Many people assume that aquatic therapy is only for low level activity, non-impact, or only geriatrics. WRONG!!
Yes, it is used in these settings, as it decreases joint compression forces, allows introduction of an individual to a supportive exercise environment, and returns a patient to functional movement, but over my years of practice, I have also used the aquatic setting for middle school, high school, college and professional level athletes looking to return to high level activities similar to their sport.
For example, running in an aquatic setting can be very beneficial for runners of all levels. An athlete may not be full weight bearing, or may be avoiding full impact on a joint due to recovery. Using an aquatic belt and water approximately 5 feet deep, lifts the patient off the floor of the pool and provides an environment to focus on upper extremity technique, core recruitment, and full lower extremity motion. The graded transition would then be made to chest deep water, with partial ground contact, and waist deep water with full contact to the pool floor. The aquatic belt would then be removed and advanced resistance may be given. At any point, a patient may be given resistance with tubing, aquatic ankle cuffs, or hand paddles. Speed drills can be added to a skilled workout, as well as cutting drills with various angles similar to those used during full sport participation.
Another example of aquatic exercise is plyometric drills. Jumping, hopping, and rebounding in the water is the perfect environment to cushion the impact to one’s joints. Using an aquatic belt gives even more support to landing, by increasing the individual’s buoyancy, and using weighted resistance requires more power to push through the water. Weighted aquatic balls can be used for a various skilled exercises, including focus on vertical training. The use of steps in the water replicates plyo-drills on land, varying height of the step and focusing on landing postures. Using the water for explosive power is easily attained with proper cueing and technique. The central nervous system/proprioception is deeply involved in all of these areas.
Using the water for high level core strengthening is another area many people don’t think about. Just walking through water engages deep core stabilizers surrounding the trunk. Properly engaging the core in the water will promote postural training, body mechanics training and spinal stability. Changing hand placement changes the length and resistance of lever arms, and can provide an intense core work out. To challenge the patient more, a physical therapist can use aquatic tools (paddles, floats, etc.) to further engage the core. Speed can also affect the resistance throughout an aquatic session. By increasing the speed, a dynamic technique can take on a whole new level of difficulty, with more concentration needed to maintain proper alignment and form.
With my experience working in aquatics, I’ve had several athletes inquire about how much of a “rehab workout,” can they actually get in the water. I think they focus on the idea of swimming. Once I get them in the pool, get them moving, and initiate treatment, they realize the possibilities are broader than they think, and their goals of returning to sports participation are in reach!
If you have any questions in regards to aquatic physical therapy, please contact Jessica S., at jessicas@jointventurespt.com .