Aquatic Therapy and the Healing Power of Exercise by 3n5ulPE


									Aquatic Therapy
and the Healing Power of
Presented by
Maureen Hagan

BA PE (Physical Education)
2006 IDEA Fitness Instructor &
1998 IDEA Program Director of the
Objectives of
1. Decrease pain and swelling and
2. Restore function, physical
   performance & quality of life,
3. Retrain or enhance kinesthetic
   awareness and life skills,
4. Train specific for sport or
   occupation to prevent future injury
   or re-occurrence,
5. Decrease rehabilitation time.
To Heighten Awareness of the
Onset of Injury…

Repetitive motion       Inactivity
 that may be forceful    Sedentary living
 and,or stressful        Regular participation
Poor posture             in exercise and sport
Poor movement           *Aging
 mechanics/patterns      Accumulative over
Overuse                  time
 Leads to repetitive
 strain injury
The Onset of a Injury…
 The body becomes depleted of energy stores (common
  in strenuous exercise bouts) and trauma results due to
  damage to tissues,
 As energy is depleted at a cellular level during exercise
  or repetitive movement, fatigued tissues can no longer
  maintain the proper positioning associated with good
 This focuses stress in certain areas and this increases
  the chance of damage to those tissues (both acute and
 If one does not recover from a bout of strenuous
  exercise, they will not be ready for the next bout and an
  accumulation of deterioration (lack of recovery) and
  performance begins to lag.
 This is the human injury cycle.
Common Sites for Injury to

1. Muscle/Tendon- damaged and scar tissue or
imbalance of muscle.
2. Joint- abnormal motion of a joint or joint has
become unstable due to ligament stress/injury.
3. Nerve- tension or compression decrease in
power to nerve.
4. Biochemical- if over-trained or deficient in
specific nutrients  global decrease in strength
which may compound the problem.
Most Common Conditions
that Benefit from Aquatic
Therapy Exercise…
Rheumatoid Arthritis
Frozen Shoulder
Stress Fractures
Joint Replacement
Muscle Skeletal Injuries
Others include:
Add Further Insult by:

Poor Posture
Poor Movement Mechanics/Patterns
Poor Conditioning/Fitness level
Over Training/Chronic Injury
Poor Instruction/Supervision
Poor Nutrition
THINK Outside Your Box...

Aqua                  Working in Aquatic
 Therapy/Exercise is    Therapy/Exercise is
 Ideal for the          Beneficial for the
 Following Reasons:     Following Reasons:
Magical Properties of Water:

1.   Resistance- ++ work
2.   Turbulence- fitness at all levels
3.   Thermal Conductivity- 82-89° ideal
4.   Buoyancy- “great equalizer”
5.   Hydrostatic Pressure-circulatory
Benefits of Aqua

Properties of:
 Resistance-
     Impose 3-demensional/multi planar movement ideal for re-training, restoring
      function: strength, endurance, stability, ROM, mobility; reduces DOMS
 Turbulence-
     Alter intensity as required which can accommodate variety of needs (by
      adjusting surface area); increases fitness/intensity, cross training effect
 Hydrostatic pressure-
     Decrease swelling, decrease stress on cardiac, increases respiratory demands
      which requires consideration, positive effect on swelling, lymphatic drainage,
      fluid balance (kidneys)
 Buoyancy- increases joint space
     Assists ROM, decreases joint compressive forces, increases joint space and
      reduces pain and stiffness; complements land training (anti-gravity forces)
 Thermal Conductivity-
     Assists with circulation, muscle properties (tension, elasticity), joint and tissue
      pain and stiffness *IF TEMPERATURE IS OPTIMAL FOR THERAPY. May impose
      challenges for rehabilitation participants. Ideal is 89 degrees (minimum is 82°)
Benefits of Aquatic

