AC4me Week 12

Maximize your Aquatic Exercise

AC4Me Article:  Week 12

 

For the final three articles for AC4Me, we are going to feature the three environments and various modalities of group, non-competitive, non-sport exercise our SLV Recreation Center offers and staffs with instructors. (I am the stand-in (er, float-in?) ghost writer for the ghost who usually writes these articles.)

 

A Mini-History of Aquatic Exercise

The water environment has long been found to be a superior healing and recuperation environment for the body. To help those stricken during the polio epidemics after WWI (20s and30s) and WWII (50s), in 1932, President Roosevelt, himself a paraplegic with the ravages of the epidemic of the 20s, founded his “Little White House” in Warm Springs, Georgia because of the water therapy in the natural springs there that had helped him when he first visited them in 1924. roosevelt_lwh2 A beloved cousin of mine, ironically born in 1924,  was stricken 3 weeks after her mother died (ironically in 1932) after tending to my mother and her three orphaned siblings in a flu epidemic of the thirties that often attended the major polio epidemics. She was admitted after her diagnosis (this took two months and quarantine in Junior League—my teenage mother went into quarantine with her) to Warm Springs for rehabilitation therapy, and there she lived for over four years—from nearly 11 to nearly 15–– among many, many other children stricken by the virus, and among some, including the President, who were actually stricken not by Polio Myelitis/Infantile Paralysis but by an auto-immune disease, like my own daughter at age 17, called Guillain Barré Syndrome instead of Polio, a disease that mimics polio except that, being auto-immune instead of viral, a greater paralysis recovery is possible  because the myelin sheath of the nerves can grow back, even if incompletely (at least until Old Polio Syndrome kicks in, for both illnesses).  The President helped teach my 10 year old cousin to swim (on her back using her arms like fins of a small fish) and play water polo––he once, accidentally, beaned her on the head! The children were removed from iron lungs if the breathing muscles were able to function for awhile and placed daily in water and helped to learn to float, and to swim and play.  There they could take off their braces or ditch their wheelchairs and be just like every other kid—they had a school, nourishing meals, friends, therapists and exercise.   My cousin (I always called her “Aunt”) could never walk, but she graduated high school and college and graduate school and became an English teacher for  nearly sixty years.  She swam whenever there was somebody or a lift to get her into a pool.  That and rolling her wheelchair and an indomitable spirit probably helped her live, despite all odds, to the age of 89! by herself, though Old Polio Syndrome reduced her mobility to nothing during her final years.  She was 95% paralyzed when she died, still telling her stories of swimming and dining with the President.  Because of the Rehabilitatin Center at Warm Springs—internationally legendary—nearly every Rehabilitation Center in the U.S. and most of the world featured and researched therapeutic exercise in water.  These were the pioneers in Aquatic Resistant Exercise and the effects of hydro-dynamics on bio-mechanics and healing.

The concept of athletic and fitness training in water, however, did not become an idea and really take off until decades later, long after the land fitness gym had become standard and ingrained in particularly the American culture. In the 70s the fitness craze boomed with the  popularity of Jack LaLane on TV and then Jane Fonda’s exercise tapes. The only filmed aquatics was in Tarzan movies and in synchronized swimming with beautiful girls practically dancing on the water, and of course the balletic performances of the swimming movie star, Esther Williams.   Fitness became linked with a kind of stardom and performance.  But fitness as sport and athletic training was on the rise, right in sync with the Women’s Movement, and interest in aquatic vertical exercise—water aerobics or aquacise as it was earlier called—also increased.  We used gallon water jugs as “weights” in the water in the 70s and early 80s (tearing out our rotator cuffs as we tried to submerge them and they flipped us out! Entrepreneurs became interested in progressing the exercise with equipment, just as in the fitness room. So of course, since dumb bells were in the weight rooms, a version of them was marketed for water. Though wooden double pinwheel, vented “paddles” had been therapeutic equipment since the 30s and 40s, and still are––updated to plastic with adjustable vents—widely used for athletic and strength training as well as arthritis aids, the invention of plastics and foam in the sixties and seventies made foam dumb bells easy and cheap to make:  a plastic stick between two foam wheels. These became (nearly) the only training and exercise equipment available, resembling in shape the hand dumb-bells people used in gyms.  It is amazing how the shape-familiarity of something persists—cognitive studies teaches us that shape is the primary stabilizing conceptual metaphor that produces all of thought and reason through spatial awareness metaphors.

