Hi Mel,

completely agreeing on all points and especially on the last phrase...Just a
small remark and auto-critic :as an academically trained PT (Belgium) we actually
'needed' 10 hours of sports-training and physical exercises as part of our
programm in our first 2 years so we would get a little feeling of what 'sports'
and PT could mean to each other...

Erik Goossens
Dipl. PT - Lic. Mot. Rev. & Kinesitherapie
Switzerland

[log in to unmask] schrieb:

> Recently someone sent me a letter asking me to critique a certain article
> which he referred to me.  Others might also be interested in reading my
> comments.
>
> ----------------------------------
>
> Dr Siff, here is an extract from an article that appeared in the April 2001
> 'Personal Fitness Professional', called 'The Healing Power of the Pool' (by
> Paul Chek).  I am not out to discredit anyone, but I am not familiar with the
> methods written and would just like to have the facts checked before I accept
> them.
>
> <.... As demonstrated in Figures 1 and 2, loading injured tissues increases
> pain, decreases circulation and fortifies the splinting response with
> increased spasm in surrounding tissues. Moving an injured joint in the water
> causes a therapeutic decompression effect, which can be enhanced by the
> addition of a weight distal to the injured joint structure and a flotation
> device above the injured joint structure. This will encourage further
> decompression or light traction, which is known to inhibit and relax the mus
> cles crossing the involved joint. The result is often decreased spasm and
> also improved functional muscle contraction. This too facilitates venous
> return, mechanoreceptor stimulation and reduced pain and aids in accelerating
> recovery (Figure 3).
>
> The pool provides an excellent opportunity to interrupt the pain-spasm cycle
> via facilitated venous return, sensory modulation and therapeutic
> decompression. Intelligent use of the pool for its hydrotherapeutic effects
> will speed recovery from injury and serve as a means of naturally increasing
> one's training volume and work tolerance. >
>
> ------------------------------------------
>
> *** Several issues need correction:
>
> 1.  Loading tissues does not necessarily increase pain, decrease circulation
> or create a stronger splinting response or spasm.  In fact, some modalities
> impose very intense, impulsive or sustained loading to break spasm or
> decrease pain.  For example, the imposition of controlled alternate loading
> and unloading or traction may achieve all that the author has attributed to
> water therapy.  Clinics even have special machines which apply this sort of
> patterned loading and unloading. If you don't have machines like that, then
> PNF offers plenty of information on how to achieve this effect manually (see
> Ch 7 of "Supertraining").   It is always important not to make any
> generalisations without stating their scope and limitations, as is standard
> practice in scientific and clinical circles.
>
> 2.  Moving an injured joint in the water definitely does not cause a
> therapeutic decompression effect.  Basic physics shows that immersion in
> water causes a COMPRESSION effect, its magnitude depending on the depth of
> immersion (H) and the density of water (s).  The exact equation is:
>
> Pressure at depth d     P(H)  =  P(o) +  s.g.H
>
> where P(o) is pressure at the surface of the water, i.e.  atmospheric
> pressure, and g is the acceleration due to gravity.
>
> In other words, the deeper that the limb is immersed, the greater the
> compression effect.  When one LEAVES the water, then the pressure is once
> again decreased to atmospheric pressure.
>
> 3.  Moving a limb at any depth in water also tends to COMPRESS the tissues in
> the direction of the motion, according to the laws of hydrodynamics, not
> decompress them.
>
> 4.  The attachment of a weight below an injured joint and a flotation device
> above the joint to provide traction theoretically is a step in the right
> direction, but Archimedes Laws show that immersion in water diminishes the
> effective weight pulling on the limb to such an extent that it would be far
> more effective and less trouble to apply normal traction methods on dry land.
>  In fact, one of the major advantages of water therapy (hydrotherapy) is the
> ability to move under diminished loading or gravitational conditions.
>
> 5.  Venous return is facilitated primarily by the contraction and relaxation
> of muscles whether this is done on land or water.   Nothing mystical or
> special about water in this regard!  Even alternate submaximal isometric
> contraction and relaxation offers effective venous return.  Physios even have
> local decompression/compression cylinders that they fit over limbs of
> subjects who are very immobile in order to enhance or simulate this natural
> pumping action.
>
> 6.  Mention of water playing a special role in "mechanoreceptor stimulation"
> is pretty much redundant in this context, since enhancement of
> mechanoreception is provided by INCREASED loading and stress on the body or
> its parts.  Maybe the author meant to say something else about the role
> played by neural activation or relaxation via mechanoreceptors (mechanical
> transducers or receivers) in water exercise, but what he wrote does not give
> any accurate or meaningful information on this subject.
>
> Note well that hydrotherapy can be a very effective and comfortable
> therapeutic and training modality - my comments above should not be construed
> to imply the opposite, because they have been provided solely to correct the
> pseudoscience that was obvious in parts of that article - nothing more,
> nothing less.  Anyone who has attended my Camps will immediately know how
> extensively I use hot and cold water in jacuzzis and pools for training
> (including water 'plyometrics' and lifting, restoration and rehabilitation,
> but I try my best not to base my use of this excellent modality on imprecise
> science or deficient practice.
>
> This lack of understanding of some ancient and very basic Grecian physics
> makes me realise that fitness professionals need more familiarisation not
> only with Newton's Laws, but also what Archimedes and others said way back
> when.  As many have already pointed out in recent posts, most certification
> programs are too impoverished or incomplete to offer an adequate working
> knowledge of applied sports and strength science.  Who was it who said that
> formal academic training is a waste of time, because the "academics know
> nothing about sport" ?
>
> Dr Mel C Siff
> Denver, USA
> http://groups.yahoo.com/group/Supertraining/