Aqua virgins (newcomers to aqua fitness), as well as some regular participants, often have questions about the way classes are taught. Aquatic exercise has amazing fitness benefits, but is a different kind of workout. People need to understand why and how things are done at the pool. They need to learn: why the instructor teaches a certain way, how to move well, and why their results depend on their focused effort.
A number of years ago, at a pool reception desk in Kitchener Ontario, I saw a participant handout. It was designed for people attending aqua fitness classes, and it was brilliant!
This post is a revision and update of that document. Thanks to the wise folks in Kitchener, who recognized that working well in the water requires knowledge and skill. I hope this article will prompt you to create or reinforce client education at your pool.
Here is a list of typical participant questions and answers appropriate to our style of teaching. Because the list is quite long, it may be best to present one point per week on the pool lobby bulletin board, or facility website. I have also offered 'Learn to Aqua Fit' training seminars that included about 1 hour of theory in a classroom, followed by an aqua fitness class. We created some very savvy exercisers. Keep track of the questions you get, and start your own participant education plan!
Anchoring is usually done specifically for muscle strengthening of the core, and limbs. Faster movements, with a choice of buoyancy options (light bouncing, or propulsive - where you are pushing off the floor to move up, out of the water), are often used during the cardiovascular component of your aqua fitness class. You may still choose to eliminate bouncing while doing cardiovascular work (in chest deep water), since this protects your joints while creating added work for your core.
Challenging: In the pool, balance, core strength, the respiratory muscles and heart experience unique training benefits different from land-based exercise. Cardiovascular conditioning and muscular strengthening exercises often happen simultaneously during aquatic exercise. Muscles can be worked in unique ways because any direction you move is resisted.
Adaptable: Aquatic resistance is easily altered to suit to a wide variety of needs, from Olympic athletes to weekend warriors, average people, and people in rehabilitation for health issues. Aquatic resistance, water depth, movement techniques and exercise intensity can be adjusted for a customized workout. You can choose the class and the pace within a workout that suits your specific needs on a given day!
Buoyant: Working vertically in water unloads your feet, knees, hips, back and arms, allowing you to move freely. Many people who could not run on land can run in the pool, effectively training their cardiovascular system. Both buoyancy and hydrostatic pressure help circulation, allowing your heart to work more efficiently. Your heart will beat slower during aqua fitness than it would for an equivalent workload on land – yet your training results can be the same.
What questions do you hear regularly at your pool? Would a participant handout improve client knowledge and satisfaction? Is it time to start a 'Learn to Aqua Fit' seminar for the start of each season? I welcome your thoughts on these questions!
This communication will outline a variety of practical strategies for decreasing pain, improving alignment and increasing strength in the cervical and upper-thoracic region. Neck pain and dysfunction can be caused by a variety of factors including:
Below, I will describe a variety of practical suggestions for soft tissue release and stretches to reduce pain and improve alignment, as well as strengthening exercises that can be used in the clinic or the pool.
Ultimately, clients need to take responsibility for their postural re-adjustments and on-going exercise program. Therefore, it is worthwhile to establish the paradigm of self-responsibility by teaching: pain management techniques, relaxation and re-alignment strategies, as well as self-soft tissue release techniques. Clients can use these strategies in the pool, at work, and at home on a daily basis. With practice, this can result in client-based problem solving and empowerment to resolve minor issues related to mis-alignment, stress or work-pacing.
Teaching Power Posture
This is always the first step with my clients. Please visit www.FortheLoveofFit.com, “Workshops & Courses” Tab and look for the video clip: ‘Teaching Power Posture in the Pool’. There you will find clear, visual instructions for achieving Power Posture. Here is the written script:
o Roll the shoulder blades up, back & down a few times.
o End with the scapulae in the ‘down’ position.
o “Pull the armpits downward toward the hips” is a useful cue to help clients maintain scapular set. Note: This is different from pulling the shoulder blades together, which tends to create an undesirable increase in upper thoracic tension.
Retract the cervical spine:
o Place the index finger in front of the lips like saying “shhhhh”.
o Breathe out making the ‘shhhh’ sound while pulling the lips / head straight back from the index finger.
o Relax 10%.
