Activities of Daily Living

Activities of Daily Living (ADLs) - Heritage Creek Assisted Living

The activities of daily living, or ADLs, are self-care tasks. These tasks are:

  • Self-feeding
  • Bathing and showering
  • Dressing
  • Functional mobility, or the ability to walk, get in and out of bed, and in and out of a chair
  • Toileting
  • Continence

It goes without saying that we all want to be able to do these tasks as long as possible. It is not true that frailty is an inevitable part of aging. Frailty is the result of inactivity. Exercise is the magic pill that will keep us enjoying the activities of life that are important to us. Certain types of exercise can target ADLs. Your exercise program should include these exercises, especially after age 62 when age related slowing typically begins. But it is never too late to begin! The ADLs have been broken down into the following movement patterns:

  • Push
  • Pull
  • Rotate
  • Bend at the hips
  • Squats
  • Lunges
  • Brace (hold still) and balance
  • Pelvic floor exercises
Push And Pull Forces Clipart - Png Download (#1828557) - PinClipart

Push. We push a grocery cart or a stroller. We push the door shut. We push away from the table when we are finished eating. We push when we use our arms to get up from any position. We push our arms into the sleeves when we get dressed. Exercises that involve pushing include the chest press machine in the gym, dribbling a basketball, and push ups. If the traditional push ups on the floor are too difficult, place your hands on a sturdy bench or couch to perform incline push ups, or try standing push ups against a wall or counter top. In a water fitness class any action where the arm moves against the water in any direction away from the body is a push. A chest press toward the pool floor can be performed in a lunge position using buoyant dumbbells. An incline push up can be performed using a noodle.

Pulling Weeds Clipart - Pulling Weeds Gif - Free Transparent PNG Clipart  Images Download

Pull. We pull weeds. We pull a wagon. We pull the car door shut. We pull when we pick something off the floor. We pull laundry out of the washing machine. We pull clothes out of the closet. Exercises that involve pulling include the rowing machine in the gym, biceps curls with weights, and pulling resistance bands. Wrap the band around a banister or sit on the floor with the band around the bottom of your shoes and pull the ends. In a water fitness class any action where the arm moves the water towards the body is a pull. Jogging arms with cupped hands and jumping jacks with the arms moving toward the midline are examples. You can row with drag equipment, such as paddles or Aqualogix bells.

Image result for Throwing Ball to Dog Clip Art | Dog clip art, Dog vector,  She dog

Rotate. Any throwing or hitting action requires torso and arm rotation. Walking and running involve torso rotation. We rotate to look behind us when we are backing the car out of the parking space, and we rotate to get out of the car. An exercise that involves rotation is to sit in a chair with both hands on one hip and then turn to look over your shoulder. Limit the range of motion if you have osteoporosis. A stretching routine called Controlled Articular Rotations (CARs) uses rotation to improve mobility. To find out more, see Dr. Larissa Armstrong-Kager’s YouTube videos. In a water fitness class you can increase the intensity of a cross-country ski or a high kick by rotating the upper body with the arm swing. Crossing the midline of the body with the arms and crossover kicks involve rotation.

Bend at the Hips. We bend at the hips when we pick something small up off the floor. We bend when we tie our shoes. We bend when we put our pet’s food on the floor. We bend when we towel off after a shower. An exercise that involves bending is a deadlift. With weights in your hands and arms down, bend forward from your hips keeping your back straight and bending your knees slightly; then return to an upright position. We also bend at the hips when doing a hamstring stretch. In a water fitness class we bend at the hips during the up action of a straight leg front kick and during the down action of a straight leg back kick. We also bend from the hips when performing suspended exercises in shallow water, and when performing exercises in the “L” position in deep water.

Squat. We squat every time we sit down in a chair, or on the toilet. The best way to lift something heavy off the floor is to squat and grab the item with both hands and then stand up using the legs. Squats are functional exercises. Stand with your chest lifted and shift your weight to your heels as you lower your hips, as if sitting in a chair. Try not to let your knees go forward past your toes. Then push through your heels to return to standing. Another version of squatting is to sit down in a chair and stand back up again. In water fitness squats do not work the same muscles because the water’s buoyancy makes it easy to return to standing. Standing on an aquatic step so that more of your body is above the water makes the squat more effective. You can work the same muscles with rebounding moves that involving jumping with both feet, such as a tuck jump, a jumping jack and a cross-country ski.

