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.
We use our hips all the time to sit down, stand up, and walk. The hip joint is a ball-and-socket joint that allows us to move our legs and at the same time gives us the stability necessary to bear the body’s weight. Unlike the shoulder joint, the socket part of the hip joint is extremely strong and dense with surrounding ligaments to keep the head of the femur (the ball part of the hip joint) in place. You rarely hear about a hip dislocation. To watch a short video describing the anatomy of the hip joint check out the John Hopkins Medicine website. Even though our hips are designed be be weight bearing, the extra pressure on the joints does make them more likely to develop arthritis. Other potential problems include bursitis and injuries because of a fall. Problems with the hip may show up as problems with gait, that is walking. Examples of gait/hip problems include:
Reduced step length (the distance you cover when you take one step)
Reduced stride length (the distance you cover when you take two steps, one with each foot)
Reduced walking speed; a slower gait increases the risk of developing a disability
Foot angle out of the line of progression (the toes point out or in instead of forward)
Transferring body weight from side to side
Quad dominance (the thigh muscles are overactive and take over for the glutes and hamstrings during squatting, lunging, running and standing)
Gluteal Amnesia (the muscles on the back of the hip are weak and not activated during squatting, lunging and running)
Difficulty with sideways movements caused by weak hip abductors
For all of these reasons, it makes sense to do exercises that keep our hips heathy and strong. There are 22 muscles that act on the hip joint. These muscles allow the hip to flex (lift forward) and extend, abduct (lift to the side) and adduct, rotate to the midline and rotate to the side. Since the muscles that lift the leg forward (hip flexors) are strong and often tight from sitting too much, it is important to emphasize extension over flexion. Here are some exercises for your hips to include in your water fitness class:
Lunge in all directions, using a clock face
Walking in all directions
Shallow water running and deep water running
Knee-lifts (emphasize extension)
Cross-country ski with rotation
Kick forward (emphasize extension)
Kick to the side
Inner thigh lift
In addition to strengthening the muscles of the hips, there are some cautions to help you avoid an injury:
Ballistic Hip Abduction. These are known as cheerleader jumps, but since very few activities requires forceful hip abduction, this move is not functional. Instead do jumping jacks. Make sure that the feet are parallel so the move is hip abduction. It is okay to change foot positions when doing jacks upright, but if the toes point out when performing suspended jacks, you are changing the move to hip flexion.
Ballistic Karate Kicks. When karate kicks to the side are thrown forcefully, there can be an injury in the labrum of the hip. Cue “control and press” so that the throwing action is eliminated.
Prone Flutter Kicks. Flutter kicks strengthen the hips and legs, but prone flutter kicks while holding on to the wall compromise the hands, hyperextends the neck, hyperextends the lumbar spine, and compresses the spinal discs. Performing the exercise with foam dumbbells does not improve these issues. The neck and spine are still hyperextended, and the spinal discs are still compressed. Instead, perform flutter kicks in deep water in a vertical position with neutral postural alignment wearing a deep water belt.
Prone to Supine Abdominal Exercises use the hips to change positions, but they require accurate cueing. Going all the way to prone involves too much spinal extension and going all the way to supine involves too much spinal flexion. I have heard this exercise called by the amusing name of Sun Tan/Superman. But using this cue encourages going supine all the way and prone all the way. I prefer to call the exercise Abdominal Pike and Spine Extension. Bring the legs forward to a 90-degree angle in front, then tuck and extend the legs diagonally back, as in the pictures above. Wear a belt to do the exercise in deep water; do not do the exercise using just foam dumbbells.
Crunches are not functional, but they do work the abdominals. The problem in the water is that we are not horizontal as are crunches on land. Instead we are in a reclined sitting position with the legs close to the surface of the water. Most people pull their knees to the chest, which is repeated hip flexion with lumbar spine flexion. This compresses the front edges of the discs of the spine. Also, placing a noodle under the armpits impinges the shoulder joint and risks damaging the nerves in the arm pit. Instead work the muscles of the core in a vertical position. See the previous posts Take Care of Your Shoulders and Take Care of Your Spine.
“L” Position. This position is a long lever in hip flexion and it is difficult to hold the torso in neutral. Limit the amount of time used in this position.
High Kick with Compromised Posture. Some participants try to increase the intensity of a high kick by getting the toes to the surface of the water. This causes too much spinal flexion and too much hip flexion. Instead, lower the kick so that the lumbar spine does not slip into flexion. Emphasize hip extension, the downward movement of the leg.
