Keep Your Balance

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The components of physical fitness are cardio-respiratory endurance, muscular strength and endurance, flexibility and body composition. The skill related components of fitness are balance, agility, coordination, and power. Balance is the ability to maintain equilibrium both while standing and while moving. Balance is important for athletes in gymnastics, football, baseball and other sports, but it is also important for older adults who worry about injuries they may sustain from falling.

Fall risk is the result of deconditioning, not age. To assess your fall risk, stand on one leg without the support of the upper extremities and without bracing one leg on the other. Count the number of seconds you can maintain this position. Time is up when the foot touches the floor or an arm touches something for support. Your chance of falling and sustaining an injury is double if you are unable to perform the one legged stance for 5 seconds. According to the American College of Sports Medicine, balance training may reduce the risk of falling and fear of falling and probably reduces the number of falls. It is recommended that balance training be performed at least 3 times a week, and daily is better. Balance training can be performed either on land or in the pool.

A sample fall prevention strength program on land might include the following exercises: (1) Resisted row with a band, focusing on squeezing the shoulder blades together, to strengthen the upper back and core. (2) Toe scrunches to strengthen the toes. (3) Standing heel lifts to strengthen the calf muscles. (4) Deadlifts, focusing on avoiding bending the trunk, to strengthen the glutes and hamstrings. (5) Chair squats, that is sitting in a chair and standing back up again, and lunges, to strengthen the quads. Also work on walking fast. since the faster older adults can walk, the lower their mortality rate.

Ruth Sova wrote an article for Akwa magazine that described multiple exercises for improving balance in the pool. Here are a few examples: (1) Sit on a noodle like a swing with the feet on the pool floor; turn eyes to the right and hold 10 seconds, and then left. No head movement, only eyes. (2) Sit on a noodle like a swing with the feet on the pool floor and bend to the right further than is comfortable and recover. Notice what is used to recover (legs, head, jerking movement?) and try to use only the core muscles. (3) Sit on a noodle like a horse with the feet on the pool floor and walk forward with feet rolling heel to toe, and nothing moving but the legs. Stop and restart. Stop and walk backwards. (4) Squat with the feet together, with the feet apart, with one foot directly in front of the other, or in a lunge position. Add various arm movements using both arms or one arm. (5) Stand and lift your toes off the floor then roll up on your toes as the chin lowers. (6) Stand with your right heel on the floor and roll the outside edge of the foot to the tips of the toes while turning your head slowly to the left. Repeat with the left foot. (7) Weight shift from side to side and from front to back. (8) Walk on tiptoes, or on heels, or with toes out or toes in. (9) Use unpredictable commands, such as marching in place on tiptoes while circling the right arm. (10) Cross-country ski with the hands on the hips and travel sideways. If you are an AEA member, you can check out the article for more exercises.

The goal is not to be able to perform on a balance beam like Simone Biles. The goal is to avoid becoming one of the 2.8 million seniors who visit the emergency room each year because of a fall. And beyond that, balance training is good for the brain. Memory, language skills, problem solving and decision making are coordinated by the cerebrum. Balance, posture and fine motor skills are coordinated by the cerebellum. The cerebrum and cerebellum are connected by a direct neural link. When an older adult trains for strength and balance, cognition improves.

My resources for this article are Ruth Sova’s article “Seated and Standing, Static and Dynamic Balance” in the October/November 2019 issue of Akwa magazine and Exercise Etc. Inc.’s 2019 webinar “Balance & Fall Prevention.”

See you in the pool!

Chris Alexander

Why Exercise?

I have been teaching water fitness for 26 years. Clearly I enjoy exercising. But I know there are a lot of people out there who do not exercise. The excuses include not being motivated, not having enough time, being too tired, exercise is not fun, being too out of shape and not liking to sweat.

Motivation. Everyone wants to look younger and live longer. The secret to longer life is not a magic pill but exercise. Scientists can predict how long someone will live by how well they perform 5 simple tasks. How many times can you stand up from a chair and sit back down in 60 seconds? How long can you balance on one leg? How long is your stride length? How is your grip strength? How good is your posture? A good reason to exercise is to make improvements in these areas to improve your longevity and make the activities of everyday life easier.

Not Enough Time. Instead of trying to find time, try to make time. Some activity is better than none. Find a time during your day when you are free of commitments and schedule some exercise during that time. It doesn’t have to be a lot of time. Start with 10 minutes and increase it by a minute a week. Soon it will become part of your routine.

The remaining excuses. Once your fitness starts to improve, you will find you have increased energy. If one type of exercise is not fun, try something active that you do enjoy. Here’s where I put in a plug for water exercise. Hanging out in the pool when we were children was so much fun that many of us find getting in the water to exercise is really enjoyable. The buoyancy of the water supports your weight so that it seems easier to exercise even if you are out of shape. And the water cools your body so that you are not aware that you are sweating.