Library of graphic black and white stock vacumming png files ▻▻▻ Clipart Art  2019

Lunge. You lunge when you step in any direction, or transfer weight from one leg to the other. Walking and running involves lunging. You lunge when you vacuum the floor. To perform a lunge exercise, take a big step forward with your hands on your hips, and slowly lower your body. Make sure that your front knee does not extend past your toes. If your knees bother you on the lunge, you can lean forward slightly from the waist to reduce the stress on the joints. Press through your heel to bring your front foot back to the starting position. If the lunge is too difficult, take a smaller step forward, or don’t bend your knees as far. You can place one hand on a wall or chair to help you balance. In a water fitness class you work the same muscles by jogging, kicking side to side and doing a rocking horse.

14 Exercises for Seniors to Improve Strength and Balance | Philips Lifeline

Brace (hold still) and Balance. Bracing involves contracting the core muscles to maintain a position. It is important in maintaining balance. The ability to balance greatly reduces the risk of falling. For exercises to improve balance, see my previous Blog post Balance Training at Home. Many of these same exercises can be performed in the pool as well. Another pool balance exercise is the Yoga plank while holding a noodle in the hands under the shoulders.

Pelvic floor exercises. Incontinence is often a problem as we age and the solution is pelvic floor exercise. These used to be called Kegels, but research has changed the way the exercises are done. Keep your shoulders relaxed and breathe normally as you smoothly raise your pelvic floor. Hold for 10 seconds then relax for 30 seconds before performing the next pelvic floor exercise; repeat up to 10 times. Or do 10 quick pelvic floor exercises in succession. For a more detailed description of pelvic floor exercise, see my Blog post Keep Your Inner Core Strong. Pelvic floor exercises can be done in a water fitness class as well as at home.

There is a Functional Core Strength lesson plan and a Balance lesson plan for shallow water as well as a Functional Core Strength lesson plan and a Balance lesson plan for deep water in my book Water Fitness Progressions. The lesson plans demonstrate options for teaching a class focusing on maintaining the ability to perform ADLs. To order the book, click on the link. Many pools are getting ready to reopen following closures because of COVID-19. I hope to see you in the pool soon!

Chris Alexander

Chris Alexander

Water Fitness Instructors Needed

Water fitness instructor class

Do you like being active? Do you enjoy the water? Do you like helping people? Are you interested in being a water fitness instructor?

There is a shortage of water fitness instructors in the Dallas-Fort Worth area. Check out the Job Postings on the website of the Metroplex Association of Aquatic Professionals at to see how many facilities are looking for instructors. So how do you go about becoming a water fitness instructor? I’m glad you asked! You can sign up for my class coming up in October.

Beginning Water Fitness Instructor Class

Saturday October 3 and Saturday October 10 – Participants attend both days

Time: 10:00 am to 2:30 pm

Cost: $60 for residents of McKinney, $65 for non-residents

Location: McKinney Senior Pool, 1400 S. College Street, McKinney, TX 75069

To register, go to or stop by the pool and register in person or call 972-547-7495 for assistance.

The class gives basic information necessary to teach a water fitness class.

Bones & muscles     Heart rate    pool water    Aquatic equipment

Some of the things you will learn are:

  • The names of the muscles and how they work during exercise
  • How to increase and decrease intensity so that you achieve your target heart rate
  • The properties of water and how to manipulate them during a water fitness class
  • How to use various kinds of equipment

The class is ideal for people who want some idea of what they have to learn before they sign up to take a certification test, for people who have lots of questions, and for people who do better with hands on experience than with just reading a book.  The next step is to sign up to get a certification. A good entry level certification is offered by the United States Water Fitness Association (USWFA). You do not have to take my Beginning Water Fitness Instructor course in order to get their certification. If you have some fitness experience and don’t feel like you need any additional training, you can contact the USWFA directly at The cost for a certification is $247. They will send you a water fitness instructor manual, an open book test, and some forms to fill out, which you will bring to a National Testing Day (NTD). At the NTD you take a closed book test and teach an 8-minute sample class. The instructor-trainer tells you at the end of the day whether you passed. After that, you can contact some of those facilities looking for instructors and get your own class.

