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hydrotherapy guide
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"Pools are excellent environments in which to train water provides buoyancy and
resistance properties that allow the individual to undertake exercise with minimum
impact on the body."
Angela Calder (performance consultant for Australian Institute of Sport)
If the pool is such a great training env ironment, why does it not feature far more prominently in our
athletic clients rehabilitation and recov ery sessions? Although the ex tent to which pool training is used
will v ary from country to country , the unav oidable reality is that most sports support professionals fail
to use water workouts as a rehab tool for one simple reason: ignorance.
That was certainly true in my case 1 0 y ears ago, when I started working at the Sports Injury and
Rehabilitation Centre in Lilleshall, central England. Up until then Id only ev er gone to the pool to swim,
play on inflatables and do some top bombing from the div ing boards. At Lilleshall I had my first
ex posure to pool-based training as part of the rehabilitation programme for footballers receiv ing
treatment at the centre. Ev en then, it didnt occur to me that y ou could also use the pool as a training
tool when y ou werent injured. It wasnt until I started working with the England netball team that I was
ex posed to the use of the pool in this way .
With the help of the team coach and Marques Church, a clev er strength and conditioning coach from
New Zealand, who shared all his knowledge with me, I soon started to include a wide range of poolbased training in my athletes programmes. Ten y ears on, I hav e learned a great deal about how water
workouts can improv e body alignment, aerobic and anaerobic fitness, flex ibility , strength and ov erall
balance and coordination, and I still use the pool with my athletes for training, recov ery and
rehabilitation. Below I set out some of the applications and drills I hav e found inv aluable ov er the
y ears.
To be able to use the pool effectiv ely , y ou must first understand a little about the properties of water,
the effect of water immersion on phy siology and how both of these things affect our mov ement and
function.
Key properties of water
Buoy ancy : The term used to describe a fluid force that alway s acts v ertically upwards. It was, of course,
the Greek mathematician Archimedes who first worked out the magnitude of a buoy ant force in his
famous principle: the buoy ant force acting on a body is equal to the weight of the fluid displaced by the
body (1 ,2,3). Buoy ancy is helpful in training because it enables the water to support the body , which is
particularly useful during rehabilitation from injury . Y ou can also increase an athletes buoy ancy with
the aid of floatation dev ices such as belts and v ests.
Hy drostatic pressure: In a fluid, this increases with depth, and is applied ov er the surface of any
object immersed in the fluid(1 ,2). This turns out to be another v aluable property in rehabilitation: the
increased pressure on the body can be used to reduce swelling and allow the athlete to ex ercise an
injured limb without the risk of aggrav ating swelling.
Fluid dy nam ics (flow): When an object such as a human hand mov es slowly through water, there is
little apparent disturbance around the hand. As the speed of mov ement increases, wav es and eddies are
created(1 ,2). Two different ty pes of flow ex ist: l laminar, characterised by smooth lay ers of fluid
molecules flowing parallel to one another l turbulent, characterised by a mix ing of the lay ers of fluid
molecules.
In pool training, we can alter the fluid dy namics to change the intensity of the training session. If the
athlete maintains a streamlined shape, they will produce minimal disruption to flow. But when they
adopt an unstreamlined shape or use an unstreamlined object such as a float, they will disturb flow and
increase drag, which ups the intensity of the mov ement.
Depth: T here is an inv erse relationship between water depth and the am ount of body
weight supported by the m usculoskeletal sy stem . When y ou stand on the bottom of the
pool im m ersed up to y our neck, y our body is bearing about 8% of its weight. Drop the
water lev el to around m id chest and the body bears 28% to 35% of its weight, increasing to
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hydrotherapy guide
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Iliotibial band
sy ndrom e or
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M Laurey s
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