Monday, September 8, 2008

The Wonder of Water

It’s probably the best-kept secret in the rehab book: water is unbeatable as a way of getting back to fitness -- safely, securely and fast. You just need to know how to use it. In the new Sports Injury Bulletin, we give you the authoritative low-down on WHY water works so well and HOW to make it work for your clients, so they can come back from injury fitter and faster.
It’s pretty well known that if you want to reduce impact on say, a broken leg or badly sprained ankle, a water workout will reduce the loading on that limb. But there’s so many more advantages to water. Such as:
-Buoyancy
-increased proprioceptive demand, by using turbulence and current
-increased resistance, because of water’s greater density
-decreased eccentric demand on the muscles
-increased stability
Consider just two universal problems of early-stage rehab for almost any lower-limb injury: swelling and loss of proprioception. As the article explains:
”Swelling is often a major problem of injury and can restrict the exercise prescription. With swelling, there is usually also a reduction in neural firing within the musculature around the injury site. This can leave a legacy of problems with stabilisation and firing patterns when we are preparing to get the rehabilitating athlete back to full function. So swelling needs to be addressed early on.
“When a limb is immersed in water it is under higher pressure than on land. This can be beneficial in two ways for early-stage rehab: it may help reduce swelling at the injury site (especially helpful for, eg, contu¬sion, sprain or post-operative injury sites); and it reduces the risk of new, or increased swelling arising from the exercise.”
Or consider proprioception, the foundation of good balance. It’s the key to effective rehab for any foot or ankle injury, and an essential component of any lower-limb or hip injury rehab. Standing on one leg on land only gets you a small way towards recovery of this complex function, because the therapist or trainer cannot easily create random movement to challenge the body’s proprioceptive responses. In water, as we explain, this becomes easy:
“The therapist can create specific current direction or speed. An excellent example is to hold standard flat floats perpendicularly under the water to create maximum resistance and then push them towards the athlete to create current. Alternatively they can be pulled away to make a ‘suction’ current from around the athlete. This pulls the athlete towards the person with the float, changing the nature of the proprioceptive demand.”
SIB’s clear and knowledgeable briefing looks at:
-how to control eccentric loading,
-how to conduct stability training, and even
-how to undertake very effective plyometric work in water – allowing your athletes to start to regain explosive power without having to wait until the late stages of their land-based rehab.
It’s also an ideal way to introduce plyometrics safely to novices.

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