Christine Alexander is the author of 2 books on water exercise each published by Human Kinetics.
Water Fitness Progressions (2019) was written for water fitness instructors and aquatic personal trainers. It describes how to use periodization to help class participants and clients progress in their level of fitness. It contains lesson plans that illustrate how to progressively increase intensity for both cardiorespiratory endurance and strength training.
Water Fitness Lesson Plans and Choreography (2011) was written for water fitness instructors. It has 36 class ideas for shallow water exercise and 36 class ideas for deep water exercise. Individuals may find the exercise descriptions and photos useful for building a personal exercise routine.
If you want a great workout in the pool, you can’t do better than deep water running. More research has been done on deep water running than on any other form of water exercise. Improvements in cardiorespiratory endurance and high calorie expenditure are well documented benefits. Deep water running can be practiced by everyone from elite athletes to water fitness class participants. Like every type of exercise, it should be performed with good form. That means that the spine is in neutral alignment, you are using a knee up/foot down motion, your shoulders are flexing and extending, your elbows stay bent and you are pulling them back so that your hand reaches your hips, your chest is erect, your shoulders are relaxed, your chin is level, and you are looking forward. In this position you are able to fully expand the lungs allowing your working muscles to get the oxygen they need. Click on Correct Form to see a video demonstration.
There are however some common mistakes in deep water running. The mistake I see most often is leaning forward, as in the photo on the right. In this position the water hits the chest first and slides down the torso, removing most of the resistance, and therefore most of the intensity. In addition, the position causes spinal compression, which means that the front edges of the vertebrae are touching. This can cause microfractures in someone with osteoporosis. There are also some common mistakes with the arm movement. These mistakes include swinging the arms across the chest, flexing and extending at the elbows, and not bringing the elbows back far enough. The shoulders should remain stationary, and not rock forward and back. The head should also remain level, and not rock from side to side. Click on Common Mistakes to see a video demonstration.
You can combine deep water running with assisting and resisting arm patterns to add muscular endurance training for the upper body. Some examples are (1) Crawl stroke, an alternating reach and pull motion; keep the arms under water where the resistance is. (2) Row, which is reaching and pulling with both arms together. (3) Double-arm press-down, which means stretching both arms out in front and pressing them down. (4) Breaststroke, which should be performed with the thumbs up to avoid combining internal rotation and horizontal abduction, a movement that is hard on the rotator cuff. (5) Rotator cuff sweep, which means keeping the elbows down near the waist and sweeping the hands out with the thumbs up. For more information on upper body exercises with deep water running, see Craig Stuart’s article “Wave Run” in the January-February-March 2026 issue of Akwa Magazine. Click on Upper Body Exercises with Deep Water Running for a video demonstration.
Deep water running can be performed at several intensity levels, depending on your goals. The basic deep water run is perfect for a water fitness class. Take it to a sprint if you wish to work harder or you are training for a 5k run. A power run is more intense, and can be used for intervals. Click on Increase Intensity for a video demonstration.
Although you do not run backward in daily life, traveling backward in the water is a good way to strengthen the back. For that reason I like to include some backward travel when I am doing a deep water running class. Again, good form is important. Participants frequently let their legs float up so that they are in a seated or semi-reclining position. This takes a lot of resistance out of the exercise, and the spine out of alignment, causing the spinal compression we wish to avoid. With the feet under the body, use a scull, a push forward or a reverse breaststroke to travel backward. Click on Travel Backward for a video demonstration.
I love deep water running. Try it out and you may love it too. See you in the pool!
As water fitness instructors, we know that the safest position for exercise is with the spine in neutral alignment. But we don’t always see that in our class participants. Perhaps they had an injury, or surgery, or years of habitual movement patterns that changed their posture. Or perhaps they have poor body awareness. You might notice shallow water participants leaning side to side as they jog, or curling forward while traveling backward, or waving their arms aimlessly during upper body moves. You might notice your deep water participants flailing in an effort to stay upright, or traveling when they are trying to stay in place and staying in place while they are trying to travel. What all these participants need to learn is how to engage their core muscles and stabilizers before activating their prime movers. The technique for teaching this is called the Heavy Concept.
The Heavy Concept: Activating Core with Neuromuscular Retraining is a new book by Christine Alexander and Ruth Sova.
Stabilization is the ability to maintain balance and control during movement. This requires coordination between the muscles, tendons, and ligaments that support the joints. When you perform any type of movement, the prime movers, or agonists, are primarily responsible for creating the movement. The antagonist muscles oppose the movement of the prime movers. There may also be some muscles that assist the movement. The stabilizer muscles provide support and stability to the prime movers. The muscles of the core, including the transverse abdominis, multifidus, gluteus medius, and pelvic floor muscles, function as stabilizers in nearly every movement. Ideally the stabilizer muscles fire first, that is, movement begins from the inside, ensuring that the movement is executed with proper form.
