How to Market an Aquatic Therapy Program to Referral Sources

Nov 21 / Aquatic Therapy University








Learn how to build physician and rehab-director referrals for your aquatic therapy program. Proven, evidence-based strategies — no gimmicks, just professional trust and measurable results.

Aquatic Therapy Essentials: Bootcamp

This on-demand course is delivered as a professionally produced instructional training designed to provide a fast-paced introduction to aquatic therapy fundamentals. 
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Stop Selling. Start Showing.

If your pool is sitting empty, you don’t have a marketing problem — you have a credibility problem. Doctors don’t refer their patients to “swimming pools.” They refer their patients to clinicians who provide results they can measure and defend. Your job? To bring the science to the water's edge.

(See specific supporting case articles at the end of this entry)

That means showing referrers that aquatic therapy isn’t simple exercise or cross-training — it’s a medically necessary environment that solves their biggest headaches: poor weight-bearing tolerance, slow gait return, chronic pain, and low patient buy-in.

Step 1: Know Who Actually Sends Patients

Skip the random mailing list. Know your ecosystem.
• Orthopedic surgeons want faster post-op recovery without setbacks.
• Neurologists need a safe way to retrain gait when land is chaos.
• Cardiologists want movement without cardiac spikes.
• SNF rehab directors need a differentiator that keeps beds full.

Find them. Learn their pain points. Then stop talking about jets and start talking about outcomes.

HydroWorx calls this “mapping your referral sources by diagnosis,” which is as close as marketing ever gets to common sense (HydroWorx, 2024).

Step 2: Build the Message Around Pain — Theirs, Not Yours

If your brochure leads with “state-of-the-art pool,” you’ve already lost. Lead with what your referrer cares about: early motion, fewer readmissions, and happier patients who stop calling at midnight.

Use the evidence to write up data:
• “Our aquatic program gets your TKA patients walking 2 weeks sooner.”
• “We cut fall risk in half for neuro clients before discharge.”
• “We transition cardiac rehab to movement without overloading the heart.”

Evidence sells itself. You just have to present it like a colleague, not a commercial.  (See specific supporting case articles at the end of this entry)

Step 3: Get Them in the Water

A surgeon who tours your pool will send you more patients than ten email campaigns. They need to see the lift, the variable depth, and the clean line of supervision that makes aquatic rehab look safe and billable.

Host “surgeon splash sessions.” (No, don’t make them swim.) Walk them through case data, let them observe a patient, and hand them a one-page referral sheet that lists indications, ICD-10 codes, and your contact.

HydroWorx’s referral playbook shows these tours double referral volume when paired with outcome reports (HydroWorx Marketing Playbook, 2024).

Step 4: Feed Them Proof, Not Pastries

You can drop off doughnuts, but data sticks longer.  Send quarterly “Outcome Snapshots”:
• Mean days to ambulation.
• Pain reduction scores.
• % of patients transitioning to land ahead of schedule.

Hospitals, SNFs, and payers eat that up because it sounds like risk mitigation, not marketing fluff. (See specific supporting case articles at the end of this entry)

See how North Central Health Care’s warm-water pool report documented shorter lengths of stay and net savings — and justified keeping its therapy pool open when budgets tightened (Norcen Report, 2017).

Step 5: Stay in the Relationship Lane

Marketing ends when your program becomes their program. Call or email progress notes directly to referrers:

“Mr. Lopez walked 150 ft in 93 °F water on day 5 post-TKA — land tolerance 10 ft.” Now you’ve just written them a mini success story they can quote at case conference.

Research confirms that inter-professional visibility drives more referrals than consumer ads ever could (Maibach et al., 2006).

Step 6: Make Your Facility Look Like a Case Study, Not a Sales Pitch

When your website says “state-of-the-art,” Google yawns. When it says “Reduced post-op rehab time by 30 % — download our outcomes report,” it leans in.

Use your digital space to:
• Post brief case studies (with permission).
• Publish photos of real sessions showing clinician handling, not spa lounging.
• Embed 60-second physician testimonial clips.
• SEO tags: “aquatic therapy post knee replacement,” “neurorehabilitation hydrotherapy,” “CPT 97113 outcomes.”

According to Endless Pools’ PT marketing study, clinics showcasing patient videos and quantified results see a measurable bump in physician engagement (Endless Pools, 2024).

Step 7: Measure Everything

Track referrals by source, diagnosis, and revenue. Use a simple CRM or even a spreadsheet at first.

Ask three questions quarterly:
1. Who’s sending?
2. Who stopped sending?
3. Who should be sending but isn’t yet?
Data beats intuition every time.

The Bottom Line

You don’t market aquatic therapy — you demonstrate it. Every tour, every data sheet, every patient story whispers the same thing to your referral base:
“This isn’t extra therapy. This is therapy done right.”

When your referrers believe that, your pool stops being a cost center and starts being a clinical destination.

