Why Aquatic Therapy Is a Great Choice for Treating Injuries

Why Aquatic Therapy Is a Great Choice for Treating Injuries

Steve and Dr. Cole talk with Danielle Debulgado from ATI Physical Therapy about the benefits of aquatic therapy.

Thanks to advancements in technologies and accessibility, a lesser-publicized therapy, known as aquatic therapy, is steadily becoming a highly endorsed secondary option for a range of injury cases. Given the countless mental and physical benefits provided through H2O, everyone from elite-level athletes, to stroke survivors are benefiting from this low-impact, high-return therapy.

At ATI, aquatic therapy is available at a handful of our locations, so we had the opportunity to catch up with one of our aquatic experts, Danielle Debulgado, from the ATI Aurora, Ill., clinic to learn more about the benefits of this increasingly favored therapy option.

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Swimming Tips to Score the Biggest Benefits from Your Pool Workout

Think beyond steady laps: our dynamic way of swimming will transform your body and wake up your workouts.

Up Your Pool Game

Many people assume swimming means just going back and forth—but that’s only if you don’t know all your options, says Sue Chen, swim coach at Nation’s Capital Swim Club in Bethesda, Maryland. A pool workout can be dynamic and involve challenging intervals and muscle-sculpting strength exercises (Example: this workout involves zero laps).

Plus, the environment offers a vibe in which you can decompress and refresh your winter workouts to keep you coming back for more, says Gerry Rodrigues, the founder of elite open-water training program Tower 26 in Pacific Palisades, California. Here, swimming tips for a better pool workout and all the reasons that will inspire you to finally take the plunge.

Work Your Whole Body

Water is resistance, and to move through it (and not sink), every major muscle group in your body— especially your core—has to pitch in, says CeCe Marizu, an instructor at Equinox in New York City who teaches in-pool classes that incorporate speed, power, and strength. To work more muscles from more angles, switch up your strokes during workouts, says Rachel Stratton-Mills, the head coach at Cleveland Swim Institute.

Freestyle (the classic front crawl) tends to be the easiest stroke to ace, and it results in a big calorie burn (30 minutes of vigorous freestyle burns 322 calories— only the butterfly gives you a better burn, at 354 calories). Backstroke (the flip side to freestyle with a windmill-like stroke) especially targets your core and hip flexors because it requires you to intensely tighten your torso and keep your hips in line with your upper body as you swim, Stratton-Mills says. For even more leg firming, do the breaststroke (where arms and legs sweep out in wide arcs), which requires bigger, more powerful kicks that, unlike other strokes, work muscles in your outer and inner thighs.

Watch Your Form

Even the smallest form adjustments can have a huge impact on how your body moves through the water, says Maya DiRado, a four-time Olympic medalist swimmer on the U.S. team. To stay streamlined and efficient—which will make you speedier—keep just three rules in mind, Rodrigues adds. First, continuously engage your big muscles (including your shoulders, back, abs, butt, and quads), and pull your ribs in almost as if you’re trying to close them together at the center.

Next, make sure your head, neck, and belly button are aligned on one horizontal plane with hips, knees, and feet. Finally, keep your hands fully extended, close your fingers, and straighten your wrists. Maintain this three-point form checklist no matter which stroke you do, and your body will remain one firm unit that moves with maximum fluidity, Rodrigues says.

Do Intervals

Think of swimming as you would any fun interval workout. For a 30-minute routine, Rodrigues suggests spending five to eight minutes warming up at an easy pace and then doing intervals for 20 minutes. Just as on dry land, you have many interval options. You could go by time, perhaps alternating ten 90-second sprints with 30 seconds of rest between each. Or work by distance; for example, you could sprint one length and recover on the way back.

Or increase your effort on each set (called laddering up): Take the first interval at an easy pace, the second at a moderate effort, and the third at a hard effort. Repeat that pattern three times, then on your final push, give it all you’ve got before doing cooldown laps. Whichever plan you pick, you’ll constantly think about what comes next, and your pool time will fly.

