The Healing Waters: How Aquatics and Swimming Benefit the Brain Injury Community

By Thomas Lehrich, President, Plus One Foundation, Traumatic Brain Injury Foundation of Seattle

Our mission is not only to support survivors and their families but to promote evidence-based programs and interventions that improve quality of life after brain injury. 

The Plus One Foundation and its Think aBout It education initiative is a program dedicated to empowering communities with knowledge about brain health, injury prevention, and rehabilitation. TBI26 has elevated public understanding and continues to spark meaningful conversations across the Pacific Northwest and beyond.

One of the most powerful yet underutilized rehabilitative tools for many of the individuals we serve is aquatics and therapeutic swimming.

Our founder, Kacey, pioneered the aquatics concept of enhancing access to pools and aquatics for those with neurological conditions. Plus One knows water. Whether it’s regaining strength, rebuilding confidence, or supporting cognitive recovery, the aquatic environment offers a range of benefits uniquely suited to the needs of people recovering from brain injury.

Why Water? The Science and the Sensation

The properties of water and buoyancy, resistance, hydrostatic pressure, and thermal effects create an ideal environment for gentle yet effective rehabilitation. For many brain injury survivors, traditional land-based therapy can be painful, fatiguing, or demotivating. Water, however, can reduce the impact of gravity, support weak muscles, and enhance movement with less effort.

Here’s how aquatics help:

1. Enhances Physical Function Without Overload
Buoyancy reduces stress on joints and the nervous system, allowing individuals to perform movements that may be difficult or impossible on land. This promotes improved range of motion, balance, and motor control, all of which are common challenges after a brain injury.

2. Reduces Muscle Spasticity and Pain
Warm water has a calming effect on muscles, often decreasing involuntary spasticity that can limit functional movement. Many survivors report reduced pain during and after aquatic sessions, which supports longer-term engagement in therapy.

3. Boosts Cardiovascular and Aerobic Fitness
Swimming increases heart rate and circulation without the jarring impact of running or walking. Improved cardiovascular fitness is linked not only to physical health but to neuroplasticity, the brain’s ability to reorganize and heal.

4. Improves Balance and Coordination
Water provides dynamic feedback that challenges the sensory and motor systems. This helps retrain balance and coordination in ways that often transfer into improved performance on land.

5. Supports Cognitive and Emotional Well-Being
Aquatics isn’t just about physical gains. The focus required for swimming patterns, breath control, and rhythmic movement engages cognitive processes such as attention, sequencing, and memory. Many survivors also describe feeling more relaxed, less anxious, and more confident after spending time in the water – a reminder that emotional well-being is inseparable from rehabilitation success.

Integrating Aquatics Into Comprehensive Care

While aquatics is exceptionally beneficial, it works best as part of a comprehensive, interdisciplinary rehabilitation plan, one that includes physical therapy, occupational therapy, cognitive rehabilitation, and psychosocial support. Each survivor’s journey is unique, and aquatics offers a flexible, adaptable pathway that therapists and caregivers can tailor to individual goals.

Think aBout It

Programs like The Plus One Foundation’s Think aBout It initiative remind us that education and awareness are critical pieces of recovery. When communities understand the benefits of interventions like aquatics, we can advocate more effectively for access, funding, and innovative practices that put survivors first.

Aquatics is one such beacon of possibility, and when combined with education initiatives like Think aBout It, we move closer to a future where every person with a brain injury has the tools, support, and opportunities they deserve