Finally, there are some good stretches you can do in the the water for your hips. Side steps lengthen the inner thigh muscles. Forward steps lengthen the gluteal and hamstring muscles of the forward leg and stretch the hip flexors of the back leg. Slow motion walking is good for balance and coordination. Swing one leg forward and back to stretch the hip flexors. Bend the knee when the leg swings back to lengthen the quadriceps. Crossover steps lengthen the outer thigh. Hip figure 8’s are good for hip mobility. Use a range of motion that is controlled and pain free. Take care of your hips so that you can continue to sit down, stand up and walk without difficulty into your golden years..
Resources: Ruth Sova, MS – Hips Mini Session 9-22-22
Pauline Ivens, MS & Catherine Holder, PT Do No Harm 2011
Dallas Mania is coming to the Westin Galleria Dallas Hotel August 25-27, 2023. Our favorite aqua presenters will be there: Manuel Velazquez, Louis van Amstel, Rosie Malaghan, Ann Gilbert, Marybeth Dzuibinski, Billie Wartenberg, and a first time Mania presenter, me!
I am excited about being able to present with these experienced performers. I have two sessions, Increase Aqua Intensity with Intervals on Saturday August 26 from 7:30 am-8:45 am, and Aqua Strength Training on Sunday August 27 from 10:45 am-12:00 pm. Below is information about each of my sessions. Click on the title of the session to see a 20-second video introducing each session.
Increase Aqua Intensity with Intervals. Interval training is popular with instructors and participants alike. It’s a good idea to use the scale of perceived exertion to help participants judge how hard they are working. It is also helpful to give them some clues on how to take the basic moves and modify them to increase intensity. The basic shallow water moves are walk, jog, kick, rocking horse, cross-country ski, and jumping jacks. All these moves have multiple variations. Walking is good for warming up. For the other moves, the first stage in increasing intensity is to increase the range of motion. Larger long lever moves are harder than smaller short lever moves. The second stage is to increase the speed of the moves without losing the range of motion. Faster long lever moves are harder than faster short lever moves. The third stage is to add acceleration, either by accelerating off the pool floor (jumping) or by accelerating against the water’s resistance (pushing harder). The instructor also has to decide how to time the intervals. Tabata is probably the most popular way to time intervals, but there are many other options: 30-second intervals, 40-second intervals, 60-second intervals, rolling intervals, surges and more. I’ll review these in the lecture and we’ll do rolling intervals in the pool session. More timing options can be found in my book Water Fitness Progressions.
Aqua Strength Training. Strength training can be done using just the water’s resistance, and it is a good idea to teach participants how to do this before adding equipment. This session begins with an explanation of the heavy concept, a technique which recruits the core muscles before the prime movers fire. Sometimes participants feel the water flowing around a moving limb, but not the targeted muscle, and the isometric contractions of the heavy concept can help them actually feel the prime mover. Next we will talk about hand positions, lever length, and frontal resistance, which are all techniques for creating a larger surface area to push through the water. Then the fun begins with the Laws of Motion – Inertia, Acceleration, and Action/Reaction. These are not just dry concepts invented by someone named Newton, but properties of water that you can take advantage of to overload the muscles and get participants moving, turning, changing directions and seeing how heavy the water can feel. You will get to experience all of this in a very splashy pool session. There is more information about the properties of water, and lesson plans for taking advantage of them in my book Water Fitness Progressions.
Eighty percent of Americans will suffer back pain at some time in their lives. Back pain often develops without a cause that shows up in a test or imaging study. According the Mayo Clinic, risk factors for back pain include age, lack of exercise, excess weight, diseases such as arthritis and cancer, and improper lifting. People prone to depression and anxiety and smokers have an increased risk of back pain. Regular low impact aerobics and abdominal and back muscle exercises that strengthen the core can help keep the back healthy and strong.
Exercises that improve posture is a good place to start. Bring the neck into alignment with chin tucks. Put a finger on your chin and, keeping your chin level, pull it away from your finger. Some people have trouble with this exercise and tend to pull the chin down. Another way to cue the exercise is to say “lift the sternum” which accomplishes the same thing. Next relax the shoulders and bring the shoulder blades down. Turning the palms forward can help accomplish this. When you stand, stand tall with your body weight evenly distributed between both feet and the knees pointing forward. When you sit, keep both feet on the floor with the knees bent at hip level or below,
Exercises to improve posture are exercises that strengthen the core. Although many people associate crunches with core exercises, the core includes all the muscles of the trunk. The pool is the perfect place to work the core because immersion in water activates the core muscles. It is a discreet but constant activation, and you do not feel it the same way as an abdominal crunch. The core muscles most in need of strengthening for good posture are the muscles of the upper back, the erector spinae and the glutes. Always stabilize the core before moving the arms and legs. The best exercise to strengthen the posterior muscles is to travel backwards in the pool. Some other exercises to try in the pool are:
Upright row. Cup the hands and pull the water toward you. You can also use webbed gloves, drag equipment or kickboards.