Specific supporting case articles: Research

Post-TKA Recovery Time Claims: Statement about getting TKA patients "walking 2 weeks sooner" aligns with the evidence. For instance, early aquatic physical therapy after orthopedic surgery improves functional outcomes without increasing wound complications.
  1. A 12-week progressive aquatic resistance training program increased habitual walking speed by 9% and decreased stair ascending time by 15% in patients 4-18 months post-knee replacement.
  2. The American Physical Therapy Association guidelines note that aquatic exercise following TKA shows positive effects on walking distance, balance, and physical function.
  3. Neurological Gait Training: The claim about safe gait retraining is well-supported. Aquatic therapy demonstrates statistically significant improvements over land therapy for functional reach (3.5 points better), gait speed (0.049 m/s faster), and Berg Balance Scale (2.3 points higher) in stroke rehabilitation.
  4. Multiple systematic reviews confirm "fair" evidence that aquatic therapy improves dynamic balance and gait speed in neurological conditions.[5-6]

Fall Risk Reduction: Your claim about cutting fall risk "in half" needs more specificity. While hydrotherapy shows moderate-quality evidence for improving balance function in Parkinson's disease patients, and reduces falls in some studies (one trial showed a reduction of 2.4 falls vs. 0.4 in controls), the 50% reduction claim requires supporting data from your specific program.
[7-9]

Cardiac Rehabilitation: The assertion about movement "without overloading the heart" is physiologically accurate. Aquatic exercise in cardiac rehabilitation patients produces similar improvements in exercise capacity and vascular function as land-based programs. [10-12] Water immersion creates favorable hemodynamic conditions without increasing myocardial oxygen requirements excessively. [13-14]

Pain Reduction: Well-supported. Aquatic therapy produces moderate improvements in pain compared to no exercise (SMD -0.31) in musculoskeletal conditions. [15] For knee osteoarthritis specifically, aquatic exercise significantly reduces pain (SMD -0.58) and improves physical function. [16-17] Low back pain patients also found relief with aquatic therapy equaling or exceeding land-based treatment [18].

Supporting References:
1. Villalta, E. M., & Peiris, C. L. (2013). Early aquatic physical therapy improves function and does not increase risk of wound-related adverse events for adults after orthopedic surgery: A systematic review and meta-analysis. Archives of Physical Medicine and Rehabilitation, 94(1), 138–148. https://doi.org/10.1016/j.apmr.2012.07.020

2. Valtonen, A., Pöyhönen, T., Sipilä, S., & Heinonen, A. (2010). Effects of aquatic resistance training on mobility limitation and lower-limb impairments after knee replacement. Archives of Physical Medicine and Rehabilitation, 91(6), 833–839. https://doi.org/10.1016/j.apmr.2010.03.002

3. Jette, D. U., Hunter, S. J., Burkett, L., et al. (2020). Physical therapist management of total knee arthroplasty. Physical Therapy, 100(9), 1603–1631. https://doi.org/10.1093/ptj/pzaa099

4. Iliescu, A. M., McIntyre, A., Wiener, J., et al. (2020). Evaluating the effectiveness of aquatic therapy on mobility, balance, and level of functional independence in stroke rehabilitation: A systematic review and meta-analysis. Clinical Rehabilitation, 34(1), 56–68. https://doi.org/10.1177/0269215519880955

5. Marinho-Buzelli, A. R., Bonnyman, A. M., & Verrier, M. C. (2015). The effects of aquatic therapy on mobility of individuals with neurological diseases: A systematic review. Clinical Rehabilitation, 29(8), 741–751. https://doi.org/10.1177/0269215514556297

6. Manning, O. J., Rancourt, S., Tomasone, J. R., Finlayson, M., & DePaul, V. (2023). Water-based therapeutic exercise in stroke: A scoping review. Disability and Rehabilitation, 45(9), 1549–1562. https://doi.org/10.1080/09638288.2022.2063415

7. Liu, Z., Huang, M., Liao, Y., et al. (2023). Long-term efficacy of hydrotherapy on balance function in patients with Parkinson’s disease: A systematic review and meta-analysis. Frontiers in Aging Neuroscience, 15, Article 1320240. https://doi.org/10.3389/fnagi.2023.1320240

8. Pinto, C., Salazar, A. P., Marchese, R. R., Stein, C., & Pagnussat, A. S. (2019). The effects of hydrotherapy on balance, functional mobility, motor status, and quality of life in patients with Parkinson disease: A systematic review and meta-analysis. PM&R, 11(3), 278–291. https://doi.org/10.1016/j.pmrj.2018.09.031

9. Volpe, D., Giantin, M. G., Maestri, R., & Frazzitta, G. (2014). Comparing the effects of hydrotherapy and land-based therapy on balance in patients with Parkinson’s disease: A randomized controlled pilot study. Clinical Rehabilitation, 28(12), 1210–1217. https://doi.org/10.1177/0269215514536060

