Many athletes are required to participate in extensive forms of athletic conditioning on non-resilient surfaces.  Such surfaces include running around town on concrete, doing laps around a hard-surfaced track, and bouncing up and down on a hard floor at a local club. 

    This form of training, however, can lead to a variety of "over-use syndromes" associated with soft-tissue or bony injuries.  Stress fractures, Achilles tendinitis and, the classic, shin splints are among the complications that can result from excessive training on hard surfaces. 

    One way around this problem is the use of aquatic training exercises. The use of aquatic cross training exercises enables the athlete to train at various levels of intensity while minimizing the effects of body weight and gravity. It is not only helpful for treating over-use syndromes, but is also effective for athletes who want to maintain a level of fitness during rehabilitation of an injury.

    To a runner, for example, an injury such as shin splints can be terribly frustrating due to the restrictive nature of the injury. The idea of "rest is best" keeps the athlete away from the repetitive pounding that increases the problem.  However, runners, like most athletes, have a hard time accepting the concept of rest.  This is where aquatic therapy plays a significant role.

    Through alternative training methods in the aquatic environment, today's athlete can remain at a conditioned state while allowing the injury to heal.

 To decrease the overall impact on the body, an increased water depth may beutilized to reduce the athlete's weight-bearing factor.  For example, standing in neck-deep water reduces body weight up to 90 percent.  Standing in chest-deep water cuts body weight down to 75 percent and then to 50 percent when the body is waist-deep. In addition, buoyancy assistive devices can be incorporated to further reduce the forces on joints. These devices are often wrapped around the ankles and/or wrists.

    Here's a typical rehabilitation/ conditioning sequence that helps athletes with shin splints:

    I. Beginning Phase for shallow water: forward walking, calf/hamstring stretching (as tolerated). Range Of Motion at the hip, active ROM at the ankle, step-ups (low step). 

    I. Beginning Phase for deep water: cross-country ski, half jacks (shoulder width range hip ab/adduction).

    II. Intermediate phase for shallow water: walking forwards/backwards, side to side walking (short-stride length), step-ups (low or high as tolerated, calf raises (double/single leg) or off low step for increased ROM, split jumps (with varying stride length or double leg jump squats (both as tolerated)), hip ROM, active dorsi/plantar flexion or calf pumps with fins.

    II. Intermediate Phase for deep water: cross-country ski with increased active dorsi/plantar flexion, jogging progressing to running (progress to buoyancy resistive devices), half jacks, scissors, begin circuit training (alternating arms and legs, combining deep water running with upper extremity paddle movements).

    Even more advanced deep and shallow water exercises are available. Aquatic therapy and aquatic training can have positive benefits for all athletes, whether you are injured or not.

Article by Shawn Hickling BSc, PTA (Article feautured in Student Sports Magazine)