Creating Better Postural Habits
Ultimately, posture is a habit. Postural habits depend on a variety of factors, including: genetics, health history, ergonomics, social norms, and mood. Through experience with clients, I find posture can be re-trained to decrease pain and optimize function. I have witnessed many patients reduce or eliminate headaches and resolve related shoulder and arm issues by retraining their posture. After learning Power Posture, here are some tips to help clients re-learn better alignment:
1. Pre / Post Posture Pictures: With the client’s permission, a lateral shot is taken on their phone showing their alignment before and after achieving Power Posture. I suggest they put a print of these pictures in a prominent place where they will see themselves daily.
2. Post small stickers: From the dollar store or office supply, get ~10 small, brightly coloured stickers you can post at eye level, where you spend your day: corner of computer screen & rear-view mirror; fridge or cupboard where you prepare meals; filing cabinet; TV console; bathroom mirror... When your eye sees that little sticker, quickly do your Power Posture check, re-adjust your alignment as required, and go about your business. This will take only a few seconds, but will build the Power Posture habit!
From: Elli N., Regina SK
Response from Connie:
Thanks for getting in touch and for your kind words. I'm happy you found so much of the material last Sunday useful in your pool work. Like aqua fitness, the training concepts from our day are effective when people pay attention and try to implement what they hear and learn. You have done that, so good for you! I'm delighted that some of your people are tuning in to your teaching and are feeling the difference. They will be your best allies and advertisements for a more concentrated way of working. Good luck with all of that - it doesn't happen overnight, but it sounds like you've made lots of good changes and discoveries in only one week!
AquaStretch™ is amazing for myofascial work. So much of the pain people feel (whether from surgery, arthritis, repetitive strain, accident / injury...) is due to soft tissue discomfort. AquaStretch™ has proven to be extremely useful in resolving that discomfort. I am the only AS trainer working in Canada, and my intention is to get more people doing this important, useful work. I'd love to hold a course in western Canada. If you want a course in your region, you would need to have 6 - 12 people, and access to a warm pool like the one we were in on Sunday. The course format is 8 hours: 2 hours classroom, 2 hours pool - lunch - 2 hours classroom, 2 hours pool. If we have more pool time, it will be used, but that is the minimum. The 8-hour course is $300 / participant (+HST), and includes a colour manual & laminated pool guide. These requirements are also listed on the AquaStretchCanada.com website. People who can take the course: aqua fitness trainers, personal trainers, kinesiologists, and any type of therapist. I recommend that people have a personal training cert so they can get insurance to 'stretch' people. If you don't plan to charge people, that is not such an issue. There are no other pre-requisites to take the training. Knowledge of anatomy is useful, but I have taught couples to AquaStretch™ each other, and they do just fine.
Let me know if you have any questions about all of that, and if you have interest in helping to set up a course.
Good Morning Connie,
This past Monday, a long-time aqua fit participant asked me if we could change it up a bit. She is bored and would like to use noodles, the step and other various items for variety.
On the rare occasion, I do pull out noodles to do aqua planks and a few other choice exercises. But overall I’m not a huge fan of “toys” – mostly because I don’t feel comfortable using items in the water that could potential cause harm if not used properly (personal experience of hurting myself using the dumbbells). I recognize that using paraphernalia isn’t “evil” but with my lack of experience I hesitate.
What happened with “aqua step”? It was all the rage when I left aquatics back in the mid 90s. The participant was very happy to tell me how another instructor uses the step as an upper body strengthen exercise (holding the step vertically to push the water) or how it would be nice to just do some step. I barely remember ANY aqua step moves. Did aqua step just get old and boring and therefore dropped out of favour? Or was there long term problems that surfaced with aqua step? A couple of the facilities actually still have the steps in the equipment rooms collecting dust.
How do you keep is fresh for those who are bored? This particular participant does spend most of her time talking and scowling at me. She isn’t your typical participant. She is about my age (late 30s, early 40s), slender and seemingly fit. However, she doesn’t work all that hard in class and loves to socialize during class.
