This week the water has caught my attention. Always a fan of a splash about on holiday and some lengths for fitness I often encourage my clients to dive in for a therapeutic swim too. But not everyone with a neurological condition is capable of that and a recent discussion with a young lady with MS made me question my recommendations. Her MS symptoms are worsening and she is finding it difficult to walk. In addition she’s decided she wants to turn her life around for the better: eat more healthily, quit smoking and do more exercise. I asked if she’d consider swimming. Her concern: that she’d only be able to swim one length. She saw this as not only an embarrassment, but a waste of time. Quite by chance, the same afternoon I stumbled upon an Multiple Sclerosis Association of America advert for their ‘Swim for MS Online Aquatics Centre’. This part of their website is dedicated to raising awareness of water-based exercise as a wellness opportunity for those with MS, and comes complete with tip sheets and video case studies to inspire people with MS to dive in and have a go at exercising in the water too. Although on first impressions the site was pasted with pictures of healthy, sprightly looking young things, watching the videos on offer was uplifting and refreshing.
People with neurological conditions often find it difficult to find a way of keeping fit that works with their lifestyle, levels of fatigue and their abilities. But all of the ladies featured in the ‘Why I Swim’ section had found their own way of making the most of the water. Kristen, a mum of two, must be pretty good as she trains regularly and swims for a masters swimming club. Mary from Pennsylvania, on the other hand likes simply being in the water – the first time she went to her water exercise class she says “I marveled at what my body would do, that it hadn’t done in years on dry land”. She tells us about how being in the supportive pool allows her to walk in a straight line, stand on one leg and even dance – all things she couldn’t dream of doing out of the water.
But do we actually know that swimming and water therapy are good for you if you have a neurological condition? Physiotherapists have long used the hydrotherapy pool as a pain relieving environment for treatment for a multitude of joint and muscle related problems. In the water you are able to strengthen and stretch, improve the amount a joint can move, and partially weight bear through say, a broken leg, because the water makes you so buoyant.
On a closer look, after stroke, for example, research shows that exercise in water can improve both strength and the ability to do day to day tasks. Studies show that in people with MS exercise in water can improve flexibility and strength but it also improves walking, fatigue and stamina when on land again. These are commonly the areas that people with a neuro condition want to improve on. This sounds great! So what’s the catch?
I think with water, people are often concerned that if they are not a strong swimmer, alongside a neurological condition it might be difficult to keep afloat. But the joy of the water is that swimming isn’t the only option. If you’re shoulder deep in water about the buoyancy removes about 90% of your body weight, taking stress off joints and meaning you can probably move more than out of the pool.
Marching on the spot, walking widths, kicking holding the side rail or swinging your arms underwater all count as exercise. The resistance of the water means you’ll be working your muscles hard, so any movement in the pool is great. And it doesn’t have to stop there.
Going back to the MSAA videos, Ginny from North Carolina found she couldn’t swim as ‘normal’ so just went ahead and invented her own strokes. And why not? She’s “62 years young”, was diagnosed with MS 26 years ago and walks with a four wheeled walking frame. She tells us that the pool brought her “joy, clarity…endorphins, freedom. It’s amazing”.
When she started swimming she could only do a few laps. Two years later she does 45 minutes of lengths four or five days a week, and has become a certified fitness trainer, helping other people get into exercise. She looks to be a great inspiration and is often told by her clients “I see you doing it and think to myself, ‘if she can do it, I have absolutely no excuse’”. She started small, and worked her way up the fitness ladder. It was great to see Ginny, with her significant mobility problems, enjoying the water as much as her younger, more able counterparts.
In a neurorehabilitation unit I used to work at we re-introduced hydrotherapy sessions, and people at both ends of the ability spectrum saw the benefits. The soothing effect of floating for someone with lots of spasms was visible. The excitement and relief of standing, supported by the water, for someone with a spinal injury was fantastic to be a part of.
One thing is for sure: anecdotal evidence shows us that people with neurological conditions love being in the water. You don’t even need to be able to swim to enjoy the benefits as part of your neurorehabilitation program. Mary, who goes to the water exercise class says “the water has helped me with my confidence, has helped me feel safer on land, more sure of myself”.
So when I see the young lady with MS again I will once again encourage her to give the pool a go. It seems especially for people with MS who may have difficulty regulating their temperature, the coolness of a pool makes it a perfect environment to exercise and continue rehab. She could do her one length, and then some exercises standing at the edge. She could start small and build up, as the start to her new healthy lifestyle.
Visit the Multiple Sclerosis Association of America to watch the inspirational videos and find resources on aquatic exercise: http://aquatics.mymsaa.org/
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