IDEAL Conditions:
  Improves on fitness components including joint
   stability & mobility
  Decreases joint and tissue pain & stiffness
  Increases muscle elasticity and balance (anti-gravity
  Decreases muscle spasm, tension & DOMS
  Increases vital capacity, circulation & venous return
  Decreases impact stress on weight bearing joints
  Improves fluid balance and lymphatic drainage
Dr Bernie Seigel…

“The emotional environment we create
      in our bodies can activate
  mechanisms of destruction or repair”
 Chronic Disease Cycle…

                    PAIN        Immobilization
Muscle Tension

         STRESS                DISABILITY

                                 Loss of Self Esteem
    Withdrawl     DEPRESSION
Practical Programming
 Aquatic environment must be inviting for clients: ideal
  water temperature is 84-89 degrees F (27-31 degrees
 30-60 minutes in length consisting of a warm-up (5-7),
  ROM (5-7 min) specific to joints/tissues involved as well
  as general, C-V exercise (5-10 min), MSE* (10-30 min)
  including isometric, isotonic in a slow, controlled manner
  encouraging full ROM as tolerated utilizing buoyancy to
  assist, Recovery (socialize, evaluate and revitalize) as
 Low to moderate intensity aerobic conditioning- 2 hour
  window to measure intensity/training tolerance,
 2-3 times per week recommended- progress to 5 days a
  week to include land based programming.
Training Tips and
 Seek the client‟s Dr or medical professional‟s guidance about your mutual
 Assess habits outside the gym; factors that + and - „ly influence.
 Assess history & quality of exercise program prior to your supervision.
 Assess quality of functional vs. isolated strength, flexibility, muscular
  endurance, muscle balance and posture. Integrate function utilizing multi-
  joint movements that require balance and stability,
 Also offer feedback, options/modifications, coach and communicate with
  empathy; self-check style
 Listen to your client and assess visual cues (teach from the deck)
 Never diagnose or prescribe treatment (limited to R.I.C.E) Recommend
  ongoing medical supervision.
 Promote general activity/exercise (however modified)is recommended for
  most all conditions described in this seminar for the benefits associated
  with regular physical exercise.
 Train the joint above and below the affected joint/area to positively stress
  the joints and muscles (proprioception and reaction skills)
 Focus on strengthening the weak for improving function and the
  tight/inflexible will often take care of themselves.
Training Tips and
 Offer/introduce exercise options in the warm-up and cool down so
  participants can prepare and recover effectively
 Teach according to sound principles of training; including functional to
  address ADL‟s in addition to fitness/sports goals and objectives
 Incorporate posture and alignment checks throughout training
 Offer options to all recognizing unique differences
 Avoid repetition and ensure balance in muscle group training
 Educate participants
 Teach/empower participants to listen to their body and recognize signs of
  fatigue, muscle soreness and even structural changes (red flags)
 “Trial and Error” one thing at a time and re-evaluate outcome.
 Do not ignore „innocent signs/symptoms‟ Put up a red flag
 Never diagnose and prescribe Rx- prevention and management
 Never think you know it all. Consult with others
 Follow up
In Closing...
As we embark on the quest to
promote Physical Activity to
everyone, the Fitness & Aqua
Professional is responsible for
recognizing and understanding
the post- rehabilitation exercise

How do/will you ‘fit in’?
References available upon
 GREAT Resource for Functional
    Programming ideas:
“FIT-iology- the study of Fitness in Action”
    by Maureen Hagan, BScPT, BA PE
                                               For more information
*Volume II will be available August 14th at     on workshops…
 Durrett, April “Opportunities in              contact Maureen at:
    Postrehab, IDEA Personal Trainer,
    June 2002 *Great article for those
    interested in creating or developing        The GoodLife Fitness Clubs (in
    their business
                                                 Canada) by email:
 Ball, Daniel “The Psychology of Sport
    and Exercise Injury”, IDEA Health & or phone
    Fitness Source, March 2002 *Great for        at 1800-790-9269 ext 245 or
    developing a better understanding of         on her own website:
    how their client(s) is adapting during
    injury                                     
 CALA- Canadian Aqua Leaders Alliance
    training manual

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