Aquatic Recovery

HydroWorx Summit

Stephen A. Black, DSc, PT, ATC/L, NSCA-CPTAssociate Professor Physical Therapy / Human Performance

Florida Gulf Coast University

Fort Myers, FL

Goals

• Specific Goals:• Facilitate recovery between training

sessions• Provide appropriate cardiovascular

response• Facilitate appropriate metabolic

response• Introduce / Initiate functional activity• Reduce incidence and severity of

injury• Enhance relaxation• Encourage fun

TEAM RESULTSUNDEFEATED A-SUN CONFERENCE19TH IN NATION – NCAA DIVISION 1

8 – FIRST TEAM ALL - AMERICAN5 – SECOND TEAM ALL - AMERICAN

Overview and rationale

of

Aquatic Recovery

Injury Reduction

Prior to 2010 season

Avg. 4 ACL’s / season

Avg. 4-8 groin/adductor injuries

Avg. 6-8 inversion ankle sprains

Avg. 1-2 Achilles injuries

Avg. 3-5 Tibial stress reaction injuries

Avg. 4-8 misc. injuries

2010 -2011 Season

1 ACL tear2 LE stress injuries (no loss of play time)

Why the change

Screening / Testing

Constant monitoring

physiology

metabolism

psychological Profiling

Aquatic Recovery

Predictions don’t work!

VO2 assessment offers the advantage of objective measure

where incremental workloads can be adjusted / analyzed to

determine key markers on an individual basis…

NOT AN ESTIMATE OR AVERAGE!

Crouse, S Texas A&M

Testing / Monitoring(Cardiovascular – metabolic's)

VO2 peak

Aerobic Threshold

Substrate metabolism

RER %CARB%FAT

0.71 0.0 100.00.75 15.6 84.40.80 33.4 66.60.85 50.7 49.30.90 67.5 32.51.00 100.0

0.0

Physiology of Sport & Exercise, Wilmore & Costill, 1994

Metabolism

AerT / AnT predictedvs.

Measured

Aerobic threshold, a critical variable in the determination of training / recovery levels.

Ranges from 50-90% of Hrmax

– 45-55% in untrained individuals– 60-68% in club exercisers– 75-80% in recreational anaerobic

athletes– 80-92% in highly trained aerobic

athletes

Tanaka, Coyle, DanielsJ Applied Physio

Lance’s #s

SV vs. HR in Aquatic Activityultimately it’s all about cardiac output (Q) on a consistent basis.

Decreased HR in aquatic environment

HR reduction due to SV

facilitated by hydrostatic pressure

2 fold benefit

Increased SV

Facilitated systemic “flush” via compressive forces of progressive immersion.

Aquatic HR formula

HRmax in H20 = HRmax on land - FC

Graef / Kruel , 2005

Factors affecting target HR in H20

Water temperature Dive reflex Reduced gravity Compression Partial pressure Reduced body mass

HR vs. immersion depth in H2O

Depth in HR (bpm)

Risch Kruel Coertjens

Neck 17 16 13

Shoulders

(arms out) 12 13

Xiphoid 16 13

Umbilical 13 11

Hip 9 8

Knee 2 0

Testing / Monitoring Musculoskeletal

•Cyriax quick screen

•SFMA

•LE Biomechanics

Testing / Monitoring Psychological

Testing / Monitoring Player Profile

Hx

Cardiovascular

Nutrition

Psychological

Strength and Conditioning

Aquatic Recovery

Aerobic BenefitsAquatic Recovery

Decreased lactateIncreased fat metabolism for fuelIncreased # and size of mitochondriaIncreased myoglobin levelsIncreased respiratory capacityIncreased aerobic generation of ATP

Aquatic Recovery Program

•Series of exercises done post- practice

or as supplemental (recovery) day.•Follows the progression principles of:

• FITT• Continuous HRM (55% or 10below AT)• HR variability in aquatic environment• Compression / Hydrostatic Pressure

• Pascal’s Law• Supportive environment – allows for

extra time to control movement – proprioception enhancement

• Turbulence functions to destabilize & as a tactile sensory stimulus

Program Composition

•Duration – 60min•Series of drills

• Progress according to• Graduated Progression

• ROM• Stability

• Single plane to multi-plane• Water flow via HydroWorx

• Concurrent data capture• CHM – various methods

Aquatic Recovery Program

Wall drills Wall drills with toys

Standing rotation Wind mills Walking kn to chest Walk kn to chest +

rotation Monster walks

With rotation

Walking lunge With rotation

Side shuffle (+variations)

Sample B

Deck supported work Legs / arms

Reverse walk Stride / spd

Plyometric Progression Eccentric recovery Reverse lunge step up Skip Bound Hop (double leg, single

leg, single leg alternate) Side sequence of above Reverse of above

Sample A

Closing Comments

•Fundamentals of successful Aquatic Recovery Program•Evidence based programming•7 P’s of successful Outcomes•Promote use of HydroWorx Technology•Provoke creativity

Questions

References• Graef, F.I, Kruel, F., Heart Rate and Perceived

exertion at aquatic environment: differences in r elation to land environment and applications for exercise prescription – a review, Rev Bras Med Esport-Vol. 12, N 4, Jul/Aug, 2006.

• Richard Ruoti, Aquatic Rehabilitation Lippincott 1997. • Hall Carrie, Therapeutic Exercise Moving Toward

Function, Lippincott Williams & Wilkins.• Houglum, P. (2001). Therapeutic exercise for

musculoskeletal injuries, 2nd ed.• Prentice, W. (2004). Rehabilitation techniques for

sports medicine and athletic training, 4th ed.

Additional upon request