5 Reasons to Try Water Exercise

Older but good Information

During a trip to China several years ago, Bob Moody, now in his mid-forties, sustained a fall and injured his neck, resulting in weakness in his limbs and problems with balance. He relied on crutches for stability and support. As part of his physical therapy, he began walking on an underwater treadmill for 20 minutes twice a week. Within six months, he had progressed to 60 minutes and had regained a measure of independence. When he forgot to grab his crutches after a particular session and was able to walk without them, he knew he had made real progress.

Illustration by Sam Island

Moody's positive experience with underwater treadmill walking is supported by research. In a 2015 study published in the Journal of Spinal Cord Medicine, Sandra L. Stevens, PhD, assistant professor at Middle Tennessee State University in Murfreesboro, and colleagues found that eight weeks of underwater treadmill training improved balance and walking in adults with spinal cord injury.

Barbara Giesser, MD, FAAN, professor of neurology at UCLA's David Geffen School of Medicine, recommends aquatic and land exercise to her patients with multiple sclerosis (MS). "Each has different benefits," she says. "In water, you're not fighting gravity, so you can move more easily. If the water is cool you won't overheat. On land, you get weight-bearing benefits you can't get in water."

Here are five more reasons to get wet.

1. WATER IS SUPPORTIVE. Water's buoyancy provides support that allows people with muscle weakness and poor balance to stand without fear of falling, says Dr. Stevens. And if people do lose their balance, the water slows down their movement and gives them more time to self-correct.
   The water's resistance is ideal for strengthening weak muscles. Even moving with the water helps minimally active muscles become stronger, adds Dr. Stevens.
2. WALKING IN WATER IS EASIER. People who have trouble walking on land, such as stroke survivors, can practice walking in water, Dr. Stevens says. "Initiating stepping in water can help build up to walking on land," she says.
3. WATER TEMPERATURE CAN ENHANCE RECOVERY. Water exercise is also good for people with MS and Parkinson's disease, who may be sensitive to heat, says Yasser Salem, PhD, MS, PT, professor of physical therapy at the University of North Texas Health Science Center in Fort Worth.
   Dr. Salem conducted a review of the literature on aquatic exercises for individuals with neurologic disorders and presented findings at the April 2018 International Conference on Evidence-Based Aquatic Therapy in Las Vegas. His review, which has been accepted for publication in the Journal of Aquatic Physical Therapy, revealed that doctors are recommending aquatic therapy as a valuable complement to traditional treatment.
   Adjusting the water temperature up or down also provides more sensory stimulation than exercising on land, which encourages recovery. "People with neurologic disorders often experience decreased sensory awareness in the affected limbs," says Dr. Stevens. "Exercising in water stimulates the sensory receptors and improves the neural connections to and from the brain."
4. WATER PRESSURE HELPS WITH BLOOD POOLING. After a stroke or spinal cord injury, blood pools in the affected limbs, resulting in a decreased amount of blood returning to the heart, says Dr. Stevens. This decreased blood flow can cause low blood pressure, resulting in weakness and fainting.
   The force applied to the body through the hydrostatic pressure of water is similar to a compression stocking and increases the amount of blood returning to the heart, which improves blood pressure and increases exercise tolerance, Dr. Stevens says.
5. EXERCISING IN WATER IS FUN. Resistant to exercise? Consider this, says Dr. Giesser: "Splashing around in a pool is fun, so perhaps people think of it more as recreation and less as exercise," she says.

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Water Exercise: 7 Ways to Take the Plunge

1. CHECK WITH YOUR DOCTOR. Before beginning any exercise program, discuss it with your doctor, advise experts. Your doctor may be able to connect you with a trainer or physical therapist who has experience with your condition.
2. LEARN HOW TO GET IN AND OUT OF THE WATER SAFELY.The riskiest part of water therapy may be getting in and out of the pool, especially if you have poor balance, says Yasser Salem, PhD, MS, PT, professor of physical therapy at the University of North Texas Health Science Center in Fort Worth. Look for non-slip surfaces and handrails and check the rubber tips of canes and walkers since they can lose their grip on wet surfaces. If your balance is unsteady, be sure to have someone with you. Some pools also offer lifts to help you get in and out safely.
3. USE SUPPORT. Attach a flotation device around your torso and minimal weights to your ankles to stay in an upright position, says Sandra L. Stevens, PhD, assistant professor at Middle Tennessee State University in Murfreesboro. You can bring your walker into the water or hold onto someone's shoulders for support. If necessary, have someone behind you to help you move your limbs.
4. START SLOWLY AND BUILD. If you tire easily, start with two and a half minutes, take a rest, then do another two and a half minutes. Over time, you will experience noticeable benefits. The more you can do, the faster you will see results, including increased strength and improved balance, says Dr. Stevens.
5. LOOK FOR A POOL WITH A TEMPERATURE IDEAL FOR YOUR CONDITION. The temperature of self-contained water exercise pools may be adjusted to suit your condition. Dr. Stevens recommends exercising at the warmest temperature possible—up to 96 degrees—to help decrease spasticity in people with traumatic brain injury, cerebral palsy, and stroke, among other conditions, as well as to ease the pain often associated with neurologic disorders. For people with conditions that cause heat sensitivity, the temperature should be no more than 85 degrees, says Barbara Giesser, MD, FAAN, professor of neurology at UCLA's David Geffen School of Medicine.
6. PROTECT YOUR FEET. Wear water shoes, an old pair of sneakers, or a pair of socks to protect soft skin and feet that may drag, says Dr. Stevens.
7. MOVE IN ALL DIRECTIONS. Walking forward strengthens the hip flexors and knee extensors, says Dr. Stevens. Walking backward strengthens the hip extensors for the stance phase of walking, and side-to-side walking stabilizes the pelvis, she says.

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Find a Pool Near You

Many YMCAs and YWCAs offer water exercise classes, and some even have underwater treadmills. To locate one near you, visit bit.ly/YMCA-WaterExercise. For aquatic therapy classes for MS, contact your local MS Society chapter at nationalmssociety.org/chapters. You can also check with your local health clubs, community recreation centers, or senior centers; most have pools and may even offer specialized classes.

https://www.brainandlife.org/articles/5-reasons-to-try-water-exercise/