Deep Water Running for Athletic Rehabilitation

Resting from one’s training routine can be particularly frustrating for the runner or other athlete while they undergo treatment for an injury. There exists however an option to continue training during an injury that is gaining more and more popularity as more athletes and teams become aware of its usefulness, deep water running.

As a form of cross training, deep water running is the most biomechanically specific form of cross training for the runner or running athlete. This means that deep water running more closely simulates actual running than other forms of exercise. This also means that the athlete should gain better fitness benefits from this form of exercise than from other forms.

Cross training has traditionally been used for several purposes:

  1. Alternative training during an injury.
  2. Supplementing one’s regular exercise program in order to gain greater fitness without excessive impact.
  3. As a primary form of training for a multi-sport athlete such as a triathlete.
  4. Providing variety to one’s training regimen in order to enhance enjoyment.

Certain injuries such as stress fractures and muscle tears will mandate that athletes refrain from running while they rehabilitate the injury. Many of these athletes have or will be able to participate in deep water running, allowing them to maintain and even enhance fitness during the time in which the injury heals.

Aqua running or deep-water running, consists of simulated running in the deep end of a pool aided by a floatation device (vest or belt) that maintains the head above water. The form of running in the water is patterned as closely as possible after the form used on land. The participant may be held in one location by a tether cord, essentially running in place, or may actually run through the water across the width of the pool. The tether serves to increase resistance as well as to facilitate monitoring of exercise by a physician, therapist, or coach. No contact is made with the bottom of the pool, thus eliminating impact. The elimination of weight bearing makes this an ideal method for rehabilitating or conditioning injured athletes, particularly those with foot, ankle, or knee injuries for whom running on land is contraindicated.

The form of running in water is patterned as closely as possible after that used on land. For the runner (or any athlete whose sport requires running), aqua running therefore represents a biomechanically specific means of conditioning during a rehabilitation program or when supplementing regular training. This has special importance, as the effects of training include improvement in cardiac and pulmonary performance as well as improvement in those muscle groups being used that undergo enzyme changes, capillary density changes, as well as other changes. Compared to land-based running, the elimination of weight bearing and the addition of resistance in aqua running change the relative contribution of each muscle group. Every effort is made, therefore, to reproduce the running form used on land and to ensure the incorporation of those muscle groups that are used in land-based running.

The following guidelines will assist the patient in maintaining proper form during aqua running:

  1. The water line should be at the shoulder level. The mouth should be comfortably out of the water without having to tilt the head back. The head should be looking straight ahead, not down.
  2. The body should assume a position slightly forward of the vertical, with the spine maintained in a neutral position.
  3. Arm motion is identical to that used on land, with primary motion at the shoulder. Hands are held tightly clenched.
  4. Hip flexion should reach approximately 60 to 80 degrees. As the hip is being flexed, the leg is extended at the knee (from the flexed position). When end hip flexion is reached, the lower leg should be perpendicular to the horizontal. The hip and knee are then extended together, the knee reaching full extension when the hip is in neutral (o degrees of flexion). As the hip is extended, the leg is flexed at the knee. The cycle then repeats itself. Dorsiflexion and plantarflexion occur throughout the cycle. The ankle is in a position of dorsiflexion when the hip is in neutral and the leg is extended at the knee. Plantarflexion is assumed as the hips is extended and the leg flexed. Dorsiflexion is reassumed as the hip is flexed and the leg extended. Underwater viewing has shown us that inversion and eversion will accompany dorsiflexion and plantarflexion, as it does with land-based running.

Runners and athletes can be encouraged by scientific evidence that has demonstrated that deep water running results in a sufficient training response in order to affect fitness improvement. This has been further documented by studies that have shown maintenance of exercise and performance in even competitive distance runners while training strictly with deep water running for periods up to six weeks long. Additionally, running in the water allows the athlete to maintain proper form and technique, and maintain quick turnover during a period of which they may have had compromise in these factors.

While training with deep water running the athletes perform workouts that closely mimic the workouts that they would do on land. If an athlete would normally be running a long distance run, perhaps one hour at a moderate pace on land, then they would perform one hour of running at a moderate pace in the water. If the athlete were doing track intervals, they would then in the water do shorter intervals at a very high intensity and turnover rate with rest periods of easy water jogging in between. We oftentimes have our athletes measure their heart rates and count their [cadences] [cadesis?], that is the number of times that they turnover per minute as measures of their exercise intensity as well.

When properly performed deep running water is a viable form of cross training for the athlete who cannot run or for the person who desires a low impact form of aerobic exercise that has been proven to demonstrate training effects.

Many of the local rehabilitation centers and fitness centers offer regular programs in deep water running. Consult your aquatic director.

Dr. Robert Wilder is Director of Sports Rehabilitation in the Division of Spine and Sports Care at UVA., and a Fellow of the American College of Sports Medicine. An avid runner, Dr. Wilder has completed a number of marathons, including Boston. He is an active member of the Charlottesville Track Club.

Article from: The Charlottesville & Albemarle Observer, October 18, 2000.


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