A little frustrated,
As you have identified, the problem is the participant (and her lack of effort), not the equipment.
It sounds like you might talk till you are blue in the face and not get through to her!
Noodle pieces can offer added resistance with a smaller amount of buoyancy than the dumbbells - we have a bag of them at WGJC - I use them occasionally. People in my classes have to 'earn' the right to use equipment:
Let me know how it goes!
I have read a number of resources, and heard a number of respected presenters explain that "water has 12 times the resistance of air". This statement is false. It will be true only under a very specific set of circumstances that would have to be carefully defined.
Resistance in water = coefficient of drag (an experimentally determined number based on how streamlined the object passing through the water is - i.e.: a cupped hand has a different C of D than a flat hand; a ball has a different C of D than a stick...lab testing will tell you what coefficient of drag is for any given object, hence all the flow studies for new car shapes).
No wonder it is so hard to quantify work in the water!
Work = Resistance (force) x ROM (distance)
This is not from a research paper. This is from university physics texts re: fluid dynamics. It's kind of like the laws of gravity.
Visit the downloads page of this website to see a picture by Line Marr of an aquatic dumbbell being weighted with a land weight of 5 lb to barely submerge it. Estimating work done when moving this buoyant object through the water does not account for the resistance factors mentioned above, including the speed of motion, which will dramatically increase resistance. Range of motion will determine work done.
Aquatic resistance is not easily quantified, and the figure "12X the resistance of air" is frankly, useless.
As I pull up to the TV with some snacks and a drink, ready to check e-mail and 'watch' Biggest Loser, I reflect on my day. Today, I turned 60. The house is redolent with the sweet scent of floral bouquets, lovingly sent by family members to mark my big day. I am reminded of a funeral parlour...but... the drama of Biggest Loser and the beauty of the flowers snap me back to reality.
At 60, I now have a legitimate excuse for failing eyesight, faulty memory, and frequent flatulence. I can hide my own Easter eggs, and repeatedly enjoy the same joke. In only five years, I will collect the OLD AGE pension (if our government doesn't move the target date farther out). My reluctant joints, thickening middle, and grey hair are daily reminders that I have reached 'a certain age'. Hubby and I can no longer refer to ourselves as 'middle aged', since it is unlikely that we will live to be 120.
Our children are approaching middle age, and our grandchildren are growing strong. Mom and Dad are in the last half of their eighties. Who thought I would ever find myself here - smack dab in the September of my life?
Who indeed! This is the 15th anniversary of my cancer diagnosis. In 1997, I didn't know whether I would live to see my children become adults, to see grandchildren born, or to glide with my dear parents into our later years. Am I worried about my sagging neck or crows feet? Delighted, no, but not worried. I have the richness of life experience I could not have gained any other way except with the passage of time. I am surrounded by a loving family and many friends who delight me every day. My career is spiralling in very interesting directions. I love life, and so far, I love being 60!
…And crack walnuts with my bare hands, it’s time to reflect on the last year of my life using AquaStretch™. If you are not familiar with the current buzz, AquaStretch™ is a unique form of facilitated myofascial release that is done in warm water. Limbs are weighted for some procedures, and the person being stretched is prompted to use ‘intuitive movement’ to resolve fascial adhesions. The result is: better range of motion, reduced pain, a feeling of ‘being loose’ and relaxed. I have worked as a facilitator of human movement, including stretching for many years. AquaStretch™(AS) is not like anything I have previously encountered. Whether you are newly trained in AS, considering training, or using AS regularly, you may be interested in some insights I have to share. This is a story of ‘practice based evidence’. I won’t be quoting research papers, because they are being written. Use of AS is new… and exciting. It gets results!
