Posts Tagged ‘Aquatic Therapy and Training’

Aquatic Tai Chi: All of the Benefits and More

August 19, 2009

As an aquatic therapist, I frequently witness the freedom warm water gives individuals who are unable to move with ease on land. One form of land exercise that lends itself beautifully to the pool and actually offers some advantages in an aquatic environment is tai chi. In fact, one form of aquatic tai chi, called “Ai Chi“, was specifically designed for performing in a warm pool. As such, it takes advantage of the water’s properties, fostering range of motion while challenging balance (safely) and facilitating core strength and stability.

Developed by a Japanese swim coach, Jun Kunno  and aquatic therapist, Ruth Sova, Ai Chi literally means “flowing aquatic energy”. The series of movements is simple, but effective and becomes meditative when performed repeatedly and coordinated with the breath. I’ve had the pleasure of doing Ai Chi with as many as 50 people in a large swimming pool at an aquatic therapy conference. Believe it or not,  it can even be meditative in a group that size when everyone is in sync. I love teaching it to my clients and it’s a great way to conclude an aquatic therapy or aquatic fitness session.

Water Tai Chi incorporates more traditional tai chi movements and translates them to an aquatic environment. Like Ai Chi, Water Tai Chi combines the mind/body benefits from traditional tai chi with the gentle, freeing, flowing environment of the water.

One important component of aquatic tai chi is the temperature of the water. The temperature for both Ai Chi and Water Tai Chi should be a minimum of 86 degrees farenheit. This allows for slow, relaxed movement and increased blood flow to joints, tendons, muscles and ligaments. Contact your local YMCA or the Arthritis Foundation to see about classes offered in your area.

Be Well, 


Aqua Pilates: Training Your Core in the Pool

June 16, 2009

Recently I blogged about the benefits of aquatic yoga. Pilates is another form of exercise that can be performed very effectively in the pool. While Joseph Pilates probably never imagined his principals being applied in an aquatic environment – pilates and the pool are natural bedfellows. 

The Pilates Method is unique in that it offers resistance (primarily of the abdominal, low back and buttocks muscles) and flexibility training simultaneously. Pilates also enhances spinal alignment, coordination, balance and body awareness. Furthermore, by fostering bilateral strength and flexibility of opposing muscle groups, Pilates exercises both help prevent and rehabilitate injuries.   

Most of the “Pool” Pilates exercises I teach incorporate the buoyancy of the deep water with the natural resistance of the water. My clients can modify the difficulty of the movements by controlling the range of motion and speed of their movements. I have them wear a flotation device and hold one or two  buoyant barbells for upper body stability in order to isolate their core muscles.

Core conditioning is even more challenging in deep water when there is no gravity to provide stability. Just remaining upright in deep water demands co-contraction of back and abdominal muscles. When this “core-stable” deep water posture is combined with movement, the trunk muscles are further challenged. At the same time, because the exercises are performed without gravity, there is no loading of the spine.

Take your Pilates or other core conditioning workout to the pool this summer. You can cool off and improve your core fitness all at once.

Be Well,


Aquatherapy, Salmon & Traumeel: My healing miracle workers!

March 7, 2009

A few days ago while working in the pool with an aquatic training/therapy client, I got too close to the wall in the deep end and kicked the heck out of  the metal ladder, smashing my second and middle toes and traumatizing my entire foot!!  By that evening, my foot was purple and so swollen I had trouble putting on a shoe!

Seriously, my foot resembled a plump piece of eggplant. Needless to say,  I started to freak out and was pretty certain I’d broken at least one of my phalanges (the small bones in the toes). After limping around much of the rest of that day I decided to put my wellness coach hat while simultaneously becoming  my own client.

So what did I do?  I took my advice and slathered on Traumeel – a homeopathic anti-inflammatory that I recommend to many of my clients – 3 times a day. I also tweaked my diet to include even more healing foods, including salmon, flax oil, chia seeds and lots of vegetables, especially broccoli and celery to reduce inflammation and collard greens for calcium and vitamin K (in case I had broken the bones).

The third key to my healing was spending time exercising with clients in the deep end – without putting any weight on the foot. Moving in warm water helps to pull edema out of the body and increase range of motion of the joints, muscles and tendons. So after a few hours of working in the pool, the swelling in my foot had significantly decreased and I was even able to bend my toes a bit without pain.

