Aquatic Therapy – Applications in Athletic Training
Clinical Review by Bruce E. Becker, MD, MS
There is a substantial volume of literature that supports the potential value of using aquatic exercise as a cross-training mode
While there are some significant differences in cardiovascular function, the overall cardiac demand appears to be at the least, equivalent [100-102] . For maintenance of cardiorespiratory conditioning in highly fit individuals, water running equals dry land running in its effect on maintenance of maximum VO2 when training intensities and frequencies are matched for training periods of up to 6 weeks, currently the longest published training studies [139-141].
Similarly, when aquatic exercise is compared with land-based equivalent exercise in effect on maximum VO2 gains in unfit individuals, aquatic exercise is seen to achieve equivalent results, and when water temperature is below thermoneutral (37°C), the gains achieved are usually accompanied by a lower heart rate [142].
Thus, water-based exercise programs may be used effectively to sustain or increase aerobic conditioning in athletes who need to keep weight off a joint, such as when in injury recovery or during an intensive training program in which joint or bone microtrauma is likely with exclusively land-based training. Although research has shown aquatic exercise to be at least the equivalent in aerobic training value to land-based training, a key question frequently raised is whether aquatic exercise programs have sufficient specificity to provide a reasonable training venue for athletes in this situation [100-102,143,144].
A study by Kilgore and co-workers specifically addressed the issue of running kinematics during deep water running as compared with treadmill running and found a very close comparison between the 2 when using a cross-country skiing pattern with respect to knee and ankle kinematics, whereas high-kick running styles did not match the treadmill kinematics [145].
A 2006 study assessed aquatic training in plyometric performance, finding comparable performance improvement to land plyometric training but with reduced post-training muscle soreness, and of course decreased joint loading [146].
It is unlikely that aquatic training can substantially improve dry land performance in coordination skills such as hurdles, high jump, or other complex coordination activities, where reflex timing becomes a major part of the performance success. But for many athletic activities, aquatic cross-training can sustain or even build aerobic fitness, with the side benefits of reduced joint loading, decreased muscle soreness and improved performance, and a significant potential for improved respiratory function. Programs typically used for vertical water exercise include buoyancy-assisted deep water running and cross-country skiing, aquatic treadmill running, waist-depth aqua-running, and upper extremity work using resistive devices in cool pool environments.
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- [100] Sheldahl LM, Tristani FE, Clifford PS, Hughes CV, Sobocinski KA, Morris RD. Effect of head-out water immersion on cardiorespiratory response to dynamic exercise. J Am Coll Cardiol 1987;10:1254-1258.
- [101] Sheldahl LM, Tristani FE, Clifford PS, Kalbfleisch JH, Smits G, Hughes CV. Effect of head-out water immersion on response to exercise training. J Appl Physiol 1986;60:1878-1881.
- [102] Svedenhag J, Seger J. Running on land and in water: Comparative exercise physiology. Med Sci Sports Exer 1992;24:1155-1160.
- [130] Frangolias DD, Rhodes EC. Metabolic responses and mechanisms during water immersion running and exercise. Sports Med (Auckland, N.Z.) 1996;22:38-53.
- [131] Reilly T, Dowzer CN, Cable NT. The physiology of deep-water running. J Sports Sci 2003;21:959-972.
- [132] Thein JM, Brody LT. Aquatic-based rehabilitation and training for the elite athlete. J Orthop Sports Phys Ther 1998;27:32-41.
- [133] Haff G, Becker B, Lindle-Chewning J, et al. Aquatic cross-training for athletes: part 1. National Strength and Conditioning Association Journal 2008;30:18-26.
- [134] Haff G, Becker B, Lindle-Chewning J, et al. Aquatic cross-training for athletes: part 2. National Strength and Conditioning Association Journal 2008;30:67-83.
- [135] Wilder RP, Brennan DK. Physiological responses to deep water running in athletes. Sports medicine (Auckland, N.Z.) 1993;16:374-380.
- [136] Bishop PA, Frazier S, Smith J, Jacobs D. Physiological responses to treadmill and water running. Phys Sports Med 1989;17:87.
- [137] DeMaere JM, Ruby BC. Effects of deep water and treadmill running on oxygen uptake and energy expenditure in seasonally trained cross country runners. J Sports Med Phys Fitness 1997;37:175-181.
- [138] Gehring MM, Keller BA, Brehm BA. Water running with and without a flotation vest in competitive and recreational runners. Med Sci Sports Exer 1997;29:1374-1378.
- [139] Gatti CJ, Young RJ, Glad HL. Effect of water-training in the maintenance of cardiorespiratory endurance of athletes. Br J Sports Med 1979;13:161-164.
- [140] Bushman BA, Flynn MG, Andres FF, Lambert CP, Taylor MS, Braun WA. Effect of 4 wk of deep water run training on running performance. Med Sci Sports Exer 1997;29:694-699.
- [141] Wilber RL, Moffatt RJ, Scott BE, Lee DT, Cucuzzo NA. Influence of water run training on the maintenance of aerobic performance. Med Sci Sports Exer 1996;28:1056-1062.
- [142] Avellini BA, Shapiro Y, Pandolf KB. Cardio-respiratory physical training in water and on land. Eur J Appl Physiol Occup Physiol 1983;50: 255-263.
- [143] Sheldahl LM, Wann LS, Clifford PS, Tristani FE, Wolf LG, Kalbfleisch JH. Effect of central hypervolemia on cardiac performance during exercise. J Appl Physiol 1984;57:1662-1667.
- [144] Silvers WM, Rutledge ER, Dolny DG. Peak cardiorespiratory responses during aquatic and land treadmill exercise. Med Sci Sports Exer 2007;39:969-975.
- [145] Killgore GL, Wilcox AR, Caster BL, Wood TM. A lower-extremities kinematic comparison of deep-water running styles and treadmill running. J Strength Cond Res 2006;20:919-927.
- [146] Robinson LE, Devor ST, Merrick MA, Buckworth J. The effects of land vs. aquatic plyometrics on power, torque, velocity, and muscle soreness in women. J Strength Cond Res 2004;18:84-91.