10. Vasić, D., Novaković, M., Božič Mijovski, M., Barbič Žagar, B., & Jug, B. (2019). Short-term water- and land-based exercise training comparably improve exercise capacity and vascular function in patients after a recent coronary event: A pilot randomized controlled trial. Frontiers in Physiology, 10, Article 903. https://doi.org/10.3389/fphys.2019.00903

11. Adsett, J. A., Mudge, A. M., Morris, N., Kuys, S., & Paratz, J. D. (2015). Aquatic exercise training and stable heart failure: A systematic review and meta-analysis. International Journal of Cardiology, 186, 22–28. https://doi.org/10.1016/j.ijcard.2015.03.095

12. Lee, J. Y., Joo, K. C., & Brubaker, P. H. (2017). Aqua walking as an alternative exercise modality during cardiac rehabilitation for coronary artery disease in older patients with lower extremity osteoarthritis. BMC Cardiovascular Disorders, 17(1), Article 252. https://doi.org/10.1186/s12872-017-0681-4

13. Teffaha, D., Mourot, L., Vernochet, P., et al. (2011). Relevance of water gymnastics in rehabilitation programs in patients with chronic heart failure or coronary artery disease with normal left ventricular function. Journal of Cardiac Failure, 17(8), 676–683. https://doi.org/10.1016/j.cardfail.2011.04.008

14. Bergamin, M., Ermolao, A., Matten, S., Sieverdes, J. C., & Zaccaria, M. (2015). Metabolic and cardiovascular responses during aquatic exercise in water at different temperatures in older adults. Research Quarterly for Exercise and Sport, 86(2), 163–171. https://doi.org/10.1080/02701367.2014.981629

15. Barker, A. L., Talevski, J., Morello, R. T., et al. (2014). Effectiveness of aquatic exercise for musculoskeletal conditions: A meta-analysis. Archives of Physical Medicine and Rehabilitation, 95(9), 1776–1786. https://doi.org/10.1016/j.apmr.2014.04.005

16. Xu, Z., Wang, Y., Zhang, Y., Lu, Y., & Wen, Y. (2023). Efficacy and safety of aquatic exercise in knee osteoarthritis: A systematic review and meta-analysis of randomized controlled trials. Clinical Rehabilitation, 37(3), 330–347. https://doi.org/10.1177/02692155221134240

17. Bartels, E. M., Juhl, C. B., Christensen, R., et al. (2016). Aquatic exercise for the treatment of knee and hip osteoarthritis. Cochrane Database of Systematic Reviews, (3), Article CD005523. https://doi.org/10.1002/14651858.CD005523.pub3

18. Peng, M. S., Wang, R., Wang, Y. Z., et al. (2022). Efficacy of therapeutic aquatic exercise vs physical therapy modalities for patients with chronic low back pain: A randomized clinical trial. JAMA Network Open, 5(1), e2142069. https://doi.org/10.1001/jamanetworkopen.2021.42069

General References

• HydroWorx. (2024). Defining Your Aquatics Referral Sources for Success. https://www.hydroworx.com/blog/defining-your-aquatics-referral-sources-for-success/
• HydroWorx. (2024). Marketing Playbook for Aquatic Programs. https://cdn2.hubspot.net/hubfs/95548/Marketing%20Playbook%20low%20res.pdf
• Endless Pools. (2024). Physical Therapy Marketing Strategies. https://www.endlesspools.com/blog/post/physical-therapy-marketing-strategies
• Maibach, E. W., et al. (2006). A Marketing Perspective on Disseminating Evidence-Based Physical Activity Programming. Health Education & Behavior. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1637805/
• North Central Health Care. (2017). Aquatic Therapy Services & Pool ROI Report. https://www.norcen.org/documents/Aquatic-Therapy-Services-and-Pool-20170116-Full.pdf
• HydroWorx. (2024). Defining Your Aquatics Referral Sources for Success. https://www.hydroworx.com/blog/defining-your-aquatics-referral-sources-for-success/
• HydroWorx. (2024). Marketing Playbook for Aquatic Programs. https://cdn2.hubspot.net/hubfs/95548/Marketing%20Playbook%20low%20res.pdf
• Endless Pools. (2024). Physical Therapy Marketing Strategies. https://www.endlesspools.com/blog/post/physical-therapy-marketing-strategies
• Maibach, E. W., et al. (2006). A Marketing Perspective on Disseminating Evidence-Based Physical Activity Programming. Health Education & Behavior. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1637805/
• North Central Health Care. (2017). Aquatic Therapy Services & Pool ROI Report. https://www.norcen.org/documents/Aquatic-Therapy-Services-and-Pool-20170116-Full.pdf

Aquatic Therapy University: Generalist Bundle

16 hours of aquatic therapy studies which apply to both pediatric and adult patients and work for both neuro and musculoskeletal population. Perfect introduction to aquatic therapy. Great for individuals seeking CEUs or those seeking any of the Aquaticist credentials.
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