Think Beyond Laps

You can use the pool itself in different ways to sculpt your body. For example, pushing yourself up on the edge of the pool deck to get out of the water deeply strengthens your anterior shoulders and triceps (and will help you pump up your push-ups on solid ground). Do that 20 times—you don’t actually have to get out of the pool each time— between intervals or at the end of your workout for a bonus firm-up, Chen says.

For a twist on speedy intervals, swim to the deep end of the pool, cross your hands over your chest, and kick vertically, keeping your head above water (similar to treading water but without the help of your arms). Aim to do that for two or three sets of five minutes. You can also do power moves, including squat jumps and running, in the shallow end, since the water’s resistance provides an extra challenge, Marizu says.

Use It As Active Recovery

“Swimming allows you to train every day while letting your joints recover from the previous day’s workout,” Stratton-Mills says. Ground-pounding activities like running can’t do that. So what might normally be a rest day can now be an active one without beating your body up too much. (ICYMI, that’s what active recovery is all about.)

And there’s no such thing as a swim hangover—experiencing soreness is rare, and typically you’ll actually be able to perform better during your next workout because exercising in water loosens up your body, Rodrigues says.

Let Go

When you’re in the pool, you’re detached from the outside world. You can’t email, text, or even talk to others. There’s also a sound that relaxes you when you’re underwater even though you’re getting a killer workout, DiRado says. “It’s very soothing, almost like being swaddled,” she explains. And since more than
90 percent of your body weight is displaced when you swim, you’ll feel completely supported by the water. “You can think about whatever you want, or not think at all,” DiRado says. “It’s an amazing stress reliever.”

By Sara Angle for SHAPE

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From head to toe, swimmers must kick the injuries and pain to get to the top

By Julie Gardner for ATI Physical Therapy

From head to toe, swimmers must kick the injuries and pain to get to the top

While many probably consider swimming a relatively safe sport, injuries can still put these athletes in hot water.  Katie Varnado, ATC from the ATI Sports Medicine department knows about swimming injuries first hand from her work with these athletes.  Here’s what Katie has to say…

What injuries are common…

  • Swimmer’s Shoulder:  The shoulder is the joint most commonly injured, and may include rotator cuff impingement, biceps tendinitis and shoulder instability.  All can result from overuse, fatigue and weakness, especially when proper techniques are not used.
  • Swimmer’s Knee:  This injury occurs during the breaststroke because of the “whip kick,” which places all of the force of the kick on the outside of the knee. The inner ligament of the knee, called the medial collateral ligament, is put under stress.
  • Other Lower Body Injuries: Breaststrokers may experience pain from inflammation of the hip tendons. Lower back disk problems or spondylolisis, a stress fracture in the vertebrae of the spine, may be caused by the dolphin kick.


Katie recommends these tips to help prevent injury. In addition to stretching, there are specific things a diver can do to help ward off a repetitive injury:

  • Understand and focus on proper stroke techniques
  • Lessen repetitive strokes that are causing the  overuse injury
  • Perform core strengthening and cross-training exercises as part of pre and early season routines
  • Be sure to warm-up and cool down after activity and use periods of rest to recover
  • Focus efforts on rotator cuff and scapular strengthening for most shoulder injuries,  and pelvic and hip strengthening exercises for hip and knee injuries
  • Speak with a sports medicine professional or athletic trainer if you have questions  about injuries, exercises and  prevention

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Segment 101.1: Olympic Swimmer Dara Torres on Sports Medicine Weekly

Dara Torres talks with Steve and Dr. Cole about her experiences in Olympic competition, her current fitness routine and the challenges facing women in sports today.

Dara Torres, Olympic Swimmer


Olympic Icon Dara Torres who is considered one of the greatest female competitive swimmers of all-time. She entered her first international swimming competition at age 14 and competed in her first Olympic Games a few years later in 1984.

At the 2008 Summer Games in Beijing, Dara became the oldest swimmer ever to compete in the Olympic Games at age 41. She took home 3 Silver Medals, including the heartbreaking 50-meter freestyle race where she missed another Gold Medal by a mere 1/100th of a second. America has fallen in love with Dara for her astonishing accomplishments and her composure in the face of defeat.

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