Adding Aquatics

7 steps to making your pool-based physical therapy practice stand out

Owning and operating a profitable physical therapy practice requires a lot of planning and forethought, as well as creativity, when it comes to embracing newer technologies. While incorporating a therapy pool into an already-busy clinic can initially seem like a daunting addition, it can be incredibly beneficial in providing a steady return on investment if implemented properly. The key is putting enough time into determining how to use the latest aquatic therapy treatment options to your advantage.

Physical therapists who want to add aquatic therapy to their offerings can follow the tried-and-true path well-cleared by some of their colleagues. Here's what we've learned through our experiences of utilizing a specialized therapy pool over the past several years.

Gather Your Staff

Before we added our pool, we dabbled in aquatic therapy a couple of times a week at local pools. These were not warm-water pools like the one we currently own; they were standard models with a cooler temperature.

Additionally, they were often crowded or unavailable, so scheduling times became increasingly difficult. Yet patients really loved being in the water, and responded well to the treatment. That's one reason we needed to have an aquatic facility available on a daily basis.

We didn't actually set out to develop an aquatic therapy business, but it became clear that we were headed in that direction. Consequently, we gathered our staff members together and discussed our options. When we realized we were all on board, we began what turned out to be an extensive and highly educational "homework assignment."

Archive Image

Get All the Info you Can

Our homework journey took us on plenty of field trips to visit other physical therapy practices with therapy pools. Remarkably, we met no one who said that aquatic therapy had been a mistake. In fact, all the places we toured were exceedingly satisfied, and some even wished they could have more than one therapy pool on site. This showed us that the water therapy market is strong.

During visits to other facilities, we spent a great deal of time discussing issues associated with only having land-based physical therapy options - e.g., patients getting discouraged because their treatment caused them pain, or wasn't moving as fast as they wanted.

As we had already seen with our own aquatic therapy experiences, patients exercising in the water felt incredibly positive about their success. Plus, we knew that some patients simply could not transition well into land-based therapy; for them, aquatic therapy was the best way to maintain higher levels of function.

Crunch the Numbers

It's no secret that a therapy pool is an investment, so it's critical to sit down and take a good look at the numbers, including all aspects of revenue generation and expenses. Again, some physical therapy practices are willing to share some of their data; this can help you determine whether you're on the right path. This doesn't mean their experiences will be your experiences, but it does mean that you'll have some indication of what your investment and water therapy business arrangement will look like.

Remember that in addition to working toward profitability, aquatic therapy becomes a unique selling point and a competitive advantage in recruiting new patient referrals. As your program begins to gain traction, your aquatic therapy program may become more profitable than you originally expected.

Structure Use of the Pool

In some circumstances, physical therapy clinics with therapy pools allow any trained personnel to use the pool with clientele. Our team opted against this setup. Instead, only one of our physical therapists runs the pool.

As we've grown, our aquatic therapist has added a part-time assistant to help her achieve patient and clinic goals. That way, other physical therapists don't need to constantly get in and out of the water during the day.

While the pool was a focus during this process, we were also focused on making sure we still have a good amount of space for land-based therapy treatments too. This created a strong balance of what we could provide to patients when they came to our facility for their rehabilitation needs. It also allowed them to transition on-site from aquatic to land-based therapy more easily.

Of course, taking a patient from aquatic therapy to therapy on land is always a challenge; most patients want to stay in the water as long as possible.

Train Everyone

When you choose a top-end therapy pool manufacturer and supplier, you get abundant assistance when it comes to setup and training on your new equipment. It's important to make sure every person on your team is included in the training; that way, everyone will feel comfortable around the pool. You can't afford to have someone on your staff who's uncertain about how to use it safely.

As a side note, training is a great way to find out more about your purchase. Our pool comes with resistance jets that, when properly used, help patients make incredible progress during sessions. These jets provide therapeutic resistance, which we've discovered is a key component in building muscle strength and stability.

Another advantage is an embedded video camera connected to a television on the edge of the pool area. Physical therapists and their patients use the live video to rectify incorrect gait and balance patterns. One of our patients (who is also a physical therapist at our facility) underwent bilateral hip replacement surgery. While walking in the pool, she could immediately pinpoint the areas she needed to improve.

If we hadn't been fully trained on how to use the resistance jets and video, we might not have been able to implement them from the beginning. That would have been a disadvantage to our patients.

Be Prepared for Surprises

As with any new venture, there are always surprises when adding a specialized therapy pool. One of the biggest surprises for us was that some physicians' groups with whom we worked were not fully aware of the therapeutic benefits of aquatic therapy.

You Might Also Like...

Fluid Movement

Aquatic therapy helps wheelchair-bound patients achieve rehab goals.

Tangible Outcomes, Intangible Results

Getting older patients into the water can provide renewed independence and a sense of pride

A Natural Fit

Aquatic therapy relieves the pain associated with lymphedema.

Water Weight

Sports training and conditioning can be enhanced by getting athletes into the pool.

For that reason, when we opened our pool, we invited them to see it for themselves. As they began to prescribe aquatic therapy, patients reported back to them that they found the experience incredible. Slowly, those referring physicians became more confident in sending additional people to our clinic. Today, many of the doctors are our biggest proponents.

Another shock - albeit a very welcome one - was how quickly patients were regaining their pre-operative abilities after spending minimal time in the pool. For instance, total hip replacement outcomes occur in a fairly predictable timeframe when the patient is engaged in land-based therapy. Yet when aquatic therapy is added to the mix, recovery outcomes are noticeably increased and the length of the rehabilitation is decreased. While we expected to see some differences in this area, we could never have imagined the speed with which a patient could gain mobility, confidence and balance.

Marketing proved to be another place where surprises happened. We assumed we would have to engage in a good deal of print media and television to showcase our pool. As it turned out, word-of-mouth advertising was our most productive form of generating new business. The more our satisfied patients shared their stories, the more business came through our doors. In fact, we actually made a net profit our first year.

Finally, we were all taken aback by how valuable our therapy pool's underwater massage hose (which attaches to the resistance jets) was. I thought it was merely a "bells and whistles" aspect to the pool until I used it after my knee surgery. Not only did the hose help break up my scar tissue and reduce muscle spasms, but it also relieved tension in that area.

Help Others 'Take the Plunge'

At this point, our staff members spend time helping other clinics that are seriously contemplating "taking the plunge" into aquatic therapy.

It's a form of giving back that can only serve to advance the profession of physical therapy as a whole.

Not only are we open to giving tours, but we're upfront about everything from understanding your reimbursement process, to figuring out how to code for aquatic therapy sessions (we usually use 97113 or 97110), to knowing what your per-visit income must be to remain viable, and more.

Above all else, we are passionate about providing our patients with the most comprehensive care they can obtain. Adding aquatic therapy has rounded out the opportunities for clients to advance faster, more comfortably, and more confidently than ever. We feel privileged to be on the cutting edge of progress in our chosen field. 

Keith Ori is co-owner of Orthopedic Rehab, a seven-location practice based in Kalispell, Montana.


Email: *

Email, first name, comment and security code are required fields; all other fields are optional. With the exception of email, any information you provide will be displayed with your comment.

First * Last
Title Field Facility
City State

Comments: *
To prevent comment spam, please type the code you see below into the code field before submitting your comment. If you cannot read the numbers in the below image, reload the page to generate a new one.

Enter the security code below: *

Fields marked with an * are required.

View the Latest from ADVANCE


Search Jobs


Back to Top

© 2017 Merion Matters

660 American Avenue Suite 300, King of Prussia PA 19406