I’m happy to report that  48 hours later, my eggplant foot is now nearly back to its usual pale, bony state. I’m walking without much pain and able to wear a normal shoe. Fortunately, I don’t think I’ve broken, rather  just badly bruised my toes. Anyway, this latest trauma was yet another reminder of the incredible healing power of the body – if given the proper tools.

Be Well (and Be Careful!),


You Don’t Have to Know How to Swim to Enjoy Aquatic Exercise

February 7, 2009

Are you a non-swimmer who never goes near a swimming pool, lake or ocean? You’re not alone  – many adults never learn to swim for a variety of reasons.

One of my clients, “Pat”, never learned to swim because her mother feared water and wouldn’t let Pat take lessons. Other clients had traumatic aquatic experiences and were never able to release their fear of being in water. Personally, I nearly drowned twice before I was 2 years old, so I know what it’s like to overcome a fear of water. Ironically, today I make part of my living working in the deep end of a warm swimming pool.

As an aquatic therapist I’ve worked with many non-swimmers who bravely recognized the benefits of aquatic therapy and exercise and overcame their fears enough to exercise in water (even deep water – wearing a flotation belt). Most of them eventually took lessons to learn to swim after growing more comfortable in an aquatic environment.

The warmth of the water is an important component in encouraging non-swimmers to relax in the pool. A warm pool (86F or warmer) facilitates the relaxation of body and mind. That’s also one of the reasons I recommend adults learn to swim in a warm pool.

One of my former clients in Tucson, “Jane”, came to me after tearing her lateral meniscus on the tennis court. A non-swimmer, Jane nevertheless agreed to try rehabbing her knee in the pool with me in an effort to avoid surgery. Much to her surprise and delight, Jane not only  overcame her injury through our work in the pool, she kept up her aquatic sessions post-rehab as she found they provided an excellent way to cross-train with her tennis.

It’s never too late to enjoy the benefits of aquatic exercise and, more specifically, it’s never too late to learn to swim. The Miracle Swim Institute in Berkeley, CA has been extremely successful in their mission to help adults overcome their fear of water and enjoy swimming. If you don’t live in the Bay Area – the Institute has a network of MSI-trained instructors in other states. Many YMCAs also have adult-focused swim classes conducted in warm, shallow water pools with caring, patient instructors. The Palo Alto Family YMCA program is one example in the Bay Area.

So, if you’ve never learned to swim – or you don’t feel confident with your current swimming skills – make an effort to conquer your fear by getting involved in some form of aquatic exercise. The more time you spend in the pool, the more comfortable you’ll become and the more you’ll develop the necessary skills to become a competent, confident swimmer. And, as you reap the benefits of aquatic exercise, I guarantee you’ll enjoy the process! 

Be Well,


Aquatic Therapy & Training Made Me a Better Athlete

December 9, 2008

Growing up, I was never a “water person”.  In fact I was the only one of my friends who wasn’t on the local swim team – even though I was the only one with a pool in my backyard. My sports and physical activities were strictly land-based — soccer, running, tennis and ballet. The only time I took to the water was to cool off on a hot summer day. Furthermore,  I had almost drowned twice by the time I was 2 years old – so an aquatic environment was not exactly my comfort zone. Frankly, if someone had told me back then that I would eventually earn much of my living by working in a swimming pool I would’ve laughed!

My passion for aquatic exercise and therapy began out of personal necessity. As a former competitive runner, I discovered the benefits of aquatic therapy and training 25  years ago after suffering from many running-related injuries (partly due to my idiopathic scoliosis for which I wore a back brace for 3+ years in high school). Rather reluctantly, I began running and exercising in the deep end of a warm swimming pool wearing a flotation belt to take the stress off of my injuries. Much to my surprise, the pool not only became a refuge for me, it became a great cross training tool, by enabling me to exercise hard while helping my injuries heal. It also helped me maintain my sanity during that frustrating period as an athlete.

In addition to healing power of the warm water, I came to discover the performance benefits of aquatic training. For whereas most athletes leave the pool behind when their injuries heal, I continued training in the deep water even as I transitioned back to land running with great results. In fact, upon my return to competition I knocked 20 minutes off of my marathon PR (personal record) and later qualified and placed 31st in the 2000 Olympic Marathon Trials. Furthermore, I became a faster, stronger, more resilient runner and . I used to call the aquatic workouts my “secret training weapon” because it gave me an edge over my frequently-injured competitors by both improving my overall strength and conditioning and preventing injuries.After finishing my masters in exercise physiology in 1996 I went on to study aquatic therapy and become an aquatic therapist specialist and today  I spend many hours a week in warm water helping others heal as well as achieve their competitive goals. With the exception of falling during a race!,  I’ve never had a major running-related injury since I began performing aquatic therapy exercise and, though I no longer compete, today I still run regularly at age 50. Furthermore, despite my scoliosis, aquatic therapy exercise has also enabled me to enjoy other physical activities besides running that have become passions of mine, including: ballroom dancing, tandem cycling and power yoga.