Many of the simple tasks that predict longevity can be worked on in the pool. Squats can improve your ability to stand up from a chair and sit back down. The pool is the perfect place to work on balance because the water supports the body and reduces the fear of falling while at the same time water movement makes balancing more challenging. You can work on increasing stride length by water walking. Hand grip exercisers are best for improving grip strength, but gripping pool equipment helps some. You can also concentrate on exercising with good posture in the water to help improve posture on land.

Exercising regularly makes the activities of daily life such as climbing stairs, playing with grandchildren and carrying groceries easier. It also improves blood flow to the brain which decreases the risk of cognitive decline. We cannot stop from aging, but we can work to maintain our functional fitness well into our retirement years.

See you in the pool!

Chris Alexander

How to Fall Safely

More than one out of every four people 65 or older falls each year. One out of five falls causes a serious injury such as broken bones or a head injury. Over 800,000 patients a year are hospitalized because of a fall injury. Each year at least 300,000 older people are hospitalized for hip fractures. These statistics from the Centers for Disease Control and Prevention are a concern for many of my water exercise class participants and for me. When I came across some articles on How to Fall Safely, I decided the information was worth passing on.

I found articles from several sources, including AARP, physical therapist blogs and wikiHow. The pictures in this Blog post come from wikiHow. The co-author of the post was Chris M. Matsko, MD.

Protect your head. Head injuries can be very serious. Make sure you prioritize protecting your head. Tuck your chin down to lower your head. If falling face first turn your head to the side. Use your arms for additional protection. Put them in front of your head if falling forwards or behind your head if falling backwards.

Turn as you fall. If you are falling either straight forward or straight backwards, try to turn your body so you land on your side. This reduces the risk of injuring your head, face, arms or back.

Keep arms and legs bent. It may be tempting to try and catch yourself with your arms. However, landing with your arms straight out can break your wrists and/or your arms.

Stay loose. Tensing up increases the chance of sustaining an injury. The tense parts of the body are more likely to break. Try breathing out as you fall to help keep your body relaxed.

Spread out the force of the fall. A big part of falling safely is to spread out the force of the impact over a large area of your body. This reduces the risk of a serious injury to a single part of the body.

Another suggestion is to roll out of the fall. This is difficult to do unless you have practiced beforehand. If you wish to learn the technique, you can ask a physical therapist to show you how, or practice falling and rolling in a gym with padded and cushioned floors.

Just as important as knowing how to fall is taking steps to prevent falls in the first place. Wear shoes with slip resistant soles. Pay attention when you walk. Be aware of uneven areas on the ground, curbs and stairs. Hold the hand rail when taking stairs. In the home, close drawers after you are done with them. Don’t leave cords in walkways. Keep the area well lit. Use non-slip bath mats. Remove small throw rugs.

Another way to reduce your risk of falling is to improve your strength and balance with exercise. The pool is the perfect place to work on both strength and balance. Because the water’s buoyancy and resistance helps support the body, exercises can be done without fear of falling. Options include the following:

Gait training. Gait training is walking practice. The goal is to lengthen the stride and improve confidence while walking.


Core Strength Training. Core strength training is training for the postural muscles of the trunk. This includes the Trapezius and Rhomboids, the Latissimus dorsi and the Erector spinae. Exercises to try are rowing, bowstring pull, and lat pull-down using the water’s resistance or drag equipment. Walking backward strengthens the Erector spinae.

Deep-Water Exercise. Deep-water exercise is performed, while wearing a flotation device, in water in which a person can remain vertical without the feet touching the floor. Exercisers must aggressively engage the stabilizing muscles of the core to remain upright.

Balance Challenges. Balance challenges are exercises performed with a narrow base of support, such as the feet together, one foot in front of the other, or standing on one foot. Slow movements are more challenging than fast ones.

Falling is scary, but learning how to fall and taking steps to prevent falls in the first place are things we can all do now to reduce the risk.

See you in the pool!

Chris Alexander

Why is good posture important in water exercise?

I suppose my classes sometimes get tired of hearing all my cues for good posture, good alignment, good form. After all, the main thing is that they are moving, right? Well, yes and no. Moving is definitely better than being sedentary. But the quality of movement is important too. The terms good posture, good alignment and good form all mean that the spine is aligned in its natural curves.

When the spine is aligned, the bones are evenly spaced and the discs between the bones are not pinched in any way. Our spines are designed to be able to bend forward (forward flexion) or to the side (lateral flexion), but during exercise it is important to have the spine in alignment. This places the least amount of strain on the supporting muscles and ligaments. It allows us to use our muscles correctly so that we can increase intensity without risking an injury. Good form prevents muscle strain, overuse disorders and back pain. Keeping the bones and joints in correct alignment decreases the abnormal wearing of joint surfaces that could result in degenerative arthritis and joint pain.

