Hydrotherapy refers to therapy conducted in water. The most advanced aquatic therapy of all is the therapeutic swimming. Therapeutic swimming is to use swimming, with adjusted strokes and changed moves, as a fashion of treatment based on patients’ diagnosis. Almost everyone is indicated.   It’s much easier to those who already know how to swim. Making local adjustment of the strokes for special needs is all therapist has to do. For instance, a scoliosis case, having C curve at thoracic region with concave to left, can use modified breaststroke. By extending elbow during power phase, the muscles on upper back and shoulder can be recruited. These muscles are protectors of the thoracic spine. Freestyle stroke can be in use, too. The left hand enters the water when the arm reaches out to the farthest; in addition, the head rotates to the opposite side of the reaching hand. These movements can stretch and elongate the shortened side. As for the lengthened side, the right side, strengthening should be emphasized more. Hence, patients put their right hand on their sacrum. This is not only effective for upper back and shoulder strengthening, but also good for chest expansion.   However, the therapy won’t jump to therapeutic swimming for beginners. New patients usually start with basic exercise, for example, walking, marching, stretching, and strengthening. Therapeutic swimming is saved to the last. “Be friend with water” is the primary mission. The therapy cannot work until the patients feel at home in water. There are seven characteristics of water, which are buoyancy, hydrostatic pressure, resistance, visual feedback, audio feedback, and balance and coordination. All exercise programs are derived from the seven characteristics. Through thousands of times of practice, patients ought to be adapted to water, to like it, to know the benefits that they can gain from water. Most importantly, patients need to understand how safe they are in the water. The mean density of human is smaller than the density of water, which means patients can always float. Once they realize this fact, they should be able to embrace water and relax. It’s easy to move by pushing water toward the opposite direction they are heading to. After they learned the skills, staying in water becomes a joy instead of fear. Do remember, therapeutic swimming is never a pageant. Speed and stunts are not our emphasis.   Once they catch up the skills, therapeutic swimming is more than a rehabilitation program. It is a part of their life. It is something they are enjoy doing. Some patients are extraordinarily talented, and they will further perfect their performance. Moreover, they can seek for professional advice of contest rules, and the speeding skills from swimming coach. At this point, they might have the chance to attend Paralympics! Therapeutic swimming was initially a rehabilitation approach. Then, people with special needs find delight from it. It becomes their recreation. Finally, this advanced exercise will likely bring them to an international stage. Therapeutic swimming realizes their dreams to outshine!