Bottom line:  I would never have experienced success and longevity in my running career or enjoyed other forms of physical activity pain-free had it not been for the water.

Be Well,


Anti-Gravity Training? Just Head to Your Nearest Swimming Pool

November 22, 2008

The other day I was reading an article on a trendy new yoga method called “Anti-Gravity Yoga.  Have you heard of it? Participants perform various postures while hanging from suspended hammock-like “yoga wings” anchored to the ceiling of the studio.  Apparently, you have to be pretty strong to maintain many of the postures, and with participants hanging and swinging from the ceiling there is the potential danger of mid-air collisions. Plus, there’s considerable risk of falling out of the hammock “wings” on to a hard-wood floor! 

Anti-gravity training is nothing new, folks.  And if you ask me, a safer, much more effective way to “throw gravity out the window” is to head to your nearest swimming pool for some anti-gravity exercise – including aqua yoga and aqua Pilates and “Ai Chi” – a form of Tai Chi developed specifically for performing in warm water.

No need to hang upside-down –  the buoyancy of the water naturally offsets gravity. In waist-deep water you are about 50% of your body weight, at chest-depth you’re 35%. In deep water you’re weightless and you can literally “off-load” your entire musculo-skeletal system by wearing a flotation belt or using a noodle. Buoyancy also increases range of motion of joints and muscles, further facilitating movement. Moreover, if you exercise in a warm pool (86 F or warmer), you’ll experience even greater ability to stretch your muscles by increasing circulation.

For more information on anti-gravity training, please visit my website at You might also check out these two short videos for specific information on the benefits of aquatic therapy and training:

Be Well,


Throw Gravity Out the Window!

November 14, 2008

Lately I’ve been thinking a lot about gravity. I suppose it’s only natural given the gravitas of the current economic situation.  It could also be the fact that as an aquatic therapist, I spend many hours a week speaking to clients about gravity’s counterpoint – buoyancy. Apart from outer space, deep water is the only place where we can literally throw gravity out the window and free our bodies (and our minds) of its heavy influence.  

Did you ever consider the negative connotation of the words and expressions that stem from gravity? There’s the aforementioned gravitas, there’s grave – as in “going to an early grave” or thegrave expression on his face“, not to mention the “gravity of a situation“. Buoyancy, on the other hand, coveys lightness, cheerfulness and exuberance – “he was buoyant in his attitude” “the fans were buoyant after the big win“, “she gave him a buoyant hug and kiss at the airport“.

Of course we need gravity to anchor us to the earth. Often, though, we are too weighted down by it – whether it be physically with musculoskeletal pain from injuries or surgery, or emotionally with worry and stress. Certainly our country is anything but buoyant economically right now. Lately it feels as thought we’re sinking rather than floating financially (unless it’s after being given a life raft like some of the banks and mortgage lenders). But maybe it’s time to literally and figuratively “throw gravity out the window” . Smile, breathe, laugh, hope and if possible, emerge yourself in a body of water, trading buoyancy for gravity.

As she was quietly floating upright in the deep end of my warm swimming pool at the end of her workout the other night, my client Cathy said to me, “everyone should have a few minutes a day without gravity”.  I couldn’t agree more!

Be well,


From the Ground Up: Keeping your Ankles Strong and Stable

November 10, 2008

In my past few blogs I covered the shoulder, hip and knee joints. Moving on down the body – we now turn to the ankle joint. Your ankles have a tall task:  they must support the weight of your entire body with only the help of small ligaments and tendons.  Furthermore, whenever you walk, run or jump, your ankles have to transmit the force of impact from your feet to your legs.  No wonder the ankle is the most frequently injured joint in the human body.

Your ankle is a hinge joint formed by the articulation of your tibia and fibula (lower leg bones) and your talus (ankle bone).  Because your ankle is designed to move like a hinge around one axis, it is resistant to lateral movements. Typically an ankle sprain occurs when the foot is forced to invert, resulting in a sprain on the outside of the ankle.  Participating in activities that involve fast-paced lateral movements such as tennis, basketball or dance can leave your ankles vulnerable to injury, particularly if the muscles, tendons and ligaments surrounding your ankle are weak and/or inflexible.

