Wheelchair to water: Breaking free from mobility limitations
Ailene Tisser & Cindy Freedman, swimangelfish.com
August 31, 2020
Have you ever considered the path to happiness and independence with swimming for someone with physical challenges? As a physical therapist and adaptive swim lesson provider, helping others achieve independence has always been what I strived for with my clients. I never realized that I could be doing this by using the modality of the water. My career splashed into the pool and, once I experienced the benefits of the water, I was hooked! The results that I have seen in my therapy and swim lesson clients have been life changing.
Imagine moving in an environment where gravity is virtually eliminated. There are many magical properties of the water that allow physically impaired swimmers to literally BREAK FREE. Come with me as we dive deeper into four of those areas related to the properties of the water that make this possible. This article will help you understand the science behind the “magic” of the water in adaptive swim lessons:
Many swimmers with neurological or muscular conditions, such as Cerebral Palsy, Traumatic Brain Injury, Genetic Disorders, or a Stroke, experience abnormal muscle tone, either tight or loose, and have difficulty moving. Some are dependent on others to help them move a lot or a little. Imagine what it would feel like to work so hard to walk. When your body is in a gravity environment, the muscle tone has to respond to hold you up so you can interact with the world. Whether you are sitting in a wheelchair or walking with a walker or crutches, your body is continuously fighting the pull of gravity. Breaking free in the water is possible because the effects of gravity are lessened. Now you are free to move without any resistance. Buoyancy now supports you and active movement is so much easier. When you are neck-deep in the water, you are 90% supported so you only have 10% of your body weight to control. New movement options can be explored, and a tight body can unlock from its holding pattern. As tone begins to relax, movement in larger ranges is allowed. When you lift your leg, the buoyancy provides an upward thrust toward the surface, assisting in activities such as kicking, stepping, or walking.
For the swim skill benchmark of flutter kicking, we love the FINIS Booster Fins. They are shorter, the lever arm isn’t as long as regular flippers, and they give just the right amount of feedback and assistance to the legs of a swimmer who is a little weaker and is trying to get more motion as they kick. Sometimes we want to counteract buoyancy and help our swimmers stay vertical. We use the ½ pound Sprint Aquatics Wrist Weights on the ankles to help ground the body and keep the swimmer in a vertical position to allow them to experience independent walking, as the water supports their body.
Buoyancy assists with the swim skill of a prone and supine float. These skills are foundational to progress towards more independent swimming. The upward thrust on the body that buoyancy provides also helps with movements that are important out of the water, like moving from sitting to standing. Altering the amount of support you are getting from buoyancy can make this activity much easier. For more information on creative ways to use our favorite equipment to assist your swimmers check out our equipment webinar.
Moving in water is like moving in Jell-O or mud. This thickness is called viscosity, and you feel it with each movement you make in the water. Viscosity gives your skin considerable input and provides feedback to your central nervous system regarding where you are in space. It also slows movement down. Imagine what it is like falling on land. It is quick, with little time to react. Now, imagine this same motion in the water. It is slowed down enough to allow a person with a neurological impairment time to process what is happening and react to prevent the fall. Most individuals with physical and neurological issues are afraid of falling. Wouldn’t it be wonderful for them to practice controlling this motion in the pool where they are supported, and the movement is slowed down, so don’t have to be afraid of getting hurt? It is liberating for them to begin to reduce the anxiety and fear of falling by teaching them how to successfully control their bodies in the dynamic environment of water.
Changing directions in the water is a vital swim skill benchmark. Viscosity helps with this by providing the input needed to know where you are in space and move from one position to another. The body control that they gain in the water carries over to transitions between different surfaces or out of various positions when they are outside of the pool.
This is the pressure that the water exerts all over your body as it surrounds you. The deeper you go in the water, the more the pressure increases. This pressure creates a calming effect on the body, as if you are getting a big hug. It washes away adrenaline and releases the neurochemical dopamine, calming the body. This explains why so many of us love being neck-deep in water and why it feels so good. Can you imagine how hard it is to move a body that is stiff and tight, or weak and floppy? Can you imagine the frustration and anxiety that builds up as you are exerting so much effort just to maintain an upright posture and interact with your environment? It’s exhausting! Most of us move automatically without thinking about every movement. Individuals with motor difficulties have to think about every movement they make and exert so much energy. I notice some of my swimmers give a huge sigh of relief once they enter the pool and experience the pressure of the water as if to say “I can finally let go.”
The bobbing swimming skill allows swimmers to experience the feeling of being underwater where the pressure is increased and surfacing to take a big breath without the pressure. This feels so good to their bodies and even stimulates the ability for them to take deeper breaths, which in and of itself is very calming and regulating.
This is used by creating assistance from the water in a specific direction so that water is pushing against your body, helping you to achieve balance, without having to be touched. The ability to perform an independent motor activity without being touched is something individuals with motor disorders may never get to experience unless they are in the water. This movement helps generate new pathways in the brain for balance reactions. These individuals need opportunities to figure out how to move on their own since they are so used to being moved by others. Turbulence allows you to help them without touching them so that they can motor plan the action all by themselves. They cannot experience this anywhere else but in the water.
The swimming skill of a rollover, from your belly to back, is an important skill to work on using this property. You can have turbulence assist the rollover so your swimmer can perform it with greater ease and independence. This carries over to rolling when they are out of the pool, which is not only an essential skill for mobility but provides excellent sensory input.
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