mobility

Children with conditions like cerebral palsy may need help to reach specific milestones like crawling and walking. Hydrotherapy can help them with their mobility and balance, assisting them as they learn to walk in the water, which then makes it easier to do on land.

Develop Social Skills

Helping to improve the child’s motor skills in the water can also boost their confidence and help to reduce social anxiety.

Doing exercises, playing games in the water, and enjoying more social interaction, can be an effective way to help them overcome anxiety.

It’s Fun

Many kids simply enjoy being in the water, so the exercises become fun rather than a chore. The setting feels more recreational and less intimidating, which may be more suitable for some children.

In addition, it can help to improve their confidence in the water and lead to better water safety, as well as simply improve their overall fitness levels.

Paediatric Aquatic Exercises for Children

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It’s important to keep in mind that you shouldn’t race into doing exercises on your own. While you may be able to do hydrotherapy in your own pool or hot tub, it’s better to start by speaking with a professional.

You may get referred to a physiotherapist by your doctor. They will then carry out an assessment of your child, taking into account many factors, including your child’s condition and whether they are suitable for hydrotherapy.

Paediatric aquatic exercises can focus on balance, range of movement, strength-building, mobility, relaxation, core stability, stretching and more, and they often focus on a combination of these.

Up and Down Stairs

One simple paediatric water therapy exercise is to practise walking up and down the stairs leading into the pool. This can help children who struggle with steps, perhaps due to balance or pain issues.

The child can start by holding onto the railing and walking up the stairs slowly, perhaps with support from the adult. Over time, they can progress to doing it alone.

The idea of this is to improve their confidence and abilities so they can get up and down stairs on land.


Walking through the water can be a highly effective way to work on balance skills and moving the body, and working on mobility.

The child could use a noodle to rest on, which keeps them standing and provides support. You can also support them as needed until they no longer need it.


Jumping is a simple and effective exercise that helps increase strength in the legs. It can be done by jumping from the side of the pool into the water or while standing on the floor of the pool.


Child exercising with parents in a hot tub

Relaxation techniques are a popular part of paediatric hydrotherapy. One of the simplest involves floating on their back with the aid of floats. For example, you could use noodles under their knees, back and head, so they stay afloat in comfort.

Hold them along their trunk, and move them from side to side gently to help relax them.


This is another good leg-strengthening exercise. Hold the child while they are floating on their back, and place their feet at the side of the pool. They then bend their knees, countdown to the blast-off, and push out from the edge.

This is only suitable in larger pools rather than smaller hot tubs.

Sitting on Float

Get a float and a ring, and sit the child on the float inside the ring. Provide support for them as needed, and practise their sitting balance. You can also do this by straddling a noodle.

Sitting up and trying to balance helps develop core strength. As they get better, you can start gently bouncing them and rocking them to increase the challenge.

Standing on One Leg

This is a simple balancing exercise that also helps develop leg strength. Start by standing on both legs, then balancing on one leg. Hold the balance, then switch sides.

Start in deeper water to make it easier, then progress to shallower water. You can also play catch with a ball to increase the challenge.


There are lots of variations of these exercises. For example, you can incorporate leg lifts and twists or arm raises depending on the part of the body you are focusing on and what the problem is that you are trying to rectify.

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Ask Your Doctor About Paediatric Hydrotherapy

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Paediatric pool therapy can be highly effective for children in many situations, whether they have a specific condition, have been in an accident, or are in pain. It is a fun and safe way to provide therapy, and the results can be excellent.

If you are interested in paediatric hydrotherapy, start by talking with your doctor or physiotherapist. Get some sessions with an experienced physio to start with. They may later suggest that you continue with the exercises on your own, perhaps in your own hot tub or swim spa.

You can then help your child to develop their muscle strength, work on mobility and balance, and have a lot of fun too.