I had a T12 SCI patient once who thought he could never swim again. His family and friends and even some health professionals told him this. When he came to rehab at our facility, he realized quickly that it just took a little persistence. He and his wife learned together how to get in and out of the pool, exercises to do in the pool, how to roll from his front to his back, and just play. It just goes to show you that you can continue to pursue the activities you loved prior to your injury or try a brand new sport altogether.
Benefits of Pool-Based Spinal Cord Injury Therapy
Exercise is generally a powerful tool for improving all aspects of life, and it can be especially helpful for individuals recovering from a spinal cord injury (SCI). Aquatic physical therapy, with its added benefits of weightlessness, gentleness, and just generally enjoyment, is one of the best forms of exercise for getting you moving again. Specifically, your physical therapist may use pool-based workouts because:
• They’re a great way to get off your butt: aquatic physical therapy increases circulation to those areas that often don’t get as much as they need
• It’s good for your skin: the hydrostatic pressure reduces swelling and pushes out edema (swelling caused by excessive water retention)
• It’s a great form of aerobic exercise! gets your heart pumping and blood circulating throughout your system, an important part of both physical therapy and a daily health program for those with spinal cord injury
• Water provides resistance: and who among us doesn’t need improved muscle strength?
• Swimming improves balance: aquatic physical therapy can help you simulate correct movement mechanics in a weightless environment
• Aquatic physical therapy Improves confidence: your confidence and comfort will improve not only in and around water, but also in your daily activities as you gain strength and coordination
Getting Started: What Equipment Will You Need?
This is just a general guide. If you have more or less function, you’ll need to make adjustments based on your individual needs. The equipment is not required for everyone; what works best for you will depend on your level of functioning. (A list of equipment resources is located at the end of this article.)
For starters, I recommend water socks or shoes to protect your skin from bumps and abrasions. Next to consider:
• Neck collar—an inflatable collar to help those who do not have good neck control
• Noodles—an inexpensive way to help you stay afloat
• Floatation belts—provide better support than the noodles and are more secure
• Webbed gloves—help propel you through the water
Transfer Techniques: With and Without a Pool Lift
Being able to transfer safely into and out of a pool is important to having an enjoyable and effective aquatic therapy session. The following guidelines will help you perform a safe transfer in situations where a pool lift is present and those without.
Above all, safety comes first! Whether you are doing an independent transfer or need assistance, assess your surroundings for possible barriers prior to the transfer (slippery spots, arm rests, etc.). Once the barriers are removed, set yourself up so that you are as close as safely possible to what you are transferring to (pool lift, side of pool, or lounge chair).
Independent transfer. If there’s a pool lift, simply place your chair close to the lift so that it is just like transferring to another chair. If there is not a lift, you have a couple of choices.
First, see if there is a lounge chair nearby. Ask someone to move the chair close to poolside for you. You can then bump yourself down from your chair to the lounge chair, then lounge chair to the side of the pool. If you are worried about protecting your skin, simply place a towel over the transfer area.
If you are strong enough to do a floor-to-chair transfer, then you can try bumping down from your chair to the side of the pool then into the pool. When going straight from your chair to the ground, I recommend using a towel or mat (like a yoga mat) placed poolside to protect the skin.
Assisted transfer. If there’s a pool lift, place your chair close to the lift. Assess whether you will need one or two people to assist with the transfer. If there is no pool lift, you can transfer from chair to poolside then into the pool.
If your assistants need more help, try transferring from your chair to the lounge chair, then to poolside, then into the pool. This allows for more breaks in between lifts. Use a towel or mat to cover the transfer surface areas to protect your skin from abrasions.
What to Expect
It’s a good idea to have someone you are comfortable with to stay in the pool with you for the first few times. After you have successfully made it into the pool, you will feel like you are wobbly and all over the place. This is normal. The water pushes you off balance, so it is harder to stabilize.
With practice, this gets easier. Be patient, it might take some time to get comfortable in the water. Another thing to consider is pool temperature. People with an SCI prefer warmer temperatures, especially if they have trouble regulating their body temperature. A nice pool temperature is 90-96 degrees.
Try different things while you are in the water to see which you prefer. Whether it is swimming laps, swimming prone with a snorkel or swimming on your back, don’t limit yourself. Try it all out. Even if you just splash around with the kids for the first few times you’re in the water, you’ll find that the next time you get in, it will be a little easier. In time, the more comfortable you become in and around the water the more confidence you will acquire for participating in other water sports like water skiing, jet skiing, and kayaking.
Get Started!
1.Find a local pool. It could be a neighborhood pool, local YMCA, or rehabilitation clinic. I worked at an outpatient PT clinic that had a heated pool that offered memberships to non-patients. You never know, so just call.
2.Call ahead. Don’t just ask if it is accessible. That means different things to different people. Ask specific questions, “Do you have a pool lift in working order? Do you have private changing areas?”
3.Meet with the aquatics director. This makes the management and staff aware of your capabilities and limitations. This is also a time when you can ask specific questions, “Do you have noodles, neck collars, etc? Or do I need to bring my own? Are the lifeguards able to assist with a transfer? Will you show me how to operate the pool lift?”
4.Get in and enjoy!