See you in the pool!

How to Train for Good Posture

You can’t really be physically fit if you don’t have good posture. Therefore you have made a commitment to train for good posture in your water fitness class. Great! This may require you to rethink how you perform the exercises. You will need to be sure to keep your sternum lifted, your shoulders level, and your core braced so that you maintain your good posture no matter what exercise you are doing. Sometimes in your eagerness to increase intensity and burn calories you may inadvertently take your spine out of neutral alignment. Let’s take a look at some common exercises and see how this happens.  All of the photos show the exercises performed with bad form.

High knee jog

Knee High Jog.  This is a great exercise for increasing the heart rate and burning calories. But sometimes in your enthusiasm to increase intensity you may bring the knees too high, as in this picture, putting pressure on the low back and possibly aggravating the sciatic nerve. Bring the knees up just until the upper leg is parallel to the floor.


Leaning inner thigh lift

Inner Thigh Lift.  This exercise improves hip flexibility because you are moving the leg in a diagonal plane. You might decide to increase your range of motion by touching your ankle with your opposite hand. But if you have to bend forward to reach the ankle, as in this picture, you are taking your spine out of neutral. Better to touch the inner thigh or knee instead.


Leaning hopscotch

Hopscotch.  This exercise works the hamstrings. It is more important to maintain neutral alignment than to actually touch the heel with your opposite hand. If you have to bend to the side to reach the heel, as in this picture, then it is better to just swipe at the heel with your hand.


Too high kick

High Kick.  This is a long lever exercise so it takes more effort and burns more calories than its short lever cousin, the knee high jog. The goal here is not to get the foot out of the water though. If you find yourself leaning backward to get the leg higher, as in this picture, you are bringing the leg too high and taking the spine out of neutral.


Arching rocking horse

Rocking Horse.  This exercise works multiple leg muscles and also challenges balance because it takes the body off-axis. Watch out for an overly enthusiastic rocking motion though. Arching the back while shifting the weight to the back leg, as in this picture, puts a lot of stress on the low back.


Greater intensity levels can be achieved when the exercises are performed with good posture and the power is put into the arm and leg movements. You might be surprised at how hard you can work while keeping the sternum lifted, the shoulders level and the core braced.  See you in the pool!

Why Train for Good Posture?

Training for good posture may not sound as exciting as high intensity interval training or deep water running, but it is important for your future health and well being.  Look at the two photos below.  Which of these postures do you want to have as you get older?

The fact is that you may be training for the posture of the second man.  If you spend a lot of time seated in front of a computer or using a mobile device, or if you spend a lotman with walkerAdam Posture of time behind the steering wheel of your car, chances are that you are in a position known as passive forward flexion.  In this posture, you are stretching out the muscles of your upper back, your erector spinae and your gluteus maximus.  Once the muscles get stretched out, just like an elastic band that gets stretched out, it is hard to “tighten them up” again.  Combine weak muscles on the back side of the body with the effects of gravity as we age, and the end result is that you become bent over, unable to stand up straight, and prone to poor balance and falls.
using a computer

What to do?  One thing you can do is take frequent breaks away from your computer, mobile device, etc.  Standing up or walking around takes some of the stress off of those stretched out muscles.  The other thing you can do is train your body for good posture in your water fitness class.

  • Lift your sternum.  This one simple action brings the head into alignment with the spine and pulls the shoulders back.
  • Keep your spine in neutral.  This means that the cervical, thoracic and lumbar regions of the spine are aligned in their natural curves.
  • Brace your core before beginning any exercise.  Once you are in neutral spine, tighten the muscles of the back and abdomen to maintain that neutral alignment.
  • Strengthen the postural muscles – the middle trapezius, latissimus dorsi, erector spinae, gluteus maximus, and the abductors and adductors in the hips.
  • If you are in deep water, resist the temptation to lean forward at the waist to make the exercises easier to do or to travel faster through the water.  This position inhibits the proper muscles from doing the work, and it creates spinal compressgood form in deep waterion equal to running on pavement.  Instead concentrate on increasing your frontal resistance and dragging the water along with you.  You will move slower, but you will work harder and your posture will improve.