To help your participants become aware of their stabilizers, ask them to stand (or suspend in deep water with a flotation belt) with good posture and imagine that they want to lift one knee, but the knee is so heavy that they are unable to lift it. As they continue to try to lift their “heavy” knee they will feel their deep core muscles activating. Have them overcome the heaviness ever so slowly, taking 3-6 seconds to smoothly lift the knee. Repeat 4-6 times to help cement the feeling of stabilization. Then as they begin jogging ask them to continue to be aware of the core stabilizers working.
The process also works in reverse – called Reverse Heavy. Have participants lift one knee, then imagine it is held up with surgical tubing. Ask them to try to lower the knee against the surgical tubing even though they are unable to do so. Again they will feel their deep core muscles activating. Take 3-6 seconds to slowly lower the knee, and repeat 4-6 times before beginning to jog. Although you cannot use the technique for an entire water fitness class, using it once or twice at the beginning of class will gradually train participants to begin to move from the inside out. You might also occasionally ask them to check in with their bodies to confirm that the core muscles are still firing first.
You can vary the technique with every class because the Heavy Concept works with any joint in the body. For the spinal stabilizers, stand (or suspend in deep water) and imagine all four limbs are sunk in concrete up to the elbows and knees. Ask participants to try to shift their weight in any direction (or lean diagonally in deep water) and feel the cylinder of stability around the spine. Slowly overcome the resistance in tiny, perfect movements. For the deep hip stabilizer muscles try to lift a straight leg forward. The torso will want to lean back, but use the brain imagining Heavy to prevent it. Use Reverse Heavy to lower the leg. For the shoulder stabilizers (rotator cuff muscles) perform any shoulder movement – flexion, extension, abduction, adduction or rotation imagining that the arm is too heavy to move. You can even use the technique with the neck stabilizers.
Over time, with practice, participants will become more aware of activating their stabilizers first, and their posture and form will improve. This will carry over into daily living, improving balance, reducing fall risk and allowing participants to perform daily tasks with confidence. Check out Ruth Sova’s Promo video. The book is available in print or as an e-book. To order the print book click on The Heavy Concept. To order the e-book click on The Heavy Concept e-book. The introductory price is $24.95. it will be $29.95 after the introductory special.
It’s a brand new year and many of us made a resolution to exercise more. We all know that exercise has many benefits for our hearts and lungs. Did you know that it also reduces your risk of dementia later in life? The best exercise is one that you will actually do, so pick something that you enjoy. For me, that is water exercise, hands down!
The American College of Sports Medicine recommends 30-60 minutes of moderate intensity exercise five days a week, or 20-30 minutes of vigorous exercise three days a week. So it is important to know how hard you are working. That’s not so easy in the pool. Immersion in water relaxes your blood vessels so that stroke volume increases, that is, your heart pumps more blood to the working muscles with each beat than it would on land. Hydrostatic pressure compresses all body systems, including the blood vessels, which means the heart doesn’t have to work as hard to return blood from the limbs back to the heart. Therefore your heart uses fewer beats per minute while exercising in water (called your aquatic deduction) than the equivalent intensity on land. You can measure your heart rate on land and in water and use formulas to determine your target heart rate. All that is too much trouble for most people, including me. Instead, many of us wear fitness watches. These do not take your aquatic deduction into account to accurately tell you how hard you are working, but they can tell you whether your heart rate is increasing or decreasing. I use my fitness watch to give me a general idea and then combine that with a rating of perceived exertion.
The Rating of Perceived Exertion is a method of assessing effort, strain, discomfort, or fatigue experienced during exercise. Research has shown that although this method is subjective, it is fairly accurate. The Aquatic Exercise Intensity Scale was developed to take into consideration the unique aspects of training in water. it uses a scale of 1-10 to help assess intensity levels.
No effort at all (lying down).
Extremely little. Your heart rate is near resting.
Very easy. You are comfortable but breathing a bit harder.
Easy. You are working a little bit, and you could do this all day without any problems.
Somewhat easy. You are working a little harder, but you can still talk easily and sing.
Moderate. Your breathing has increased at a noticeable level. You can still talk, but not sing.
Somewhat hard. You now have to breathe through your mouth. You can still talk, but you don’t really want to.
Hard. Your heart is pounding. You can grunt in response to questions, but you can only keep this pace a short time.
Very hard. Your breathing is rapid and so is your heart rate. You can’t do this much longer.
Maximum effort. All you can think about is how much you would like to stop because you can’t go any further.
If you are wanting to do 30-60 minutes of moderate intensity exercise five days a week, you would work at level 6 to 7. To work at level 6, use long levers at full range of motion. To work at level 7, increase the speed of your movements without decreasing the range of motion. If you are wanting to do 20-30 minutes of vigorous exercise three days a week, you would work at level 7 to 8. To work at level 8, add acceleration and power to your movements.
