Aquatic Recovery

HydroWorx SummitStephen A. Black, DSc, PT, ATC/L, NSCA-CPTAssociate Professor Physical Therapy / Human PerformanceFlorida Gulf Coast UniversityFort 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 seasonAvg. 4 ACL’s / seasonAvg. 4-8 groin/adductor injuriesAvg. 6-8 inversion ankle sprainsAvg. 1-2 Achilles injuriesAvg. 3-5 Tibial stress reaction injuriesAvg. 4-8 misc. injuries

2010 -2011 Season1 ACL tear2 LE stress injuries (no loss of play time)

Why the changeScreening / TestingConstant monitoring

physiologymetabolismpsychological ProfilingAquatic 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 peakAerobic ThresholdSubstrate 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

athletesTanaka, 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 environmentHR reduction due to SV

facilitated by hydrostatic pressure2 fold benefit

Increased SVFacilitated systemic “flush” via compressive forces of progressive immersion.

Aquatic HR formulaHRmax 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 13Shoulders(arms out) 12 13Xiphoid 16 13Umbilical 13 11Hip 9 8Knee 2 0

Testing / Monitoring Musculoskeletal

•Cyriax quick screen•SFMA•LE Biomechanics

Testing / Monitoring Psychological

Testing / Monitoring Player Profile

HxCardiovascularNutritionPsychologicalStrength and ConditioningAquatic 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