However, though we can create a motor boat and drive it like a car, we know that a boat must float and cannot look like a car or have wheels—the surface resistance must be increased with a boat and decreased for a car. We were not that smart for a long while about aquatic exercise equipment.  It took a couple of decades and the professionalizing of aquatic exercise through the rise of professional associations and university sports, health, recreation, and therapy programs to tease out the fact that water exercise and training (and therapy) are exactly the opposite of land exercise, because the aquatic environment is opposite.

Differences Between Aquatic and Land Exercise

Whereas on land there is weight and gravity, the water has buoyancy, and in it we can be virtually weightless.  Waist deep we weigh about 50% less; chest deep, 75% less. Whereas all power moves on land are upward and against gravity, the power moves in water are always downward against buoyancy—we don’t have to lift our leg in water as it will float up all by itself. Jumping up in water is pointless—the hard part is to get both legs back down to the pool floor.  Bobbing up and down and hopping about provide zero exercise benefit in the water—the real exercises is getting your feet to stay flat on the floor to sit down and perform a jog in the water without bobbing one iota, to cross country ski in water without moving the neck or turning the torso or bobbing, with full extension of arms and legs forward and backward (with knees and elbows nearly straight, including extension of hands and feet for 7 to 11 more inches of lever length), pumping the feet with each ski, putting heel down in the front to dorsiflex, toe down behind you to plantar flex.  Air/air pressure is thin and cannot be felt except when it is moving, as wind, or when you are moving through it as in a long fall, again felt as wind rushing past you, helpless to catch you.  But water/hydrostatic pressure is always viscose, and movement creates not only directional current, but turbulence, inertia currents (oh, and with a Sunami at the other end!), and other weird motions or stillnesses that can topple anybody off a noodle or overpower the most powerful swimmer.  It will also catch your fall and float you.

As the science of hydro-dynamics in concert with bio-dynamics and body systems expanded and deepened knowledge, they altered the strokes of swimming to make them more safe for the joints and more efficient and powerful, and all the dynamics of vertical water exercise for the same reasons. Many other kinds of buoyancy and resistive equipment have now been developed and are still being developed for water training and exercise. Water does use muscles differently and it does ease the vertical weight stress on joints—BUT it increases horizontal and all other directional “weight” on the body.  It just distributes that “weight” and force of resistance all along the limbs rather than one point.  This distribution of force along the levers actually enables a person to work more “weight,” not less.  I have trouble lifting a 30 pound weight with a biceps curl on my left arm, but no trouble at all working 40 pounds of water resistance distributed from my left shoulder to straight elbow, flat wrist and hand.  Though you can intend to target a muscle or muscle group in the water, you will be recruiting many other muscles as well, and often most of your muscles, just to stay upright. Vertical water exercise is not swimming—swimming is streamlining to decrease resistance for speed. Vertical water exercise is increasing the surface of resistance and adding speed to increase the force needed to move through the water and keep from floating.

Floating is death to exercise.

In water, you can train muscles concentrically, if you use equipment properly, even simple, webbed gloves.  But without equipment (or sometimes with) a great deal of vertical work trains muscles “eccentrically”—in their lengthened state (on land this would be like walking down hills which makes your tibialis anterior muscle sore—that muscle is lengthened by the slope but is holding up your entire body in its non contracted state; or lowering a heavy weight slowly with one arm—the muscles of your biceps have to work in a lengthened state rather than concentrically contracted to lift the weight.  A lengthened biceps muscle group is around 6 inches long, though contracted/shortened is maybe 2 to 3 inches long.  Whereas on land you rarely have to perform a sustained isometric contraction of your core muscles or your gluteals (except against strong wind as against strong water current), in water there are currents created when you, other people, and wind move the water, so sustained isometric core work is a huge constant in vertical water exercise—water provides 12 to 44 times the resistance of air.

