Image

Late-night television is inundated with products designed to bring buff abdominals to the flabby masses. A potpourri of silly contraptions, including I kid you not what looks like a miniaturized La-Z-Boy recliner, are sold for three easy payments of $29.95 each to the eternally hopeful.

Therapists concur with late- night hosts on one point, at least: The ability to stabilize the pelvis and spine is trainable. It?s just hard.

And for patients with back pain, land-based spinal stabilization can be too uncomfortable. On land, gravity rules: compressing spinal disks, loading joints and reinforcing muscular tension. In the water, buoyancy combats gravity and the spine wins.

Spinal stabilization is a natural fit in water. It is possible to make a task easier (assisted by buoyancy) and more challenging (resisted by buoyancy or drag) in the water. It?s much easier for patients to achieve pain-free training in the pool than on a mat.

Additionally, to provide efficient spinal stabilization training in the water, you do not need a specialized therapy pool. Almost any water temperature and depth will do in a pinch.

Unlike cardiac conditioning, which often requires cooler waters for heat dispersion, or Watsu, which is best performed in water warmer than 93 degrees Fahrenheit, core muscle strengthening can occur in nearly any temperature.

Most therapy pool water is kept between 90 and 94 degrees Fahrenheit, which works just fine for spinal stabilization exercises. However, community pools with water temperatures near 85 degrees are perfectly appropriate for many core training techniques. Keep in mind that the true lap swimming pool with a temperature around 78 degrees to 82 degrees can leave a patient spending his or her time shivering and no longer interested in the intricacies of controlling pelvis or spine.

Pools with sloping bottoms work best for therapists who want to provide a varied spinal stabilization program. Depths between 2 feet to 2 1/2 feet are necessary for quadruped or kneeling tasks, while 3 1/2 feet to 4 1/2 feet is ideal for standing core workouts. Deep water (5 1/2 feet or more) is not strictly necessary for a stellar spinal stabilization program, but most therapists covet a deep-water running lane for their lower back-pain patients.

Truly, spinal stabilization training can be performed in practically any position or depth in the pool. No single exercise defines this kind of training. However, some of the more popular training methods include:

1 Walking against a current while maintaining a neutral spine. (The natural position of the spine when all three of its curves cervical (neck), thoracic (middle) and lumbar (lower) are present and in good alignment).

2 Walking in chest-deep water with a kickboard held stiffly in front of the thorax.

3 ?Charging the hill? (striding from chest-deep water to thigh-deep water and back again) while maintaining a neutral spine.

4 Deep-water running, jogging, bicycling, cross-country skiing or other deep-water maneuvers while maintaining a neutral spine.

5 Single leg stance, quadruped, kneeling, single-knee kneeling or plantar-grade tasks while maintaining a neutral spine.

6 Loaded pelvic tilts (anterior-posterior and lateral) and circles using the pool wall as contact.

7 Unloaded pelvic tilts (anterior-posterior and lateral) and circles using a noodle as flotation device.

8 Unloaded abdominal pikes and spine extensions using a noodle as flotation device.

9 Pressing kickboard, flotation bell or other buoyant device down toward the pool bottom while bracing abdominals.

10 Rapid pace movements of the arms or legs (using resistance devices) while bracing abdominals.

At a minimum, your facility will need to stock water noodles, flotation belts and resistive equipment such as buoyant barbells, boots and kickboards.

Pools with swim currents or strong single-direction jets can make use of currents to address core muscle strengthening.

Few commercial seminars address only spinal stabilization training, but there are many aquatic therapy seminars that include core strengthening and stabilization techniques.

Fortunately, there are dozens of training DVDs that explore abdominal and spinal stabilization in the pool. Many of these exercises can be extrapolated for use in your pool by a competent therapist.