Tight calf muscles can also lead to ankle injuries by making it difficult to flex your ankle. This isn’t a problem if you’re moving on even ground, but if you step in a gofer hole, your foot may come up short and twist laterally, resulting in a potential sprain or even fracture. When this happens, the ligaments surrounding the ankle often get overstretched. Because they aren’t very elastic, ligaments often don’t bounce back to their original supportiveness. Protect your ankles by shortening your stride when traversing uneven terrain. This will allow you to react more quickly to potential pitfalls in the trail. Also, practice walking heel-ball-toe.

Case Study

If you do injure your ankle, the pool is a great place to both rehab it and strengthen it to prevent future injuries. Deep water cycling, running and other ankle-specific exercises can help reduce swelling, restore range of motion (ROM), and gradually allow the return to normal activity.  “Bob” came to me after severely breaking his ankle while hiking in Telluride. The break was so bad that surgical pins were placed in his ankle to hold it together. After several months of aquatic therapy and aquatic workouts, the ROM and strength of Bob’s ankle were largely restored to his pre-accident level. Furthermore, he’s now back to running trails pain-free. For more information on aquatic rehab and training, please visit my website at

The key to preventing ankle injuries is to strengthen and stretch the muscles supporting the joint. Try the following three exercises and be sure to stretch your calf muscles after each exercise.

1. Heel Raises

Standing with your feet shoulder-width apart, rise up on the balls of your feet as far as possible and hold for five seconds, then lower your heels. Work up to 20 repetitions and then try the exercise on the edge of a step, lowering your heels below your toes and then raising them as high as possible. Next try walking on your heels around a room. Stretch your calves afterward by letting your heels hand off the edge of the step and holding for 20-30 seconds.

2. Toe Raises

Standing on your heels, lift your toes off the ground and hold for five seconds. Work up to 20 repetitions and then progress to walking around the room while keeping the toes elevated.

3. Edge of Foot Walking

Alternate walking on the inside edges of your feet and then on the outside. This strengthens and stretches the peroneal muscles above your ankles on the sides of your lower legs.

Be Well,




Kicking Knee Pain

November 10, 2008

No body part is more vulnerable to exercise-related injuries than the knee joint. But exercising regularly doesn’t have to lead to painful knees. In fact, Stanford’s Arthritis Center compared the knee problems of runners and non-exercisers ages 50 years and older over an eight-year period and found that the exercisers experienced 60 percent fewer knee problems than their sedentary counterparts. In another study, researchers at the Boston University Medical School tracked the development of knee arthritis in older adults for nine years and found that exercisers had no greater or lower risk for developing osteoarthritis of the knees. So while exercising may not delay the progression of osteoarthritis of the knees, it doesn’t appear to accelerate it either.

Other Origins of Knee Pain

Like your shoulder and your hip, your knee is a ball-and-socket joint. It is the largest and most complex joint in your body, held together by strong tendons and ligaments which act like stays and pulleys, allowing the joint to twist, bend, push and withstand the stress of hiking, dancing, playing tennis or just climbing stairs.

In addition to osteoarthritis, knee pain is often a symptom of a biomechanical problem or muscular imbalance in another part of the body. Weak quadriceps muscles combined with tight hamstrings can, for example, lead to an improper tracking of the knee and can even pull the knee cap out of its groove. Knee pain can also be caused by excessive foot pronation (when the arch collapses and the foot rolls too far inward) or tightness in the muscles surrounding the hip joints. Worn or improperly fitting athletic and everyday shoes can further exacerbate a knee problem.

Replacing Worn Out Knee Joints

Severe degeneration of the knee joint usually results from osteoarthritis or repetitive knee trauma/injuries. In either situation, the protective cushioning of cartilage wears away resulting in the painful rubbing of bone against bone. Knee replacement surgery is usually a last resort when pain becomes constant and the ability to function normally is impaired. Exercising both before and after surgery is critical: pre-habilitating” your knee prior to surgery makes the post-surgery rehabilitation faster and easier. In both cases, aquatic exercise is particularly beneficial in developing the leg muscles without loading the knee joint.