Lat pull-down. Hold resistance tubing overhead and pull the ends down to the sides. Or do jumping jacks with foam dumbbells or drag equipment.
Rear delt fly. Hold resistance tubing chest high and pull the ends apart.
Shoulder external rotation. Rotator cuff sweep out with thumbs up.
Straddle a noodle with the end of the noodle between the thighs; adjust the height of the knees to find the difference between extension, neutral and flexed.
Abdominal pike and spine extension. Go only 45 degrees to the back to avoid hyperextending the back. Use a deep-water belt. Do not try this exercise with just foam dumbbells. (See the previous post on the shoulders.)
Back rotation. Upper body twist or hula hoop.
Squats with feet hip distance apart or a narrow stance.
Hip extension. Skate kick or cross-country ski.
In addition to strengthening the core, there are some cautions to help you avoid an injury. When running in deep water, maintain the spine in neutral alignment. In this position the spine is off-loaded because of the buoyancy of the water. However, people often lean forward which reduces the frontal resistance and allows them to travel faster, but this position also causes spinal compression even though there is no lower body impact.
It is also important to maintain good posture in shallow water. Other things to avoid include prone flutter kicks at the wall. This compromises the grip, the neck, and the lumbar spine. Do not hang on the wall and do double leg lifts; this overloads the lumbar spine. Wall-hanging sit-ups do not exercise the abdominals and it is too difficult for many water exercise participants to get into that position. The risks outweigh any benefit. Crunches in a supine position put stress on the neck and use the hip flexors instead of the abdominals. Do not do rotation and forward flexion at the same time (opposite elbow to knee) as it puts stress on the lumbar spine. Participants with compressed discs or osteoporosis should avoid trunk flexion. It is better to work on core stabilization by bracing the core and emphasizing good posture.
Working on good posture and strengthening your core muscles are good ways to take care of your spine and reduce your risk of back pain in the future.
Ruth Sova, MS – Backs Mini Session 9-1-22
Pauline Ivens, MS & Catherine Holder, PT Do No Harm 2011
We don’t usually think about our shoulders, but we use them all the time to do things like lifting a bag of groceries, opening the car door, wiping the kitchen counter, picking up a child, lifting a drink, combing our hair, reaching behind our back to thread a belt through the loops and more. Two major bones of the shoulder are the humerus or arm bone, and the scapula or shoulder blade. The four muscles of the rotator cuff stabilize the shoulder joint or keep it in its proper position. Muscles in our chest and back and the deltoids on top of the shoulder are responsible for moving our arms in all the multiple directions they are capable of. Our shoulders are complex and amazing!
Rotator cuff injuries are common and increase with age. Fifty percent of adults over 60 have rotator cuff tears. Thirty-four percent of adults who have rotator cuff tears have no symptoms. For more information about the causes and treatment of a rotator cuff tear, see this article from the Mayo Clinic. It is a good idea to take care of your shoulders by keeping your muscles strong before an injury occurs. The water is an excellent place to do this because buoyancy decreases joint compression and allows better muscle function and relaxation. When the shoulders are submerged, circulation increases which assists in removing toxins and bringing in nutrients. Start by relaxing the shoulders. When your shoulder blades are flat, the rotator cuff is in good alignment. With your arms by your sides, turning the palms forward helps to bring the shoulders in good alignment. Some shoulder exercises to try in the water are:
Lat pull-down. Hold resistance tubing overhead and pull the ends down to the sides.
Jumping jacks with the thumbs up.
Breaststroke with the thumbs up
Rear delt fly. Pull the ends of resistance tubing apart at shoulder level.
Shoulder extension. Bring the arms in front of the body at the surface of the water and press down. You can add resistance with drag equipment, such as paddles. Or hold resistance tubing at the surface of the water with one hand and pull the opposite end down with the other arm.
Cross-country ski with the palms facing forward.
Rotator cuff sweep. Bring your elbows down near, but not glued to, your waist. Sweep your hands out to the side and back to center. Or keep your hands out to the sides and walk backwards.
PNF. (1) Bring one fist to the opposite shoulder then sweep it diagonally out to the side near the hip with the palm facing back. (2) Bring one fist to the opposite hip then sweep it diagonally up to the side with the palm up, as if pulling a sword out of its scabbard and brandishing it.
Figure eights to the sides, to the front, or one arm at a time.
