By Nancy Alexander, PT, CSCS
Go ahead, get in the water and move. This time of year is a great time to change up your exercise routine by performing some exercise in the water. Regardless of where you live, the water can be downright refreshing and even therapeutic. Here we will discuss the benefits of water exercise and offer some simple exercises to get you started that take only 20 minutes to do.
Many of you may not realize I am a big fan of water exercise. It wasn’t long after starting my career as a physical therapist that I became a certified instructor for aquatic exercise and rehabilitation. I can safely say I instructed hundreds of patients in water exercise over the years in each facility where I practiced. This even included home care where I set up a contract with a local college to use their pool for our patients. I was that sure that it would be beneficial for them. And it was. I have repeatedly seen the results first-hand of how the water has improved the quality of life for so many.
I’ve heard the naysayers tell me, “But Nancy, we don’t live in the water. How can it help?”
My response is always, “I realize that. But the benefits gained in the water help you on land.” Once they experience it, they fully understand.
Water exercise is typically done in chest-deep water, so you can push off the bottom or jog in place. Don’t let depth scare you, though. Many people start in the shallow end and eventually move to the deeper end which can provide a more challenging workout in terms of strength and balance. Water temperature is ideally between 83 – 86 degrees Fahrenheit so that it is comfortable yet cool enough to prevent overheating.
All you need to get started is a pool and a bathing suit. No equipment is needed. But if you want one thing, I’d make it a noodle. There is just so much that can be done with it and they are easy to find online or in department and dollar stores.
If you need further evidence of water’s benefits or just want to know how to make up your own routine, the following principles will help guide you.
Principles
Buoyancy
You are lighter in the water than you are on land. In water up to your waist, you are 50% lighter. In water up to your chest, you are 70% lighter. If you are up to your neck in water, you are 90% lighter. The unweighting effects on your body decrease load and stress through your joints. That is why water therapy is ideal if you have arthritis or degenerative changes at your spine.
“You don’t deal with the same type of ground reaction forces that you do on land,” said Elizabeth Nagle, an associate professor at the University of Pittsburgh who has spent her career studying aquatic exercise. “So it’s much gentler on the joints.” (New York Times)
Hydrostatic pressure
The water imposes a pressure on you, all around you. This is called hydrostatic pressure. Exercising in water doesn’t get your heart pumping as fast as when you do it on land because of the hydrostatic pressure of water, which pushes blood back to the heart. While you might not feel like you’re getting as good a workout, there’s reason to believe you are: Some studies have shown similar improvements (both aerobic and anaerobic) between aquatic exercises and treadmill workouts on land. (New York Times)
Because of this, be careful not to overexert yourself. Take it easy at first and see how your body responds to the new exercise. Give yourself 24 hours to assess this. If you had no adverse effects, you can continue at that level of exertion and slowly increase it over time. If you become overly fatigued and/or sore, back off from that level.
Hydrostatic pressure also impacts your strength training routine. There is less resistance of a moving part of your body in water the slower you move. Move more quickly and the resistance level increases in a hurry. What does this mean for your routine? Start by moving slowly to help build strength. Once you feel stronger, you can increase your speed of movement to challenge yourself more.
Hydrostatic pressure helps you perform balance training effectively, too. The water helps to hold you up decreasing your fear of falling and allowing you to progress your balance training safely and with more confidence.
Viscosity
Viscosity is defined as the friction between molecules of liquid that cause them to adhere to each other or a submerged body. That is the science behind it. The take-away for you is that in water, the larger the surface area the more resistance is applied. The smaller the surface area, the less resistance is applied. You can test this yourself. Open the spaces between your fingers and move your hand through the water at a steady pace. Then, at the same pace, close all your fingers and do the same thing. When your fingers are closed, you have a larger surface area and therefore it requires more force to move your hand and arm through the water. There is special equipment you can use like webbed gloves to help you achieve this same thing. By simply changing surface area, you can advance your workout very easily.
Conditions
Knowing the principles behind water exercise can help you understand the health benefits for certain medical conditions. Water exercise can help someone of any age, but many chronic conditions that you experience as you get older can be managed in the water. These conditions include, but are not limited to:
Joint arthritis
Spine arthritis
Spinal stenosis
Degenerative disc disease
Degenerative scoliosis
Spondylolisthesis
Previous joint replacement including of the knee, hip, and shoulder
Neurological conditions such as spinal cord injury and stroke
Exercising in the water can meet your needs for anything from recovery to improved health and fitness. It is important to note, though, that water therapy is not the primary exercise of choice for those concerned about building bone density due to the buoyancy of the water. If you can tolerate it, a land-based exercise program would be preferred for its weight-bearing benefits.