It is fun and hard at the same time to combine two exercises at once in the water along two planes of motions, a feat nearly impossible on land and in gravity (trapeze work and gymnastics the two exceptions, parallel situations because you are immersed and suspended, feet off the grounding/stabilizing ground in both environments). One of my favorites is a deep water suspended cross country ski with full, extended lever range of motion on the sagittal plane (opposed arms and legs, forward /backward movement) for the legs and hips (hip acting as part of the leg to increase the lever-length and add the strength of extension muscles) but changing the Nordic Track arms to an open lateral/horizontal sweep to the sides on the frontal plane of motion. I call it the “Flipper” because we look like Flipper the Dolphin when we do it, our rhomboid muscles squeezing our shoulder blades together and helping to pull arms (with thumbs up to protect the shoulder joints from impingement) wide and to the back then slicing forward and together in front.  Your legs are keeping you up, their pumping back and forth builds a shelf of inertia current below you.  Your arms move laterally to balance your upright torso so you don’t fall over.  Huge core body strengthener and CV workout. That is a great exercise for intervals—your hr will skip up to nearly maximum in about 10 seconds, which for me, at 68, is 180 bpm, the average maximal heart rate of a forty year old and better than it was when I was forty, after twenty years of smoking and emphysema. I quit, on my surgeon’s orders, by starting to swim laps daily again, as I did all my growing years, and do vertical water exercise.  I discovered that cigarettes and chlorinated water do not mix well—the chemical reaction between chlorine and tars probably from the chemicals in the paper makes cigarettes taste terrible for awhile.  So every time I wanted a cigarette, I went to the pool and swam laps.  Finally I stopped coughing. And I was able to progress to suspended cross country ski laps, which are much more strenuous—it was then I finally could feel breath slamming against my contracting diaphragm. Five years of daily swimming and water aerobics cleared all traces of emphysema.

A Brief Inventory of Aquatic Exercise Equipment:

(As always, make sure your are doing the exercises properly in good form before you use any equipment at all).)

Buoyancy Equipment

Noodles—4 types: recreational standard or closed cell noodles (flimsy) and recreational large diameter noodles (stiff and hard), neither of which are very good as exercise equipment;  closed cell foam  very dense standard noodles usually smaller in diameter but with the buoyancy of a larger noodle. and closed cell octagonal “super noodles,” longer and larger and octagonal in diameter, and absolutely solid to the core as no water ever penetrates.  These last two are superior for aquatic exercise use and safe for straddling, swinging on, and to use as a fulcrum for aquatic gymnastics and intense suspended work.  Also square in circumference large noodles—have never seen or worked with these.

Foam dumb bells (see *note at end)

Buoyancy cuffs for ankles and wrists (several varieties)

Webbed gloves (these act as both buoyant and resistant equipment––great for all water work, they add surface area resistance and buoyancy simultaneously.  My favorite are the Speedo Velcro close.

Resistant Equipment:

Vented paddles, plastic with ergonomic grip, and they don’t have to be gripped.  Great for strength training as well as dynamic water aerobics.  Not to be used in deep water for suspended work.

Boxers and kickers: plastic, these resemble medieval torture equipment, but are wonderful worn around lower legs and with hands inside the boxer with ergonomic grip.  Does not have to be gripped with hands inside, held on the outside grip, they invert to kells. (No longer manufactured, pity.)

Resistant bands, looped at ends: wide or narrow tubing.  Great for strength training of lower and upper body—as long as the joints, even the shoulder, are submerged in the water).

Fins:  for better butter burning by the muscles of the buttocks.  Training fins for shallow pools, scuba or standard fins for deep water.  These are fabulous for vertical water exercise.  Really burns the buns and the calories, build muscle.

You can adapt anything made to go in the water for some sort of game or exercise or both: balls, splash bombs, Frisbees, jiggle bars, etc.

Personal Best in Water: Success Stories

So I’ve given you a couple of my personal and family success stories regarding aquatic exercise for therapy, recovery and fitness. The threat of death is a powerful motivator.  But pain is also a motivator—and water exercise has enabled me to live and manage myself well within fibromyalgia, ankylosing spondylitis, psoriatic arthritis with attending vitiligo and scary melanoma episodes that fortunately were caught very early, and brushes with several other auto-immune diseases.  Water enabled my daughter to walk again and live semi normally again, and is still her primary, well, really her only form of exercise nowadays.