In addition to strengthening the shoulder, there are some cautions to help you avoid an injury. Look at the drawing of the shoulder bones. The head of the humerus is like a golf ball sitting on a tee (the glenoid cavity). This allows the shoulders to be extremely mobile, but they are not designed for weight bearing. Therefore, do not hang on walls, because then you are using your shoulders to support your weight. The photos demonstrate some other things NOT to do. You want to avoid impinging the shoulder, which means pinching the tendons of the rotator cuff. Impingement occurs when you hang from foam dumbbells with the arms extended to the sides and when you are suspended from foam dumbbells in a reclining position. Using a noodle around the torso can also cause impingement if it is too high. Position it mid-torso, just below the shoulder blades. Do not hang from foam dumbbells under the armpits as it damages the nerves in the armpit. Always wear a deep-water belt when using foam dumbbells in deep water. Keep your feet on the pool floor when using foam dumbbells in shallow water. Keep your shoulders relaxed while working with foam dumbbells. Impingement occurs when using the equipment with shoulders shrugged. If you have difficulty holding the dumbbells under water without shrugging the shoulders, use a smaller set of dumbbells, or switch to webbed gloves. Another instance of impingement occurs when the arms are extended to the sides with the shoulder internally rotated, that is with the thumbs down. That is why the breaststroke is done with the thumbs up. Yes, swimmers do the breaststroke with the thumbs down, but they are in a horizontal position, not in the vertical position of exercisers in a water fitness class. Be careful about bringing your arms too far back when doing a breaststroke. This exposes the head of the humerus, risking an injury. Keep your hands within your peripheral vision, unless you are doing a slow stretch.
Overhead reaches are functional, but do not sustain them for too long. The shoulder muscles fatigue quickly, so take a break after a few repetitions, or alternate arms. Do not bring the arms in and out of the water. As the arms break the surface, the resistance is suddenly gone, and the movement becomes ballistic. When you hold your arms out to the sides, do not continuously maintain a position between 80 and 120 degrees, because that can cause bursitis. It is better to have the arms at a 70 degree angle. Fast arm circles overload the small shoulder muscles. Slow the arm circles down. When holding a noodle in the hands for upper body work, it is best to have the hands shoulder distance apart. If the hands are too narrow, the shoulders are rounded. If the hands are too far apart, the shoulder blades are no longer neutral. Triceps dips with the noodle behind the back are also hard on the shoulders, and there are many triceps exercises that are more effective.
Take care of your shoulders so you can continue to lift those grocery bags, open the car door, wipe the kitchen counter, pick up a child, lift your drink, brush your hair, and reach behind your back to thread your belt through the loops without pain.
Ruth Sova, MS – Shoulders Mini Session 9-8-22
Pauline Ivens, MS & Catherine Holder, PT Do No Harm 2011
Did your mother remind you to sit up straight when you were a teenager? Most of us don’t think much about our posture, but poor posture can lead to a variety of health problems.
Headaches. Your head weighs about 10 pounds, but every inch you tilt it forward adds10 pounds. If you tilt forward 1 inch, your head weighs 20 pounds. If you tilt forward 2 inches, your head weighs 30 pounds.
Rotator cuff tears. Rounding your shoulders forward pinches the tendons in your rotator cuff, which can lead to a rotator cuff tear.
Back pain. Slouching stresses the muscles of your back which can lead to chronic back pain.
Reduced lung capacity. Poor posture compresses your chest area, which means your diaphragm is not able to fully expand.
Increased risk of injury during exercise. Neutral spine with the core engaged is the safest position for exercising. It makes sense that working out with forward head, rounded shoulders, poor posture and an inability to fill the lungs completely with air is a recipe for injury.
For more information on problems caused by poor posture, see “What Really Happens to Your Body When You Have Poor Posture” in Live Strong.
Good posture requires core strength. Often when you hear the term core strength, you think of abdominals and crunches. But the core includes all the muscles from your shoulder girdle to your pelvic girdle, in other words, the entire trunk area. There are a variety of exercises you can do to improve core strength. These include head retractions, overhead arm raises, bridges, the Yoga tree pose and planks. There are also a variety of stretches that are helpful. These include neck stretches, chest stretches, and hip flexor stretches. For more information on these exercises see “These 12 Exercises Will Help You Reap the Health Benefits of Good Posture” from Healthline.
To improve core strength, it is also helpful to pay attention to your daily activities. Often we use our arms to support ourselves when it would be better to use our core strength instead. If you are unstable because of an illness or an injury, then you may need to use your arms. Otherwise it is better to straighten up your posture and take back your ability to move from your core. Ruth Sova did a series of 30-second videos about situations in which doing things the easy way may cause us to lose function. She entitled the series “Take It Back” and gave permission to share the videos. There are links to the videos in the titles of the six pictures above. The videos show Ruth’s sense of humor and they are delightful.
Don’t forget to also practice good posture when you exercise. See you in the pool!