Sunday, August 24, 2008

Aquatic Therapy

"...for whatever we lose (like a you or a me)it's always ourselves we find in the sea."- e.e. cummings.

I've never had a real athletic training room. But if I had to give up our swimming pool to get one, I'd gladly pass. The athlete in the picture is rehabing a hip flexor strain. He is doing some deep water mountain climbers, then some hurdle walks in the shallow end.

Aquatic therapy has gotten a bad rap. The reason being it is over used, or not used in the context of the big picture. In northern N.J., private clinics sprung up in the 90's that only did aquatic therapy. I imagine to justify the tremendous cost of building the hydrotherapy units, everyone got thrown in the water regardless of injury or stage of healing.

In general, I feel the further you go down the road in the rehabilitation process, the less valuable the aquatic environment becomes. I use it primarily the first few few weeks after an injury to reduce edema and preserve function. It's not the same as just submerging the body part in a whirlpool. It has more to do with the hydrostatic pressure of the water (7 times the resistance of air) pressing on the body combined with the weightless environment. This creates a cardiovascular response that enhances venous return more than any other modality can.

A little further down the road you can use this environment to ease the athlete back into weight bearing activities. At neck height, you are working with approximately 10% body weight; chest- 20%, umbilicus- 50%. With the use of underwater steps, I can begin step ups & single leg squats long before I can begin them on land. The same holds true with proprioceptive exercise. Do you think e.e. cummings had this in mind when he wrote that poem? I'll be posting more on aquatic rehabilitation in the future.


Josh said...

Kudos on the fantastic blog!

I look forward to further info on aquatic therapy. Perhaps some suggestions on educational resources?

What injuries do you most often utilize pool work for? At what stage?

Anonymous said...
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Joe Przytula said...

Mainly lower extremity, but occasionally low back & shoulder.  Check back frequently- This post was just a quick overview.