After breaking an ankle or wrenching a back, getting better can be a delicate balance.
You need to take it easy, avoid pain and allow an injury to heal, but at the same time, you have to bolster supporting muscles around the injury, keeping them from deteriorating, stiffening or losing mobility. A water-based exercise regimen can help. It provides a workout that is gentle on muscles but rigorous enough to restore function and movement.
Joint Base Myer-Henderson Hall's Rader Clinic has been offering a pool rehabilitation program at Zembiec Pool for the last year and a half. Sponsored by Rader's Physical Therapy Clinic, a handful of patients meet there twice a week with a physical therapist to treat and mend an assortment of injuries. From 7 to 8 a.m. Tuesdays and Thursdays, patients swim laps, don flotation devices that simulate jogging in water, perform scissor kicks at the side of the pool, lift aqua weights or indulge in a friendly game of water polo in the 20 x 25 yard pool.
"It allows people who can't tolerate their body weight to get a good workout," said Physical Therapy Clinic noncommissioned officer in charge, Staff Sgt. Nelson Nunez, who is also a physical therapy technician. He said the program assists all types of musculoskeletal injuries allowing patients to perform strengthening exercises that otherwise would be impossible or too uncomfortable to perform.
"A lot of patients get very motivated because they're able to do things they didn't think they could do … because they haven't been in a gym in so long," Nunez said. "It also provides mental rehabilitation." "It changes the whole aspect of weight-bearing," explained Sgt. Nacoln Phaipanya, another physical therapy technician. "Patients complaining of pain discover the buoyancy of the water. It helps patients relax more, improves their flexibility and relieves swelling."
Capt. Barbara Bujak, chief of the Physical Therapy Clinic, said the program used to be held once a week and that it shut down over the winter before Zembiec acquired a removable roof that keeps heat in. The clinic expanded the program to two days because the frequency of treatment was deemed more effective. "It allows patients to stay active and keep their endurance up," said Bujak. "We try to keep it to five or six people. It's open to anyone who is our patient and on active duty." Candidates for the program are evaluated and selected by clinic physical therapists.
Capt. Ernesto Amador, of The Old Guard's Hotel Company, damaged the anterior cruciate ligament in his knee by jumping out of an airplane during training at Fort Bragg. He said he didn't swim much before, but found the therapy was helping him get the motion in his knee back.
"It feels better. There's more stability," Amador said. He praised the Physical Therapy Clinic staff for the positive reinforcement they provide in getting him back into shape.
Maj. Kerry Cuneo of Army CID at Quantico slipped on ice and injured her knee during the Army 10-Miler in 2010. She said what helps her most in the pool are "exercises that intensify a lot of kicking. "I started out with pain, but it eased by the end of the session," she said, five weeks into the class. "I think the program is fantastic."
The Old Guard's Spc. Sheri Croteau fractured a knee and experienced "a possible shoulder impingement" while running through Rosslyn as part of regular physical training.
"I don't get pain when I exercise now," she said three weeks into the class. "Working out in the water is better for the knee. I like the whole program. I've always been a swimmer."
Aquatics Program Manager Matthew Jongema said the water in Zembiec Pool is treated with salt to reduce the amount of chemicals in the water. "It's good for the skin and makes the water more buoyant," he said. Jongema added that some of the activities patients do in the pool are used for healthy warriors in the Marine Corps Semper Fit program, which can be supplemented with additional equipment on hand at the pool, like submergible stationary bikes, platforms for stair-stepping and water barbells.
"The water takes away gravity and puts you in another realm," Phaipanya said. "Muscles can shorten because of atrophy," he explained, emphasizing the need to keep active while recovering from an injury. "Most [patients] will not be able to jump or run outside of the pool. We start with stretching. Water provides a lot of resistance. It gives you a whole cardio workout."
Phaipanya said participating in the program fulfills the physical training requirement for most military personnel. He said many of the problems physical therapy staff sees at the clinic, like ACL, are similar to the injuries one sees in professional sports.
"That shouldn't be surprising," he said. "As Soldiers we are semi-pro athletes."