If you are just starting out. It is common to go all out in your enthusiasm to begin a fitness routine. But if you have not exercised for a long time, you can easily overdo it, and suffer from muscle soreness, fatigue or even sustain an injury. It is better to focus on form (maintaining good alignment) and performing the exercises correctly at first. Work at a somewhat easy level. After you have gotten comfortable with that, then start to increase your intensity gradually. Your goal is to make your exercise routine a life long commitment.
For many people (and that includes me) working out in the water is perceived as fun. Adding some exercises or activities with a ball makes a class seem like play. Balls and fun just go together. I like to include fun activities occasionally as a mental break from the hard work of doing cardio, intervals and strength training throughout the year. During the holidays at the end of the year, when there is often so much shopping, baking, decorating, and entertaining stress, I like to tone down the training a bit and spend more time on fun and games. These can be relay races, obstacle courses and a variety of things with noodles, but nothing brings out the smiles like walking into the facility with a bag of balls.
You can find inexpensive play balls at discount and dollar stores. You want them to be approximately volley ball size. Take a little air out of them so that participants can grasp them, otherwise they can be hard to manage. You can do strength training exercises with balls. Push and pull them while jogging, lunging or squatting. Push them across the midline of the body or sweep them from side to side. Push them down under the water with a jacks tuck or Cossack kick. Put them between the legs and squeeze them for inner thigh work. With the ball between the legs go suspended and travel with breaststroke or reverse breaststroke. Use them for hand exercises. Squeeze with all five fingers to improve grip strength, or squeeze one finger at a time. For finger flexibility lift one finger off the ball at a time.
Then there are the games!
Eye-Hand Coordination. Have the class stand in a circle. Give them 1-3 balls to toss around the circle. Periodically add another ball to make it more challenging. Call out “Switch” and they must change from passing the ball clockwise to counter clockwise, or back to clockwise.
Pass the Ball. Form a circle with an even number of players. Every other person is on the same team. Give one ball to a player on one side of the circle and a second ball to a player on the opposite side of the circle. On signal, pass the ball from one team member to the next in the same direction around the circle. The first team to have their ball overtake the other team’s ball wins the game.
Ball Toss. Partners stand 6 feet apart with one ball between them. They toss the ball back and forth. Periodically have them take a step backward to increase the distance the ball is tossed.
Batting Practice. Partners stand 6-8 feet apart. One partner has the ball and the other has a kickboard. The one with the ball tosses it to the other who bats it back to the pitcher. Then they trade the ball and kickboard and change roles.
Walk the Dog. Divide the class into 2 or more teams, depending on the size of your class. You don’t want to have too many people standing in a line waiting for their turn. Give each team a ball and each person a noodle. Each person in turn keeps one end of the noodle in contact with the ball while walking to the turning point and back, where they hand off the dog to the next player in line. The first team to complete the relay wins.
Waiter Relay. Divide the class into 2 or more teams, depending on the size of your class. Give each team a ball and everyone a kickboard. The first person on each team balances the ball on the kickboard while walking to the turning point and back, then hands the ball off to the next person on the team. If the ball falls off the kickboard, that team member has to chase it and return to where they lost the ball. The first team to complete the relay wins.
If you have some other ideas for games with balls, put them in the comments section below.
Stabilization is the ability to maintain balance and control during movement. This requires coordination between the muscles, tendons, and ligaments that support the joints. When you perform any type of movement, the prime movers, or agonists, are primarily responsible for creating the movement. The antagonist muscles oppose the movement of the prime movers. There may also be some muscles that assist the movement. The stabilizer muscles provide support and stability to the prime movers. The muscles of the core, including the transverse abdominis, multifidus, gluteus medius, and pelvic floor muscles, function as stabilizers in nearly every movement. Ideally the stabilizer muscles fire first, that is, movement begins from the inside, ensuring that the movement is executed with proper form.
When we were born, we all moved from the inside out. Eventually our bodies found it was easier to move from the outside in. Our superficially placed muscles fire first when we are being efficient or mobility focused. When we are safety or stability focused, our deep tissue muscles fire first.
Our bodies want to be efficient, so they often find the easiest way to do things. The easiest, most efficient way to lift your arms during ‘the wave’ in the stadium is to propel your head forward. The safest way is to stabilize your core so only the arms move. The easiest, most efficient way to lift your knee up high is to propel your torso forward. The safest way is to stabilize the torso before lifting the knee.
Other common efficiency examples you’ll see or feel:
Rib flare and lumbar extension to reach overhead instead of letting the thoracic spine/ribcage mobilize.
Knee collapse (valgus) or foot collapse during squats and stairs because the hip isn’t stabilizing in the frontal plane.