Case Study

“Tom” came to me three months prior to his scheduled knee replacement. We worked hard in the pool to prepare him for the surgery, specifically focusing on building the strength and increasing the flexibility of his quadriceps and hamstring muscles. Because of the aquatic “prehab” he did prior to surgery, Tom breezed through the knee replacement and was the star of his post-surgery physical therapy class with his very impressive range of motion. For more information on aquatic prehab and rehab, please visit the aquatic therapy/training page on my website at

Strengthen Those Leg Muscles!

Speaking of exercise – “weak in the knees” is more than just an expression. Rehabilitating sore knees and preventing future problems requires strengthening and stretching the muscles and tendons surrounding the knees. When the quadriceps, hamstrings and gastrocnemius muscles are weak and/or tight, the knee joint receives the brunt of the force with weight-bearing exercise or activity. Exercises such as wall or chair squats, seated leg lifts and even stair climbing strengthen the leg muscles so they can provide shock absorption for the knee joint.

Note that knee pain can result from a sudden increase in exercise. Give your knees time to adjust to a new activity level by gradually increasing the duration and intensity of your workouts and by scheduling rest days in between. Also, make sure you have the proper adjustments when using exercise equipment. For example, a bicycle seat that’s positioned too high or low or too far forward or backward puts additional stress on the knee joint. Bottom line: exercising intelligently doesn’t increase your risk for knee problems, but being sedentary does.

Be Well,



The Hip Bone’s Connected to the…..

November 10, 2008

In my last blog I discussed the shoulder joint. Now, I want to take a closer look at the hip joint, formed by the junction of the pelvis and the femur (thighbone). Like the shoulder, the hip is a ball and socket joint. Unlike the shoulder, the hip joint is a deeper, more stable joint due to its weight bearing role. Moreover, in contrast to the shoulder joint, the hip joint is further stabilized by the resilient muscles and ligaments that surround and cross it.

 The hip joint is part of the so-called “pelvic girdle”. Because of this, the flexibility and strength of the muscles and ligaments surrounding and crossing the hip joint affect the pelvis and the entire spinal column. For example, some of the muscles crossing the hip have attachments on the spine so hip movements can have repercussive effects on the spine. Movements of the hip joint include flexion (moving the femur toward the pelvis); extension (moving the femur away from the pelvis); adduction (moving the femur toward the center of the body); abduction (moving the femur away from the center of the body); lateral and medial rotation (turning the femur outward or inward); and circumduction (moving the femur in a circular direction).

Common Hip Injuries

Typical hip injuries include trochanteric bursitis, hip adductor strains, osteoarthritis of the hip and hip fractures. An inflammation of the bursa, or fluid sac, of the trochanter bone, trochanteric bursitis presents as a pain in the side of the upper leg.  This inflammation can also affect the fascia (fibrous connective tissue) surrounding the hip joint. Trochanteric bursitis is often caused by a leg length discrepancy. A strain of the hip adductor muscles (commonly known as a groin pull) frequently results from quick lateral movements or slipping on wet pavement. Adductor strains can also be caused by imbalances in the body or when there’s not enough lateral movement of the ankle.

Osteoarthritis of the hip can sometimes be caused by repetitive trauma to the hip joint. If severe enough, it may necessitate a total or partial hip replacement. Hip fractures are usually one of two types:  a femoral neck fracture one-to-two inches from the joint, or an intertrochanteric fracture three-to four inches from the joint. Most require surgical repair with the use of either a pin or a compression screw and side plate to keep the bone in place while it heals.

Strength and Flexibility

When hip structures are weak and unstable, excess forces are transferred down the leg during impact exercise, leading to injuries of the knee, ankle and foot. The key to preventing hip injuries is to strengthen the muscles supporting the hips with exercises such as squats, leg presses or even stair climbing. For those with osteoarthritis of the hips, water exercise and stationary cycling are ideal. Flexibility of the hips is equally important and can be enhanced with regular yoga and stretching exercises. 

Case Study

“Lisa”, a competitive runner, came to me with chronic left hip pain. I discovered that Lisa had a leg-length discrepancy which was compounded by tight hip flexors and tight and weak hip extensors.  I recommended Lisa see a sports podiatrist to correct her leg-length discrepancy with an orthotic. I then prescribed a daily yoga routine for her, emphasizing hip-opening and gluteal strengthening postures. Today Lisa is training for her 5th marathon….pain-free! For more information on athletic training and rehab, please visit

“Bottom” Line

Right now you are sitting on the biggest muscle in your body – your gluteus maximus.  Keep it and your other gluteal muscles strong and flexible and your hips will be happy years from now.

Be well,