Now offering Aquatic Therapy in Helena, MT

Have you had an injury and are wondering if you can do your rehab in the pool? See below for more details on aquatic therapy! 

Aquatic physical therapy (PT) is physical therapy done in a pool with a certified aquatic therapist. Aquatic physical therapy is also referred to as aquatic therapy, aquatic PT, pool therapy, pool PT, water therapy, or aquatic rehabilitation. No matter what you call it, aquatic therapy is an excellent complement to traditional physical therapy. Or all by itself. And, all ages and all fitness levels can benefit from it. You don’t even need to know how to swim. 

Aquatic Physical Therapy

What is aquatic physical therapy?

Aquatic therapy is the practice of physical therapy in the water to promote healing, movement, and wellness. It is unique from other types of therapy. The water unloads the body of some physical restraints that may otherwise prohibit certain types of movement. This allows our patients to improve movement and healing with less pain and difficulty. 

Our aquatic physical therapist evaluates each patient’s condition and customizes a water PT program that meets your specific needs and helps you achieve your goals. This may include improved strength, flexibility, endurance, or balance. All are possible with aquatic physical therapy. 

What are the benefits of aquatic physical therapy?

During aquatic therapy, the water helps to relax the body while improving blood flow. This allows patients with a variety of injuries or conditions to experience benefits that may otherwise not be possible with traditional physical therapy. Aquatic PT targets improving or maintaining:

  • Mobility, balance, and strength
  • Posture, gait, and movement
  • Flexibility, coordination, and agility
  • Decreasing pain
  • Aerobic capacity and endurance conditioning

Water-based PT provides many benefits due to some unique (and useful) properties of the water. Aquatic therapy principles include include buoyancy, viscosity, and hydrostatic pressure. 

When performing PT in a pool, the water provides patients with buoyancy or a sense of weightlessness. Buoyancy reduces stress on joints that may be painful when doing weight-bearing activities. This is particularly helpful for patients with arthritis. Buoyancy also helps make some movements easier which can be beneficial for patients struggling with movement disorders.

The resistance you feel when trying to move through the water is known as viscosity. This resistance can help to strengthen muscles. When combining resistance with buoyancy patients can more easily complete exercises. All with less pain while still gaining strength and function.

Lastly, the hydrostatic pressure in water produces forces perpendicular to the body. This pressure helps to decrease swelling and improve joint positioning. This is particularly helpful for patients who have suffered a joint injury or have arthritis.

How is aquatic physical therapy different from water aerobics or water exercise?

Aquatic PT is a one-on-one therapy session with a physical therapist who specializes in treating patients in the water. The physical therapist will evaluate your mobility and strength to provide you with specific aquatic exercises that will help to meet your physical therapy goals. Most insurance companies cover aquatic PT with the same coverage as they cover physical therapy. 

Water aerobics or water exercise takes place in a group setting. Additionally, it is not personalized to your specific mobility and strength goals. Water aerobics can be very beneficial for many of our patients in meeting their exercise goals, especially after graduating from physical therapy. Be sure to talk with your physical therapist before starting any new exercise program.

Are there any conditions that would limit me from participating in aquatic physical therapy?

Open wounds, seizure disorders, renal or heart failure, skin infections, incontinence, or other illnesses can limit you from participating in aquatic PT. We recommend discussing any special medical concerns you may have with our therapist. This allows us to address any concerns you may have and ensure that participation is safe and that you get the most out of your aquatic PT appointment. 

Do I need to know how to swim to participate in aquatic physical therapy?

No! Aquatic therapy can be done safely and successfully without knowing how to swim. We do many of the exercises in water that you can stand in or hold onto the wall as needed. Be sure to share your swimming level or any fear of water with your therapist. This will help us personalize each exercise to your ability level.

Injuries and Conditions That Benefit From Aquatic Physical Therapy

Our therapists use aquatic PT to treat several injuries or conditions including:

  • Low back pain including disc issues, sprains, or strains
  • Lower extremity injuries
  • Post-surgical conditions including back surgeries, total joint replacements, or hip/knee/ankle surgeries 
  • Injured runners
  • Chronic pain conditions
  • Arthritis including rheumatoid and osteoarthritis conditions
  • Movement disorders including Parkinson’s and spinal cord injuries
  • Fibromyalgia and other autoimmune disorders.


We customize our aquatic PT exercises to account for age-related or physical limitations. This makes it safe and effective for both adults and children. For children, aquatic PT can help to improve motor skills, coordination, and balance in children with autism, cerebral palsy, and other developmental delays.

What will I need to bring for Aquatic Physical Therapy?

You will need to bring a swimming suit or water clothing, a towel, water shoes or sandals for the pool deck, and a water bottle or snack if needed. All participants will have access to a changing room and bathroom to shower before and after their therapy session. 

Meet Our Aquatic Physical Therapist

Dr. Margaret Koenig, DPT

I have been an aquatic therapist for the past 7 years and have been serving patients in Helena since 2014. Though originally from Montana, I graduated from PT school at Mayo Clinic in Minnesota. But, I couldn’t stay away from these mountains here at home. Just as I love hiking, skiing, and seeing the mountains daily, I love being in the water. Water provides a gentle but effective medium to help individuals gain strength and stability for overall wellness. Whether you are recovering from an injury or illness, are managing your chronic pain, or are working to improve your general health, aquatic therapy could be a benefit to you. I love helping individuals meet their mobility goals and get back to an active lifestyle, using water as a stepping stone in that journey. Outside of being in the pool, I enjoy chasing my children around, petting my herd of cows, pretending to play the cello, and enjoying the outdoors. 

Learn more about Dr. Koenig’s aquatic therapy training from the Aquatic Therapy and Rehab Institute.

Interested in trying aquatic physical therapy?

For more information about aquatic PT check out our blog post.  To see if aquatic PT might be a good fit for you, contact the Optimal Sports PT office at 406-502-1782. Our team of physical therapists and office staff can help determine if aquatic PT is right for you and verify your insurance benefits.

All aquatic PT services will take place at the DoubleTree by Hilton in downtown Helena.

DoubleTree by Hilton

22 N Last Chance Gulch

Helena, MT 59601

Click here for a link to a map to pool therapy!