If we exercise with poor posture we create muscle memory that makes poor posture feel normal and good posture becomes harder to achieve. No one intentionally wants to train for poor posture! Let’s take a look at some examples of common mistakes in alignment during water exercise.

This is the classic image of good form/bad form in deep-water running. The runner on the right (with the big red X) is leaning forward, streamlining his body so that the water hits his chest and slides down his abdomen. He can travel faster than the runner on the left who presents a larger surface area to the water’s resistance, which is probably why so many people adopt this form. But the front part of the discs in his spine are compressed and he is causing abnormal wear of his joint surfaces. The runner on the left is able to work harder, run with more power, without risk of an injury.

High knee jog

In this photo I am demonstrating another common running mistake, bringing the knees up too high. People who adopt this form are usually trying to increase intensity. But the spine is out of neutral and the high knees risk aggravating the sciatic nerve. Bring the upper leg up no higher than parallel to the floor. Another running mistake is bobbing from side to side. It may feel like you are working harder because there is so much movement going on, but you are compressing the sides of the discs. The best way to increase intensity is to maintain the entire trunk in neutral alignment and add power to the movement of the arms and legs.

High kick

Another mistake is trying to get the leg up too high in a high kick. You are aiming for your full range of motion in this exercise, but you do not want to push it beyond normal. If you try to get your toes out of the water you end up arching your back and taking your spine out of neutral.

Rocking horse

Another exercise that is often performed with an arched back is the rocking horse in shallow water. The exerciser should rock from the back foot to the front foot without taking the spine out of neutral alignment. Arching the back is not a safe way to increase intensity.

Inner thigh lift
Hopscotch

Mistakes are often made while performing the inner thigh lift and hopscotch. The exerciser tries to touch the ankle during the first exercise and the heel during the second one. If you can do that while maintaining neutral alignment, great! But if you have to bend forward to reach the ankle or lean to the side to reach the heel, then you are straining the muscles of the back. It is more important to keep the shoulders level. The purpose of the inner thigh lift is to work on hip flexibility and the purpose of the hopscotch is to work the hamstrings, and both objectives can be achieved without touching the ankle or the heel.

These are pictures of what not to do. For photos of the correct way to perform the exercises, see my books, Water Fitness Lesson Plans and Choreography and Water Fitness Progressions. 

See you in the pool!

Chris Alexander

Water Fitness Progressions

fullsizeoutput_1e57   I like my class participants. Over the years I’ve heard about their families, their pets, their challenges, and which of my playlists they like. They are more than just class participants, they are friends. I want them to get a good, safe, effective workout every time they come to my class. I don’t want to bore them with the same old routines. I want to challenge them to progress in their levels of fitness. I want to help them make their hearts stronger, to give them an opportunity to improve their muscular endurance, to challenge them mentally, and I want them to have fun doing it.

This means I have to keep learning. That’s why I attend conferences, workshops, and webinars and read water fitness books and articles. One of the things I’ve been looking for is a system for offering progressions. One system that I learned about is periodization. It’s a training tool used by athletes to help them be in the best possible shape during the most challenging season of their sport. Periodization divides the year into 4 seasons, Preseason, Transition Season, Peak Fitness Season and Active Recovery. Why not use this tool to train for the sport of daily living?

My experiments with periodization have become the basis for my new book, Water Fitness Progressions, which has just been published.

Chris Book Cover

Each season has its own focus. In the Preseason we focus on improving posture, performing the exercises with good form, increasing range of motion, doing low intensity intervals, and using the properties of water to create overload. In the Transition Season we improve the quality of our movement by paying attention to how the arms and legs move the water, increase interval training to moderate intensity, and add equipment to sessions of strength training. In Peak Fitness Season we focus on increasing power, performing high intensity interval training (HIIT) and using both concentric and eccentric muscle actions in our strength training with equipment. In Active Recovery we give our bodies a chance to repair any microtrauma that may have occurred during the previous months. We do light cardio-respiratory training, core strength training and have fun activities such as games or relay races to provide a mental break.

The book explains how to do all of this, complete with lesson plans. Each interval lesson plan has 3 versions, a low intensity version, a moderate intensity version and a high intensity (HIIT) version. There are strength training lesson plans using various properties of the water, using buoyant and drag equipment, and focusing on eccentric muscle actions. There is also a section of fun activities.

Thanks to the American College of Sports Medicine, the Aquatic Exercise Association, Pauline Ivens and Stephanie Thielen, who all provided some of the ideas used in this book. My special thanks goes to my water fitness classes, who are my inspiration. The book can be ordered from Human Kinetics (the publisher) or from Amazon.com. Just click on whichever source you wish to order from and the link will take you there.

See you in the pool!

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Chris Alexander