POOL SEASON IS RIGHT AROUND THE CORNER

Pool (aquatic) exercise provides many benefits, including an ideal environment to exercise throughout the year. The buoyancy of the water supports a portion of your body weight making it easier to move in the water and improve your flexibility. The water also provides resistance to movements, which helps to strengthen muscles. Pool exercises can also improve agility, balance, and cardiovascular fitness. Many types of conditions greatly benefit from pool exercise, including arthritis, fibromyalgia, back pain, joint replacements, neurological, and balance conditions. The pool environment also reduces the risk of falls when compared to exercise on land. Below are some tips and tricks provided by the APTA as suggestions to get you started in the right direction.

Preparing for the Pool

Before starting any pool exercise program, always check with your physical therapist or physician to make sure pool exercises are right for you. A wonderful option is asking your physical therapist to take your home exercise program and adapt it so that it's possible to do in the water. Here are some tips to get you started:

• Water shoes will help to provide traction on the pool floor.
• Water level can be waist or chest high.
• Use a Styrofoam noodle or floatation belt/vest to keep you afloat in deeper water.
• Slower movements in the water will provide less resistance than faster movements.
• You can use webbed water gloves, Styrofoam weights, inflated balls, or kickboards for increased resistance.
• Never push your body through pain during any exercise.
• Although you will not sweat with pool exercises, it is still important to drink plenty of water.

10 Excellent Exercises for the Pool

1. Water walking or jogging: Start with forward and backward walking in chest or waist high water. Walk about 10-20 steps forward, and then walk backward. Increase speed to make it more difficult. Also, increase intensity by jogging gently in place. Alternate jogging for 30 seconds with walking in place for 30 seconds. Continue for 5 minutes.

2. Forward and side lunges: Standing near a pool wall for support, if necessary, take an oversized lunge step in a forward direction. Do not let the forward knee advance past the toes. Return to the starting position and repeat with the other leg. For a side lunge, face the pool wall and take an oversized step to the side. Keep toes facing forward. Repeat on the other side. Try 3 sets of 10 lunge steps. For variation, lunge walk in a forward or sideways direction instead of staying in place.

3. One leg balance: Stand on 1 leg while raising the other knee to hip level. Place a pool noodle under the raised leg, so the noodle forms a “U” with your foot in the center of the U. Hold as long as you can up to 30 seconds and switch legs. Try 1-2 sets of 5 on each leg.

4. Sidestepping Face the pool wall. Take sideways steps with your body and toes facing the wall. Take 10-20 steps in 1 direction and then return. Repeat twice in each direction.

5. Hip kickers at pool wall: Stand with the pool wall to one side of your body for support. Move 1 leg in a forward direction with the knee straight, like you are kicking. Return to start. Then move the same leg to the side, and return to the start position. Lastly, move that same leg behind you. Repeat 3 sets of 10 and switch the kicking leg.

6. Pool planks: Hold the noodle in front of you. Lean forward into a plank position. The noodle will be submerged under the water, and your elbows should be straight downward toward the pool floor. Your feet should still be on the pool floor. Hold as long as comfortable, 15-60 seconds depending on your core strength. Repeat 3-5 times.

7. Deep water bicycle: In deeper water, loop 1-2 noodles around the back of your body and rest your arms on top of the noodle for support in the water. Move your legs as if you are riding a bicycle. Continue for 3-5 minutes.

8. Arm raises: Using arm paddles or webbed gloves for added resistance, hold arms at your sides. Bend your elbows to 90 degrees. Raise and lower elbows and arms toward the water surface, while the elbows remain bent to 90 degrees. Repeat for 3 sets of 10.

9. Push ups: While standing in the pool by the pool side, place arms shoulder width apart on pool edge. Press weight through your hands and raise your body up and half way out of the water, keeping elbows slightly bent. Hold 3 seconds and slowly lower back into pool. (Easier variation: Wall push up on side of pool: place hands on edge of pool shoulder width apart, bend elbows, and lean chest toward the pool wall.)

10. Standing knee lift: Stand against the pool wall with both feet on the floor. Lift 1 knee up like you are marching in place. While the knee is lifted even with your hip, straighten your knee. Continue to bend and straighten your knee 10 times, and then repeat on the other leg. Complete 3 sets of 10 on each leg. For more of a challenge, try this exercise without standing against the pool wall.

WHY AQUATIC REHABILITATION?

WHY AQUATIC REHABILITATION?

Performing exercise in the water is beneficial for several reasons:

• The thermal properties of water are therapeutic because it helps increase circulation.
• The hydrostatic pressure of the water compresses the tissues causing decreased swelling, and improved lymphatic return.
• The buoyancy of the water helps to “un weight” the body and facilitate movement, with less stress on musculoskeletal system.
• Drag is a property of water that creates resistance to movement, facilitating strengthening of the musculoskeletal system.

WHO CAN BENEFIT FROM AQUATIC REHABILITATION?

A variety of patients with musculoskeletal conditions benefit from aquatic rehabilitation:

• Patients with arthritis benefit from the being able to exercise in an environment where there is minimal stress on the joints, improved circulation, and facilitation of movement.
• Patients with joint replacement surgery benefit from the decreased stress on their joints, reduced swelling and facilitation of movement.
• Patients with low back pain benefit from the decreased stress on the back and relaxation of the water temperature.
• Patients with sports injuries benefit from performing exercises at a faster pace due to the reduced stress on the joints.
• Patients who are unable to perform dry-land exercises due to pain or swelling

CAN I GET THE SAME BENEFITS FROM LAND THERAPY AS AQUATIC?

Yes, most of the time, you can.  Aquatic therapy is best for some cases with severe pain, or to gain range of motion.  The kicker is: it'll only get you so far.  Manual therapy is going to be the best solution to improve your range of motion, and aquatic therapy does not permit the proper positioning to perform manual therapy, so even if your therapist is in the water with you or you're using buoys or body weight to increase your range of motion, land therapy will still be more beneficial.  Aquatic therapy provides a natural resistance to perform activities, but the water also provides a natural stabilizer which doesn't allow your muscles to contract as well as they need to to help maintain your balance - it will only allow you to practice the movements you need to work on, but patients usually still struggle when the time comes to perform those activities on land. For example: a meniscus repair requires that patients be non weight bearing or partial weight bearing for several weeks after surgery. Aquatic therapy is going to allow them to practice walking in the resistance of the water before they can do so on land.  And while by the end of 6 weeks after surgery they may be walking flawlessly in the water, they will still struggle to walk on land because aquatic therapy does not provide the circumstances under which patients complete their daily activities. By no means is this to say aquatic therapy is not beneficial - because it definitely is - land therapy will just help a wider range of patients get back to their end goal at a more efficient rate.