Over the past ten and even just five years, research that tests aquatic exercise for training as well as therapy against comparable exercise on land has exploded, and has shown the aquatic environment to be a superior training, as well as therapeutic, environment, and in many ways the superior athletic and conditioning environment (see notes at the end).  All those fairy tales about water not being a weight-bearing form of exercise have been pretty much debunked by professionals who understand how water really works the body and the body really works the water.

Designing the water therapy for my daughter after she left the Rehabilitation Institute of Chicago, on quad canes at age 18 looking like she was doing an imitationof a very spritely 90 year old woman; and helping my dad in his mid and later 80s rehab and get some speech back after each of his countless strokes, and teaching various aquatic classes and populations at SLV and elsewhere has put me—like all of our instructors here at SLV and elsewhere–in daily contact with amazing success stories.  Of course everybody wants to lose a few pounds or a lot of them—and many who work out in the water do lose weight.  Many more maintain their healthy weight through regular aquatic exercise as well as other exercise.  But success has many faces in a­­––shall I say “seasoned”?—population like we have in our small retirement resort community.

A favorite poem begins “Excellence in millimeters, not miles.”  I have worked for going on three years with an amazing, spirited, determined lady who suffered a massive stroke that left her with severe contractures—spasticity. That she survived is success.  That she walks with a cane and the nifty aid of a Bioness is success. That her arm can finally nearly extend at her side instead being locked in a contraction that puts her fist at her face, that each week there is a millimeter more of mobility that we manage, that she can push a noodle down in the water, can pull that noodle backward across the surface, that she can balance in the water to walk, that she can with only one hand of someone’s help, do cross country skis and jax in the water, those are many miles that it has taken years of millimeters that she inches out daily with her husband/devoted coach and with me weekly.  Another lady who joined AC4Me this winter and started coming to class, is exultant! A strange and thus far nameless neuromuscular disorder caused nerves to die and of course muscles to atrophy right along the path of the nerves.  After two fusion surgeries to see if decompression would help the neuro-muscular pathways, and lots of rehab that got her not very far, and dropping everything she picked up and being more and more limited in her range and intensity of activity, she got in the water. She is thrilled to be able to pick things up without dropping them now, to walk across her floors with a cup of coffee without dropping or spilling it.  She works sometimes two hours in the water, in class, alone and with other neuromuscularly challenged exercise friends.  She’s thrilled to be using some muscles she didn’t know she had to make up the deficits along the kinetic chains and hoping that others come back to life one day, thrilled that her clothes fit better and looser, that her health and energy are great, that she has regained a world of fitness, health, activity, that she can knit again, that she is nearly pain free. “My improvement is huge!” she beams, right at me and her exercise buddy who is showing us what she can do after just two weeks in the water: touch her thumb to her little finger on the same hand, and go through day after day without being sickened with headaches, as well as perform an uncommon amount of water exercise and not be tired, and see day by day the resculpting and balancing and lengthening of bunched and tense muscles.  Another mile of millimeters.

Our Aquatic Program Here at SLV 

We here at Savannah Lakes Village are extremely fortunate to have two pools, one of them indoor and year around, in which to exercise, stretch our muscles and limbs and spirits, and have fun.  We are deliriously lucky to have a large staff of six dedicated and certified aquatic fitness professionals who design, prepare and instruct a variety of aquatic fitness classes, including one Master Trainer/Rehabilitation Exercise Specialist who trains instructors and designs training programs and edits/writes/films educational materials across the United States and internationally. In fact, the SLV recreation center offers 16 classes every week: water walking (and I kid you not—there are more than 100 ways to walk in the water and get a full body workout and toning, every body system); three intensity levels of water aerobics taught by three different instructors so you can switch around for variety and their different takes and expertise, with Level One specifically designed to train correct form and to progress the aquatic exercise skills and inventory for seniors and people with common medical conditions and arthritis, all the way to the level of weight loss/management, while training for ADLs (Activities of Daily Living), as well as for strength, endurance, balance, coordination, posture, flexibility, cardiovascular health, and increasing VO2 uptake; and one specialty class, Aqua Power Gym which is a power class that turns the pool into a 360º multiplex gym, using the body alone and with specialized equipment for circuit training, interval training (intervals take you to your strength, skill, speed, force, range of motion, and cardiovascular limits—nearly gasping—for brief intervals interspersed through various double plane-of-motion exercises), strength training, core conditioning, and aquatic gymnastics. scheduel

