into the water and out of the wheelchair        Before being injured I never liked swimming and therefore couldn't swim very well…I live in the desert for gosh sakes it's not like there are a lot of swimming holes around here. After being injured I jumped at the opportunity to do some pool therapy and within a week was swimming like a fish.. a flounder maybe but like a fish. I looked forward to every session. Unfortunately time came to move on with life so I don't get to swim as often as I would like too. All I can say is I highly recommend swimming and pool therapy to anyone you'll never regret it! I can never thank Jackie enough for turning me on to it! This is an excerpt from “Overcoming Paralysis, into the water and out of the wheelchair” by Igor Burdenko PhD The Importance of Using Water to Recover From Injury In traditional rehabilitation, exercises and activities are performed on land in a clinic, gym or physical therapy room. Land based exercises all rely upon the muscles to resist gravity and carry the weight of the body. The body has to constantly exert enough energy to counteract the force of gravity. When water is used as a modality for rehab, it takes less energy to exercise. The force of gravity in the water is one-tenth of that on land. For example if a person weighs 150 pounds on land, his or her weight in the water is about 15 pounds. People feel less pain and are more comfortable in the water. It is my understanding that this occurs because the body does not have to fight against the full force of gravity. In this situation, you save a lot of energy. The laws of physics teach that energy can neither be created nor destroyed; however, energy can be changed from one form to another. Where does this energy go that we have saved by working in the water? It's believed to be redirected toward helping the body heal. Physical properties of water that make it ideal for reconditioning Water has a number of properties that make it an ideal therapeutic environment. These properties make exercise in the water less difficult and painful, while at the same time, providing resistance to increase the effectiveness of water workouts. Relative Density Density is the mass per unit volume of a substance. Relative density is the ratio of the mass of an object to the mass of an equal volume of liquid at standard temperature and pressure. Relative density is what determines whether or not an object sinks in water. Simply stated, if an object is denser than water it will sink. With your lungs inflated, your body weighs less than an equal volume of water, meaning it has a low relative density. In other words, you float. When your lungs are deflated, your body weighs more than the water it displaces, meaning it has a higher relative density…i.e., you sink. Muscle tissue is denser than fat. People who are lean and muscular, therefore, have a higher relative density than those that are not. Men tend to have more muscle mass than women, due to the biological design of their bodies. Parts of the body that have been swollen after an injury or due to edema retain fluid. The fluid is lighter than muscle tissue, giving those parts of the body a relative low density, and they tend to float. Therefore it takes less energy to raise your extremities than it does to lower them in the water if they are weak or swollen. Parts of the body that are limp or paralyzed may experience atrophy-the muscles wither due to lack of exercise. Buoyancy Buoyancy is the upward thrust that a fluid exerts on an object less dense than itself. Archimedes, a Greek mathematician, described this force in what has become known as Archimedes' Principle: When a body is fully or partially immersed in a fluid at rest, it experiences an upward thrust equal to the weight of the water being displaced. We have established that a human body weighs less than an equal volume of water (when the lungs are inflated). So what keeps buoyancy from pushing us entirely out of the water? Your right the answer is gravity. The gravitational pull of the earth is trying to pull us down, while buoyancy is trying to push us up. These two forces are constantly opposing each other, and they are in equilibrium when you float partially immersed. In the vertical position, you reach this point when about 90% of your body is immersed, with the water up to your neck level. Buoyancy has a wonderful therapeutic effect on the human body. It can be used to assist or resist movement. As an assist, buoyancy counteracts the force of gravity, letting your body experience the feeling of weightlessness. The buoyant effect of water puts less strain on the muscles and joints making it significantly easier to move underwater. This helps you relax and exercise with less pain. This is particularly valuable when attempting to move parts of your body that are weak or stiff, or that have been paralyzed. It takes less effort to see the results. As resistance buoyancy adds difficulty to exercising with floatation devices when pushing or holding the devices underwater. This becomes important for making exercises more challenging as your strength increases. Hydrostatic Pressure Everyone knows that if a submarine goes to deep in the ocean, the pressure will cause it to implode. This force is called hydrostatic pressure. This property of water is described in Pascal's Law: Fluid pressure is exerted equally on all surface areas of an immersed body at rest at a given depth. In laymen's terms, this means that when you're in the water you feel pressure pushing against your entire body. This hydrostatic pressure has a therapeutic effect in that it helps increase circulation. It keeps blood from pooling in your arms and legs when low in the water. It also helps circulation in areas of your body that are swollen. So being in the water is like putting on a pair of compression stockings. Hydrostatic pressure makes it harder to breath when you are in the water. Although you may not be aware of it your lungs have to work harder to inhale the same volume of air that you would have breathed on land. So just breathing with the trunk of your body immersed in water is a form of exercise. Hydrostatic pressure also helps return the blood to the heart. This will cause your heart to work more efficiently under less pressure. Your pulse and heart rate will go down as a result. Fluid Resistance Fluid resistance is the force that tends to oppose or retard movement of an object through fluid. The fluid resistance in water is caused by friction and by the clinging action of water molecules to the object. In other words when you move through the water, you have to push your way through all that thick stuff, and it slows you down. The physical properties that explain this are viscosity, adhesion, and cohesion. Viscosity is the degree to which a fluid resists flow under an applied force. This resistance is caused by the friction your body makes as you move through the water molecules. Cohesion is the attraction of dissimilar molecules. Water molecules actually stick to your body. Adhesion is the attraction between similar molecules. Water molecules tend to stick together, making it difficult to push your way through them. Fluid resistance is beneficial for water therapy in two ways-it supports and resists movement. As a support, water helps to hold you in position. This means if you lose your balance you won't fall over. As a resistance, water impedes your movement. This added resistance causes your motion in the water to be much slower than in the air. This gives you a chance to counteract your movements, and greatly reduces the risk of injury. One of the first conditions to develop in the water is balance. The resistance of water makes it the perfect place to relearn how to maintain balance with out the fear of falling. Turbulence Part of the fun of being in the water is splashing, making waves and hearing the water makes as it splashes around you. This is all a result of turbulence. Turbulent flow is the random motion of the water as it moves at changing speeds and pressures, caused by some disturbance, As you move through the water, pressure builds up in front making waves. At the same time, pressure drops behind, creating a drag that swirls the water in a rotary motion. The combination of these differences in pressure creates turbulence. Turbulence provides therapeutic effects in the form of massage and resistance, the swirling and pressure of the water on your body acts like a gentle massage. This helps increase circulation and reduce pain. Your peripheral nerves are overloaded with the sensation of water all over your skin. The overloading causes the brain to ignore some of the signals your body is sending, making the massage just plain feel good. Turbulence is the main source of resistance that helps exercise the muscles during a water workout. You can vary the resistance by changing the speed, direction, and streamlined effect of your motions. The use of devices like floats and hydrostatic cuffs will reduce the streamlined effect and cause more turbulence. This will increase the difficulty of your workout by adding more resistance. Water Therapy is quite beneficial as a means of rehabilitation. It provides a fun way to relax and exercise while putting less stress on your body. You can take advantage of the support and resistance offered by the physical characteristics of water. More than any other modality, water offers the best medium in which to exercise and stimulate paralyzed nerves. A tech at rehab got me swimming after she read “Overcoming Paralysis, into the water and out of the wheelchair” by Igor Burdenko PhD The book is good reading, it includes many great exercises for people in wheelchairs, most are water based but it includes more than enough land based workouts, he even devotes a chapter to nutrition. His website is http://www.burdenko.com/