Swimming is increasingly recommended by medical practitioners in treating a wide variety of medical problems, including post surgical recovery. It is readily adapted to a wide variety of needs and capabilities. A major advantage of swimming programs, is that for many with disabilities, or health problems, either temporary or permanently, who may require assistance on land (e.g. wheelchair, crutches, braces), water enables them to go without, or minimise the amount of assistance required. In many cases they are able to join in activities with the able-bodied with little or no disadvantages.

When swimming is used as part of a hydrotherapy program, it should be supervised by suitably qualified people (e.g. physiotherapists) with extensive training in human movement, and knowledge of the characteristics (e.g. pathology of disease, limitations of movement) associated with particular health problems. Hydrotherapy programs might incorporate appropriately amended swimming strokes, or therapeutic recreational swimming. Qualified swimming teachers, with suitable training in hydrotherapy techniques (e.g. from tertiary institutions) could be readily involved in supervising or assisting in adapted swimming programs.

Choice of swimming strokes is very important. The person designing a swimming program for someone with a health problem (e.g. physiotherapist) must have a detailed knowledge of the patients condition, degree of mobility, and the muscles used in different swimming strokes. An injury that is to be treated via rehabilitation requires specific exercises in appropriate amounts to ensure improvement and not hindrance.

Two important components of any therapeutic swimming program are firstly ensuring that the swimmer has been allowed to adjust to the differing conditions of the water environment (e.g. buoyancy, water resistance, turbulence) and has gained a suitable degree of breathing and head control, and secondly has been taught, or can demonstrate vertical and lateral rotational control of their body, and a combination of these rotations. The swimmer should be able to hold a balanced floating position against disturbing forces (e.g. turbulence in the pool), and be able to regain an upright position as required. Successful completion of these two components raises the confidence levels of the swimmer and ensures that they can always return themselves to a safe breathing position.

These components are commonly learnt, or assessed, as part of an orientation or pre-swimming program. As little as one session may be required, or multiple sessions may be necessary, to achieve satisfactory results before commencing the swimming program. Orientation sessions might involve walking in different directions (i.e. backwards, forwards, sidewards), and in different depths of water, or holding on to the side of the pool or a kickboard in a horizontal position and doing gentle kicking movements. Floating in a balanced position might then be attempted with the assistance of a person the participant trusts for example a trainer, or perhaps friend or relative. As the learner gains confidence, and increasing control of their body, the assistance can be reduced, and eventually removed completely.

A high level of supervision is required at all times for hydrotherapy programs. Swimmers could easily overdo things and get into trouble, or as they get tired start to change their stroke, which could be potentially harmful. Good supervision should ensure that such things do not occur. It also provides a feeling of security to the swimmers, helping to keep confidence levels high.

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