 

All of your instructors can tell you success stories of fitness and the sense of well being, of community, stories of weight loss and healthy weight maintenance, gains in strength, power, balance, posture, VO2 uptake, cardiovascular health, and flexibility (and oh, is that important or what!?—recent research shows that joint flexibility has a 1 to 1 relationship with arterial flexibility, I kid you not!–a one to one ratio.  If you can touch your toes and perform a 55 degree torso rotation and pat you left shoulder with your left hand without touching or scrunching your neck or head, you probably do not need a stress test.  The reverse is also true).

 

We know you are a success story too—or you intend to be, else you wouldn’t be reading this.  So come on in with us, for the first time or the thousandth—(re) dedicate yourself to your own excellence, your own health, joy, wellness. Set a goal, and if you are not quite sure how to go about reaching it, ask us.   The AC will help get you there. Maximize your aquatic exercise!

 

 

 

 

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Notes and Quotes

 

“Water exercise can relieve pain and improve physical function on land. . . .”

Training in water provides significant improvement in balance and stability among older adults, and superior improvement in “forward reach.” Exercising in water may be more appropriate than land exercises for individuals with musculoskeletal problems. In addition, Simmons and Hansen found that water exercise was a means of improving forward reach in community dwelling elders. Their study had 4 groups. Improvements in forward reach were significant in the land and water exercising groups. These researchers noted greater compliance of a water exercise group compared with 3 other groups. Furthermore, the majority of the water group (80%) continued to exercise several months after the study. Simmons and Hansen demonstrated a greater increase in forward reach with aquatic exercise versus land exercise. Forward reach has been shown to correlate with forward limits of stability.”

         Journal of Geriatric Physical Therapy Vol. 26;1:03

The Effect of Land and Aquatic Exercise on Balance Scores in Older Adults.

Peter Douris, PT, EdD, Veronica Southard, PT, MS, GCS, Celia Varga, PT, MS, William Schauss, PT, MS, Charles Gennaro, PT, MS, et. all

Journal of Geriatric Physical Therapy Vol. 26;1:03

“The water provides a natural resistance and can be used to strength train the entire body, says the American Council on Exercise. If you are new to exercise or working out in the water, focus on pushing and pulling yourself through the water as you perform each movement.”

(“Can Water Aerobics Restore Old Muscle Loss.” LiveStrong.com

Resistance training is probably more important for people after the age of 40 than before and becomes more important with each decade, as resistance training can help offset the usual rate of decline of muscle strength. “(15 to 20% per decade in the sixth and seventh decades and 30% per decade thereafter.)

Therapeutic Exercise—Foundations and Techniques.  Fifth Edition, Lynn Allen Colby, PT, MS E.A. Philadelphia: Davis Co, 2007, 29-30.

In a reseach study in specific muscle activation and strength, carried out R the University of Valencia,  Valencia Spain and at Appalachian State University, “ data . . . showed that there was significantly greater activation of the muscles . . . when the exercises were carried out in water compared with when they were carried out on dry land.”

“A Method for Monitoring Intensity During Aquatic Resistance Exercises,” Juan C. Colado, et. al. Univ. of Valencia and Neuromuscular Laboratory, Appalachian State Univ., NC. http://libres.uncg.edu/ir/asu/f/Triplett Travis 2008.pdf (Vol 22, Number 6, November 2008.  Copyright © National Strength and Conditioning Association.

“Muscle Loss

The most common cause of muscle loss or muscle atrophy is not using your muscles enough because of age and/or a sedentary lifestyle. In cases where disuse is the sole cause of the loss of muscle, the right nutrition and exercise program can reverse loss, reports MedlinePlus. However, if there is an underlying neurological or other chronic illness, your doctor or physical therapist will need to review your case in order to determine how much muscle you can expect to regain through exercise.