AquaStretch™ was developed by George Eversaul in Nevada. His years of cranio-sacral training and bodywork evolved into the unique technique he calls AquaStretch™ (www.aquastretch.com). George uses AS with dancers and performers in Vegas, as well as the local hotel workers, UNLV athletes, and ‘just plain folks’. If you are fortunate enough to meet and work with George, you will marvel at his creative genius, his ‘great hands’, and his Socratic teaching style. Since December 2010, I have had two training sessions with George, and look forward to the next. The first day of training, my head was buzzing with all the grips and holds. The next day, after hours in the pool, I had difficulty holding my fork as I slumped, exhausted, over my supper. My grip strength is strong, but I was not prepared for the muscle overload involved during a long day of AS with an unending stream of clients. I was AquaStretched to the limit!
When I got home from Vegas after that first AS training, I headed straight for the pool, and didn’t want to get out. My ‘new toy’ was so interesting, and so effective, everyone in my path got AquaStretched! Previously, my pool therapy repertoire had involved traditional aquatic stretching, strength work, gentle cardio, and sometimes flotation work with a variety of soft tissue release and relaxation techniques. Patients made progress; goals were achieved. However, patience was required, because for some, progress was at a glacial pace. I discovered my favourite thing about AquaStretch™ was the immediacy of the result. The client and I could instantly feel a positive change. Pain, movement restriction, and ability to exercise were almost universally improved. Client participation in AS is another bonus. AquaStretch™ involves teamwork between the facilitator and the client.
Within my first week home from that first training with George, I began using AS with a patient named Jan S. With her permission, here is her story.
Jan S. DOB 1952
“I was diagnosed with arthritis 3 years ago, in the neck, spine, hands and feet. It progressed very quickly and limited my mobility in a short period of time. AquaStretch has had a profound effect on me both physically and mentally. I experienced pain relief at the very first treatment. AquaStretch has increased my range of motion, and cut my consumption of painkillers by 95%. Thanks to you, I have also learned home techniques for stretching and pain management to help prolong the effects of the AquaStretch session, and get back some of the activity I had lost. This has given me a much healthier outlook on dealing with this (arthritis), as well as being able to finally take a proactive approach to pain management. I can't thank you enough, Connie, for your ongoing care and support”. Jan S.
Jan’s Health Status Before Beginning AS
· ≥ Eight 500 mg Tylenol / day – reduced but did not stop pain
· Poor sleep; 1 – 2 hrs max at a time
· ROM, ≤ 50% in neck & shoulders
· Feet & ankles very painful, difficulty load bearing, antalgic gait
· Could not garden due to neck pain; able to do only 10% of activity level previous to onset of arthritis; used to ride 750 lb motorbike – had to sell this
· LB surgery in 2004; discectomy relieved bilateral sciatic pain radiating to feet
· Arthritis was now interfering with low back exercises, therefore, recurring LBP
· Had become much less active due to pain with movement, therefore, had become much more sedentary
· Grieving loss of strength, favourite activities, sense of self
· Muscle weakness & atrophy; systemic fatigue; lack of CV fitness
· Stomach pain from taking so many meds; weight gain
· “A little old lady had moved into my body and was taking over” – I had become matronly”.
Jan Began AquaStretch™ Dec 6 2010 – Her Observations:
o Felt relief of pain the first session of AS – felt better that night
o Warmth & improved ROM in lower extremities, hips, low back, shoulders and neck
o Benefits of AS were extended by learning and doing stretches and soft tissue release (STR) at home as needed
o Decreased pain meds by first week
o By 3rd week, got membership to community warm pool to be able to access warm water more frequently
o Changes in ability to move: by 3rd week noticed being able to do things better due to knowledge of body mechanics, better posture
o Knowledge of pain-tension-pain mechanics; work-pacing strategies; understanding how to self-solve tension issues has had significant benefit in quality of life
o Pool exercise has replaced the motor bike; gardening is back on track
o Pain meds now: 2 Tylenol / MONTH (500 mg each). Occasionally take 1 at night if achy, to assist sleep
o Overall feeling of well-being
o Sense of self-control re: dealing with pain and movement – pool exercise, self-directed STR techniques at home as required
o AS is more powerful than self-directed STR for relieving pain
o The warm water & AS have changed thinking, attitude & ability to manage pain
o Ai Chi is now a regular, enjoyable part of warm water exercise (also learned in this past year)
o Acknowledges movement as powerful medicine.