Hip hitch or leaning the trunk forward during walking/running when the lateral hip can’t hold the pelvis level (Trendelenburg).
Neck tension and breath-holding when the diaphragm isn’t leading the breath, forcing accessory neck muscles to overwork.
Back rounding and twisting to pick objects up when the hips won’t hinge.
None of these mean you’re “broken”. It means your brain / nervous system chose a strategy that worked once and then it became automated. Habit, fatigue, aging, pregnancy/postpartum changes, and sport repetition—can prompt the body to find “workarounds” that feel efficient in the moment but quietly tax joints, tendons, and the nervous system.
Sometimes an injury or surgery can change the muscle firing sequence. When you injure a body part it will hurt to use the muscles around it, so other muscles get involved. This is called compensation. Your body should return to normal after healing, but it often doesn’t. You may end up with muscles that shouldn’t be involved firing for the rest of your life. When a joint that should hold can’t, the neighbor tries to move less or move too much.
The good news is that we can teach our bodies to choose safety, which means moving from the inside out (stabilize first). At its simplest: stability is controlled stillness—the precise amount of muscular co-contraction that lets other segments move freely. It is not “rigid bracing all the time.” It’s dynamic and follows two steps.
The first step is the breath. Real core stability starts with the pressure system inside the torso. When the diaphragm descends on inhale and the pelvic floor responds, the abdominal wall and deep spinal muscles (transversus abdominis, multifidi) create 360° intra-abdominal pressure that supports the lumbar spine like an internal airbag. Exhalation then organizes the ribcage over the pelvis so force transfers cleanly from the ground up through the hips, trunk, and shoulders. This is why “stack your ribs over your pelvis and breathe wide into your sides and back” is such potent coaching; it sets the platform before you move.
Step two is brain entrainment. Brain entrainment, also called neural entrainment, is a phenomenon where the brainwaves synchronize with external stimulation. It is how the brain picks movement patterns (helpful and not). Your brain has two top priorities: safety and efficiency. If a pattern feels safe and lets you accomplish the task quickly, your nervous system will favor it … even if it steals stability from one place to create motion somewhere else. Practice engrains these choices into durable habits. Some habits are protective and powerful; others become compensations that limit performance or invite overload. Therefore, it is necessary to relearn stabilization.
The Heavy Concept is an excellent technique for relearning stabilization. It puts the focus back on the synergistic and stabilizing muscles and takes it away from the prime mover. Here’s an example. While you are sitting, do 4 alternating knee lifts. You probably will notice that your body rocks either side-to-side or forward and back. Now imagine that someone has super-glued your foot to the floor. Try to lift it. It won’t come up but continue trying harder (without letting the body lean). What you did was activate the deep tissue trunk/core muscles, the stabilizers. Next, imagine that you are slowly overcoming the super-glue as you lift your leg. The Heavy Concept is neuromuscular retraining.
Another re-education option is to organize from the center out (a 60-second reset)
Stack: Stand with ribs over pelvis, soft knees, long back of the neck.
Diaphragmatic 360° breath: Inhale through the nose, expanding low ribs, sides, and back; exhale through gently pursed lips to feel the lower ribs glide down without crunching.
Set pressure: On the end of the exhale, keep a gentle 15–20% abdominal tone (not a hard brace) while you begin the next inhale.
Move: Keep this quiet pressure while you hinge, reach, step, or perform any exercise. If you lose it, reset.
There are exercises you can do to strengthen the stabilizers. On land the exercises typically challenge the body in an unstable environment, such as on a stability ball. But the water is a dynamic environment, making it ideal for stability challenges. Here are some examples:
Knee lifts using the Heavy Concept
Yoga plank on a noodle. Try lifting one leg toward the surface.
Yoga side plank on a noodle. Try lifting the top leg toward the surface.
Single leg stand. Try extending one leg forward as you stand on the other foot. Or raise one or both arms overhead.
Single leg squats.
Fall forward, tuck your feet under you and stand up.
Fall sideways, tuck your feet under you and stand up.
You can practice stabilization using the Heavy Concept in daily-life situations:
Lifting the dog/groceries: imagine that they are heavier than they actually are and you should feel deep tissue muscles in the torso engage.
Stairs: As you shift your weight up, imagine that your body is incredibly heavy and you should feel your core engage.
Reaching high: imagine that it’s really hard to lift your arms, and you should feel your shoulder blades depress.
The benefits of improved stabilization include reducing the risk of falls, reducing the risk of suffering from an injury, improving your brain-body connection, increasing your overall body awareness, and quicker reaction times. Stabilization isn’t about bracing harder, it’s about breathing, stacking, and timing so that the right parts hold while the right parts move. Nail that first, and the Heavy Concept will feel intuitive: add the right kind of “heavy,” and your brain upgrades the pattern for keeps.
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