Water Aerobics and Muscle Strength

While building muscle is most often associated with lifting weights, water aerobics can also help. The water provides a natural resistance and can be used to strength train the entire body, says the American Council on Exercise. If you are new to exercise or working out in the water, focus on pushing and pulling yourself through the water as you perform each movement. As you get stronger, you can use fins, buoys, plastic water jugs and many other devises that add even more resistance.

Strength-training Guidelines

Whether you use weights, machines or water for your strength-training program, there are some general guidelines that will help you get the most out of your workout. To regain muscle mass or improve muscle strength, you must challenge your muscles to the point of fatigue. You want to do two to three sets of each exercise using a resistance that is heavy enough to cause fatigue on the eighth to 12th repetition, explains the Harvard Medical School. Aim for two to three workouts a week, allowing for a day of rest in between. Make sure your water aerobics program is well-balanced and includes exercises for all the major muscle groups.

Considerations

Performing the same exercise routine over a long period of time can lead to your body’s adapting to the routine, and you may no longer get the same benefits as when you started.”

[So be sure and change it up: participate in other aquatic classes and land classes, learn to swim and do it, find other active things you enjoy and get good at them.  Instructors have large arsenals of exercise and equipment inventory that they learn to use while getting their 16 recertification hours every two years and additional certifications—they are trained and very good at helping you change things up. Author]

http://www.livestrong.com/article/546203-can-water-aerobics-restore-old-muscle-loss/#ixzz2Mn36U6jw

A new study from Canada, presented at the Canadian Cardiovascular Congress in October 2012, “showed that maximal oxygen consumption, a measure of an effective workout, was the same whether the cycling took place on land or in water.  Exercise in water has long been considered a good alternative to landbased workouts for the overweight or people with joint problems or injuries. What’s new here are the findings that exercise in water can be equivalent to training on land and may be more efficient than a land-based workout because the pressure of the water on the legs and lower body makes the blood return more effectively to the heart.”

Andrew Weil, Weekly Bulletin, 11/22/12.

 

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More on aquatic dumb bells and buoys

*Foam buoys/dumb bells when submerged in water are much heavier than land hand weights in gravity, and must be gripped intensely unlike small hand weights. None of their underwater effects are the same as those of land weights! – you cannot use them to target arm muscles in water. It requires huge, primarily upper back and deltoids and upper traps and lat dorsae strength  to continuously keep the shoulders down and pushing on the weights.  You can’t “lift” weights in water if they and the water are both buoyant.  You have to hold them down.  Eventually, even with a strong person, they will pop up anyway and can yank one or several joints out of their normal range of motion as the exerciser fatigues. Now that a zillion foam dumb bells inhabit the equipment rooms of most club pools in the United States, we know that buoyancy equipment, especially that which forces a firm grip around a small, hard circumference, can be cautionary for anyone not as strong (especially in their weakest links, like finger, wrist, elbow, and shoulder joints) as the equipment, especially if you add the properties of water and the bio-dynamics of the body in water.  Now we know that while it is very difficult to injure oneself in the water of a pool without equipment, exercising in the pool with water equipment takes a lot of training to be safe—or a person will be injured in almost precisely the same ways they are injured in a gym with no trainer to teach them and a weight or a machine they do not know how to use or are not strong enough to use or the right size to use. Pushing and holding a dumb bell with even small foam weights down through the water with the shoulders held in safe downward and back position by the muscles of the thoracic back, upper arms and shoulders, is the equivalent of lifting two 20  pound weights on land and if you move them with force through the water they way they are supposed to be moved, that is the equivalent of moving the two 20 pound weights through the air in a 40 mph wind.  So most people keep them at or near the surface where they are not so “heavy,” which of course causes the shoulders to rise up around the ears, contracting, shortening all the muscles of the neck and around the vertebrae (which over time will cause compression of the vertebral joints and spinal nerves),  and immobilizing the muscles of the back while packing into little circles of concentric contractions the upper-mid trapezius muscles which in turn rounds the shoulders and humps the upper back like those of a line-backer and causes the head and neck to start to fall off the thorax.  What most people don’t realize, is that you can get just as much force going, and much more safely, using the arms and hands, feet and legs, and core abdominal and thoracic back muscles properly with no equipment at all, perhaps increasing the surface resistance of the hand with webbed aquatic gloves.

 

 

 

 

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