How to Use Aquatic Therapy equipment and Pool Features for Rehab

Have you seen the big bins of aquatic therapy equipment at the pool like noodles, floaties, and kickboards? These items are not only for kids or for lap swimmers, they can also be used to create a functional workout for rehab in the pool for your clients.

These days clients don’t have to be doing front crawl or breaststroke to challenge themselves physically. But there's a lot to know with any aqua fitness service and it's hard to know where to start with pool-specific exercise equipment for your clients.

Adding exercise equipment to a workout in the water can change the resistance at which you work, change things up by introducing variety in your exercises, and aid with balance and support. Clients can strengthen muscles, improve balance, and increase flexibility more effectively with aqua equipment which takes advantage of water's natural buoyancy.

Below I’ll describe some of the exercise equipment and parts of the pool that I use with my clients in my aquatic therapy sessions and give you some uses that I find effective to try out on your own!

Aquatic Therapy Exercise Equipment


Noodles are  long cylindrical pieces of foam that can be used for flotation or for adding extra resistance to limbs moving through the water. In aquatic therapy pool noodles help with floating for gentle offloading of the back and lower body to reduce pain and stiffness. 

Noodles are comfortable to grip and easy to control in the water, so it is great for any type of pushing or pulling movement. Your client can also press or drag the noodle underneath the water to challenge your balance. Density of pool noodles can vary, so test out different types while exercising. Noodles that are more firm/dense will provide more buoyancy in the water. 


Kickboards are flat, compressed foam shaped like a large paddle. Kick boards are useful in the pool because they add surface area to the body part that is moving and therefore provide more resistance to the aquatic exercise you are doing. 

An example of an aquatic exercise that challenges the upper body with a kickboard is the ‘push-pull’. Have your client hold the kickboard vertically in the water with both hands, and stand in a split stance. The client then presses the kickboard straight forward in the water. Once their arms are fully straight, reverse the direction by pulling the board towards the chest, while maintaining it vertically. With moderate intention, this is a good challenge for the chest, arms, and upper back. 

Foam floating dumbbells

Dumbbells that you use in the pool are made of a handle and two foam disks. Contrary to dumbbells that you use in the gym where you need to lift the weight against gravity, dumbbells used in the pool require you to work against the floatation of the object by pushing them down into the water, most often for upper body strength and endurance. Dumbbells can also be used for stability training and floatation support while standing or kneeling. 

Because foam dumbells are comfortable to use and add a significant amount of overload for upper body exercises, they are often used in the water. Dumbbells can be used for warming up by engaging in a boxing motion. Holding one dumbbell in each hand, submerge both items under the water, and alternate punching out away from the body like you are boxing. Increase or decrease the intensity by speeding up or slowing down your movements. You’ll be sure to get your heart rate up quick!

Weighted rings

Weighted rings, about 10 cm in diameter, are great for practicing balance in the pool. Because they sink to the bottom of the pool, you can transfer them with your feet/toes, while standing on one spot/one leg. People who have difficulty with hand dexterity can also practice grabbing and picking up these rings underwater.

Floating waist belts

These are foam straps with belts that can be made smaller or larger and are worn at the waist. The purpose of these belts are to give you flotation assistance mostly in deeper water however they can also be used while still having your feet on the ground of the pool. In deeper water, these can be effective in aiding you with water running. In shallow water they are helpful for those who are recovering from injury to further reduce the forces applied on their joints (knees, hips and ankles).

I don’t have this equipment to provide for my client, what should I do?

Most public pools in the lower mainland provide floating exercise equipment such as noodles, dumbbells and kickboards for patrons for use in group classess like aquafit that are included in the purchase of an admission. Large exercise equipment stores or even some department stores will also carry this equipment if you plan to use a private pool or your client goes on vacation. Noodles are generally inexpensive and can easily be found in the children/youth’s water sports department as well. 

Do you need aquatic exercise equipment for aquatic therapy?

No you don’t. Here are some pool features you can use for aquatic therapy that are available for free at most facilities:

Water/our own bodies:

Because of the natural properties of water, it drag which acts on the body to counteract and slow movement in any given direction. Changing the speed, size and shape of a moving limb of the body is directly proportional to the resistance you experience. Therefore, just moving your limbs back and forth in the water can already provide resistance without even adding any exercise equipment. For example, you can vary the intensity by slicing the water with your hand (light) or creating a paddle with your fingers (heavy). You can also change the resistance by speeding up or slowing down your movements. Make sure to educate your client on these principles when you first start.

Various surfaces: wall, steps, seat: 

Most pools will also have steps or seats built into the floor/sides of the pool that can be used for aquatic exercise. Going from sitting to standing on an underwater seat can replicate a squat which is especially good for strengthening the lower body, and the pool wall can be a starting point for doing an elevated push-up. 

Lazy river

Depending on the pool you go to, there may be a lazy river. The lazy rivers (aka active river) is a small passages built in a pool (most often in the recreation pool) that has jets that propel water in one direction. The stream these jets create is intended for floating down with just your body or with a foam floating object.

A lazy river is also useful for strengthening the lower extremities.  When the coast is clear, you can walk against the current to get the heart beating and use your quads and hip flexors against the current. Most pools prefer you only go with the flow of water when other patrons are using the lazy river, so ask the lifeguard if it’s okay to use it this way and go to the pool on off-peak hours.

Hot tub

This doesn’t fall under the category of objects that we use in the pool to increase strength and endurance, however it is an important tool for flexibility and pain relief that we don’t have access to in a dry gym/studio. 

Taking some time at the end of the workout to sit in the hot tub is perfect for soothing worked muscles. The water temperature is great for increasing the internal temperature of your muscles which causes them to relax and become more elastic. This mimics the feeling of muscle relaxation when taking a hot shower after a long day of work. 

Time in the hot tub is not only ‘sitting around’-you can use this time to increase your client’s flexibility as well by doing stretches for their target area. Most public hot tubs have a depth that the average person can stand in the water up to their hips, which means you can do many stretches for the lower body like a quad or calf stretch with the muscle in question underwater. Hot tubs also have seating so you can sit and stretch your upper body as well such as the pec stretch.


You don’t need much to challenge your client’s balance, cardio, range of motion, and flexibility when you have a pool and some floating objects at your disposal. Many aquatic exercises that you do in the gym can be modified so that they can be completed in the water at a variety of different depths.

Want to learn more about how to use a pool noodle or kickboard for active rehab or aquatic exercise? Jump in the deep end and book a session with one of our aquatic therapists in Vancouver or Burnaby today.

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