· Jan’s hands are still affected by arthritis. Acupuncture gives relief from swelling, but is not slowing progress of arthritis into new joints.
· Jan’s hands did not respond favorably to AS. Pain was increased; ROM decreased, so AS is not being used on her hands.
· Fortunately, Jan’s feet respond very well to AS Procedures. ROM is immediately increased; spasm and pain decreased. Gait is dramatically improved by AS.
Jan is a ‘super responder’ to AS. She gets better results than many of my other patients. I believe this is at least partially due to the fact that her body has learned to relax and accept AS willingly. Jan has the luxury of unlimited, insurance funded access to this pool program. Therefore, she has had AS once or twice per week since December 2010. Though Jan responded instantly to AS, and continues to have excellent results, some people I have worked with are non-responders to AS, or are too sensitive to tolerate even the lightest touch.
For patients with neuropathic pain, I proceed very slowly and cautiously. In some cases, I will not touch them, but instead (for the appropriate AS procedures), have them move intuitively from AS starting positions, applying their own pressure (if possible) on their areas of tenderness. For a number of patients, this has worked well. Results are not as dramatic, but we are much less likely to flare their pain. 80 - 90% of my clients have a good-to-excellent response to AS (reduction of ≥2 – 5 points on VAS pain scale) pre / post AquaStretch™.
If you are a newly-trained facilitator, I recommend you chart specific progress with the people you AquaStretch™. The AS manual has suggested materials for data collection. You can develop your own tools, specific to the populations with which you work. Consider collecting pre / post information regarding:
· VAS – pain scale
· ROM measurements
· Pictures / videos of gait or typical movement patterns of concern to this person
· Ask about sleep following the AS session
· Monitor use of pain medications
· Ask about performance of daily activities (ADL), work and recreation
Other Thoughts about AS:
The more I facilitate and teach AquaStretch™, the more I observe the differences in the characteristics of facilitators, clients, and the pools in which we work.
I have relatively small hands. Large people present challenges for some grips and holds. The four-step AquaStretch™ technique stays the same: Play – Freeze – Pressure – Move, but the way I grip / hold to apply pressure has to be adapted with some large or very muscular clients. If you are not sure what I mean, try to hold onto an athlete’s size 14 foot, plantarflex and invert the foot, and keep your grip while this large, powerful person moves intuitively! In clinics where there are several AquaStretch™ facilitators, I think it is ideal to assign clients to facilitators based on client body characteristics that match facilitator strengths.
The warm pool I use is nearly shoulder deep for me. This depth of water necessitates a heavy weight belt (20 lb) to keep my body anchored for AS procedures. One Leg Standing is very challenging, since I must follow unpredictable limb movement quickly, in shoulder-deep water! I have moved Against the Wall to the pool stairs. I have a small plastic step stool that gives me a height boost where needed. Even “move if you feel the need to move” has been adapted to, “move how you want to, and I will follow”. The point is, no pool environment is ideal. Each AquaStretch™ facilitator will have his or her own challenges when working with clients. I believe we all have to adapt to create the best possible result for our clients, while honoring our own strengths and abilities.
AquaStretch™ sessions don’t end at the pool. I always teach patients the AS four-step technique for use on their tender spots at home. We discuss how they can apply the pressure (tennis balls, their own hand, a hand from a friend…), then move until the tenderness or restriction is resolved. Jan, and many other patients have found this extremely useful. For most clients, treatment is finite. Their pain is not. It is empowering for people to learn simple ways to resolve their own pain, tension, and movement restriction.
Instructor self-care is an issue dear to my arthritic thumbs. From experience, I know that hands, shoulders, neck, low back, and feet (on abrasive surfaces) can suffer from fatigue or over-use. Ideally, you will work with someone who can AquaStretch™ you! Where needed, I modify grips and holds, and find ways of pacing my workload, while optimizing body mechanics. I don’t know how may years of AquaStretch™ are left in my hands, but I intend to continue providing pain relief and improved movement as long as possible. Training new AquaStretch™ facilitators is also a passion. I look forward to meeting and working with other AquaStretch™ enthusiasts in the pool!