There are also certain conditions that, when present, would prohibit you from being in the water. Open wounds need to be completely healed to decrease risk of infection. Skin sensitivities, incontinence and even the fear of water are a few other conditions that would make this type of activity inappropriate. When in doubt, check with your physician to see if water-based exercise is right for you. As always, consult with your physician before you begin this or any new exercise program.
Exercise routine
The following exercise program would take most adults about 20 minutes to perform. Adjusting time or repetitions can help you stay at the 20-minute mark, as needed. Perform this at a comfortable pace. That is, you should not exert yourself so hard to cause you to be out of breath. Test yourself by trying to complete a sentence out loud. You should be able to do that with ease at any time. If not, stop and consult with your physician.
Try to perform the following activities in chest-deep water and breath normally. No special equipment is needed for this exercise routine, though a noodle as noted above would help you vary the activities you can do. As noted above, start by moving slowly and as you gain strength and mobility you can slowly increase your pace of movement to experience further gains.
Warm-up 5 minutes: Walk in water or jog in place at a comfortable pace and depth. To advance it and when in deeper water, place a noodle under your arms and perform a bicycle movement with your legs without touching the bottom.
Jumping jacks: Start standing with legs together and both arms at your side. Move legs and arms out to the side and back in to the starting position in a rhythmic pattern. Position arms with thumbs up and keep them under water. Perform 10-20-30 times as able.
Wooden soldier: Start in the same position as above. With each jump, bring the opposite arm and leg forward while keeping elbows as straight as possible and knees slightly bent. Then alternate arms and legs for up to 10-20-30 reps.
Arm sweeps: Stand with knees bent with feet in a wide stance (wider than your hips) and tuck your belly in to keep your trunk and core strong, still, and stable. Place arms out away from your side keeping them slightly underwater. Hands should be lower than your shoulders. Point your thumbs up toward the ceiling (or sky) and keep your elbows slightly bent. Bring both arms to the front of you at the same time until palms touch, and then return to the starting position. Perform 10-20-30 times as able in a comfortable range of motion. Keep fingers splayed apart at first and then bring them together over time for added resistance.
Kicking: Hold on to the wall of the pool or recline with a noodle under your arms (if space and equipment allow) and perform a kicking motion with your legs. Perform at varied speeds for 3-5 minutes as able.
Balance: Try to stand with feet and legs together near the side of the pool with arms at your side (the side of the pool is within reaching distance, if needed) Try to keep your balance steady while staring straight ahead. If you can hold this for 30 seconds, try this next one. Stand on one leg for up to 30 seconds as able, alternating legs and performing 3 times each leg. Try to gaze straight ahead with this one, too. Please keep in mind that the activity elsewhere in the pool can impact turbulence of the water. This will be easier if the water is calm. Conversely, it will be harder with more turbulence around you.
Stretching:
Calf stretch: Go to the side of the pool and place the forefoot of one foot on the wall while keeping that heel on the bottom as best you can. Lean your hips forward as needed to feel the stretch. This helps stretch your calf and the bottom of your foot, too. Stop when you feel a gentle stretch and hold for up to 30 seconds. Repeat with the other leg for a total of 3 times each leg.
Double knee to chest stretch: Go to the side of the pool where you can hold onto the side. Or you can use a ladder in the water, if available. Hold onto the side or ladder and place both feet on the wall of the pool (your heels don’t need to touch the side of the pool). Bend your knees so that both knees come closer to your chest. Stop when you feel a gentle stretch at your low back and buttock and try to hold for up to 30 seconds. Perform 3 times.
Done! You will have completed a routine that in 20 minutes helps you improve your cardiac health, strength, mobility, and balance.
Summary
The above routine is meant to be performed in the order listed here. Each routine should begin with a warm-up and end with a cool-down. Stretching is a great cool-down activity. Please know there are many more exercises and activities that can be done in the water. This barely scratches the surface. Please seek out a qualified instructor or a class near you for further options.
Hydration is still important when you exercise in the water so keep a bottle of water with you, especially on a hot day or if the temperature of the pool water is warmer than ideal. Watch for any lightheadedness or dizziness when you exit the pool due to the loss of hydrostatic pressure on you. Exit slowly, if unsure, especially if you have any respiratory or cardiac medical history. Be sure to drink water after your workout, too.
As noted above, please consult with your physician anytime you start a new program or if results are not what you expect. Water exercise can be a wonderful way to help you meet your health and fitness goals. The benefits are many including improved cardiovascular health, increased mobility and strength, and better balance. And it is unlike any routine you can do on land. You might even have some fun doing it.
Keep moving. Keep splashing.
Source: https://www.nytimes.com/2023/07/12/well/move/full-body-workout-pool-exercises.html?smid=nytcore-ios-share&referringSource=articleShare. By Hilary Achauer. July 12, 2023.
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