Aquatic Therapy and the Healing Power of Exercise by 3n5ulPE

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									Aquatic Therapy
and the Healing Power of
Exercise
Presented by
Maureen Hagan

Physiotherapist
BA PE (Physical Education)
2006 IDEA Fitness Instructor &
1998 IDEA Program Director of the
Year
Objectives of
Therapy/Therapeutic
Exercise…
1. Decrease pain and swelling and
   disability,
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
  mechanics.
 This focuses stress in certain areas and this increases
  the chance of damage to those tissues (both acute and
  chronic).
 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
Occur…

INJURY CAN OCCUR IN:
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…
Osteoarthritis
Rheumatoid Arthritis
Fibromyalgia
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
Genetics
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
     effect*
Benefits of Aqua
Exercise/Therapy…

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
Therapy/Exercise…

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



    Isolation/
                                 Loss of Self Esteem
    Withdrawl     DEPRESSION
Practical Programming
Considerations...
 Aquatic environment must be inviting for clients: ideal
  water temperature is 84-89 degrees F (27-31 degrees
  C),
 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
  required,
 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
Recommendations...
 Seek the client‟s Dr or medical professional‟s guidance about your mutual
  client.
 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
Recommendations…
 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
process.

How do/will you ‘fit in’?
References available upon
request.
 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…
    Can-Fit-Pro
 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 &        mo@goodlifefitness.com 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                                      www.mohagan.com
 CALA- Canadian Aqua Leaders Alliance
    training manual

								
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