When new facilities are in the planning stages or existing facilities are looking for
new revenue streams the terms Water Therapy or Aquatic Therapy are frequently heard. The community benefit is indisputable, but the model for this service needs to be understood. 

Terminology:  Unfortunately, the definitions of terms like Aquatic Therapy are not standardized in the aquatic business world. We need to make sure that everyone in the aquatic business is speaking the same language. Most of the time the following definitions are accurate:


  • Aquatic Physical Therapy: Medicaid, Medicare or Insurance reimbursable services that are delivered by a licensed Physical Therapist at an inspected and approved facility.
  • Aquatic Exercise: Aquatic services that are “private pay” and that should be delivered by a professional with certification such as that offered by the AEA (Aquatic Exercise Association.)
  • Aquatic Therapy or Rehab:  Loose terms that sometimes are used when referring to either of the above.

There are a few things that need to be seriously considered when planning a facility that will include either Aquatic Physical Therapy or Aquatic Exercise.

At least one and preferably two pools need to be designed strictly for Aquatic Therapy. These pools must be designated strictly for Therapy during the identified hours. In other words, shared programming is not allowed if it is reimbursable therapy. The pool can be used for other programs before or after the hours for therapy, but not simultaneously. These pools do not have to be large, in fact they can be as small as 10’ wide x 15’ long x 4’ deep as long as they have staired or ramped entry and a lift.  Water temperature should be controlled between 88 and 92 degrees.
When addressing the needs of the Aquatic Therapy piece, there are other considerations that must be addressed:

  • Unisex assisted care-giver dressing rooms and showers
  • Examining and treatment rooms for the therapist to evaluate patients
  • Land based exercise equipment for cross training and evaluation purposes
  • Waiting areas and other amenities

In almost all cases, the facility or club will not want to get involved in the daily business of water therapy. This is best left to the professionals while the facility or club stays in the “water rental” business. There are many hospitals looking to move into “a wellness environment” encouraging active people trying to be healthy. For a hospital or independent therapist to operate an average size therapy pool and business, it will cost approximately $82 per hour. That price includes, chemicals, equipment upkeep and repair, utilities, a Certified Pool Operator, cleaning crew, guards and technicians for assistance. Operational costs and intensive staffing requirements are the main reasons many therapy pools are not built. If, however, a facility adds a therapy pool and maintains and staffs it professionally, the hospital or therapist would willingly pay $70 per hour rental. Both the hospital or therapist and the facility benefit.

The pool for Aquatic Exercise needs to be larger that the designated therapy pool. The size will depend on the community served and the other supporting programs at the same location. A versatile size is 75’ long x 45’ wide with depths ranging from 4’ to 6’. A ramped entry is also a very good idea. Temperature should be controlled from 83 degrees to 86 degrees or warmer. If necessary the pool size can be reduced to as little as  25’ x 45’.

The Aquatic Exercise pool is also a great setting for Learn-to-Swim classes, 1:1 Aquatic Personal Training, and a host of other warmer activities including 10 and under competitive swimmers practices. 

If a specialty pool is not in the plans, a more conventional lap pool can also be used for aquatic exercise as long as the temperature, access, and depth issues are properly addressed. Obviously a 50 meter pool that is 7 feet deep and maintained at 81 degrees with ladders for entry would have very limited programming opportunities. 

The aquatic exercise business should be considered by facilities and clubs. Most patients that are released from Physical Therapy are immediately looking for a safe and comfortable environment where they can continue their exercise regime and maintain their newly found healthy lifestyle.  A membership based program can be offered to these clients.

Many things have to be considered for a program like this to be successful:

  • Pool and facility design: temperature, access, depth
  • Staffing professionalism and accreditation
  • Program design
  • Client service and scheduling
  • Value received pricing and facility/club business planning

An Aquatic Exercise program can develop into a major facet of a facility’s income potential. Additionally it can be a very valuable community service. 



  • A two tank therapy pool with dressing areas can be designed in 2,000 square feet 
  • The supporting rooms and exercise area can be designed in 3,500 square feet
  • The Aquatic Exercise “continuum area” can be designed in 6,000 square feet
  • An additional 4,000 square feet can be added for meeting rooms, hallways, concession areas, public areas, storage, offices, cleaning and laundry
  • Total square footage required for entire facility is approximately 15,500 square feet

For design and planning information please contact Mick Nelson

For programming information please contact Sue Nelson

For additional resources, click on the following links:

Aquatic Therapy 
Aquatic Exercise

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