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Learn How To Do SAFE Core Exercises In The Pool

Pools are definitely on our minds in the heat of the summer. Who wants to go on a run when it's 100 degrees outside? But a nice dip in the pool can be refreshing AND get you the exercise you need. There are tons of benefits from being in the pool, but there's one big one that largely helps my patient population. Pool exercises can be so beneficial for people with both acute and chronic pain. Because of that, we are working on a new water therapy program called Aqua OrthopedX™.

Aqua OrthopedX™ (AOX) is a progression-based aqua fitness and training program taken from the Neuromechanical Therapy™ (NMT) paradigm. This philosophy, which was created by Dr. Justin Lin, is based on the belief that treatment stems from the inside out, first improving the nerves/nervous system, then working outwards towards the bones and muscles. NMT, according to Lin, is an integrative and holistic approach to water therapy and looks beyond one’s symptoms to treat the root causes of pain. This training, which is done in water, assists with de-weighting the body to facilitate awareness and encourage ease of movement, perfect for those hoping to enhance function and increase mobility, strength with stability.

With progressions in mind, AOX is set apart from your YMCA or 24-hour fitness pool program. We want intentional movement to be our driving force.

Why water rehab?

As the weather warms up. Working inside and laying outside the pool is a fantastic way to rehab smarter and not harder. When you are working or walking in the water you are deweighted 50% when the water is around your waist and 80% when the water is at your chest height.

This allows us to work with functional movements and add resistance via the water without the compression pains that can affect our bodies.

Gravity is a driving force to us all and when outside of the buoyant water. During my doctoral research on cadavers, I discovered that we incur up to 3x our body’s weight at our hips, 7x to our knees and 27x at our ankle. This load can pay an extreme toll.

Any way to decrease this means we can get our cardiovascular system pumping without too much pain. You won’t totally be devoid of pain in severe cases. For chronic pain and arthritic folks though, this is a great bridge to move before working on land in the rehabilitation process.

The core is always a good place to start:

As many know, our core helps coordinate our upper and lower bodies for more efficient movement. It also supports important structures like our lower back and spine. I'm outlining my favorite core exercise progression below. Start with the easy variation and work your way up to the harder. It's also always a good idea to consult a physical therapist before trying any new exercises to make sure they're right for you.


So I start this exercise by holding pool noodles in front of your chest and doing a curl up and hold. We can hold up 90 seconds at first to engage our cores and then you can do a repetitive form by drawing your knees to your chest to about belly button height.


This one is exactly the same as the one below but the noodles are now positioned behind your upper back. This means that this


You can either have the noodles in the front or the back and now at a slight rotation or twist. The twist should ideally come from the stomach versus thrusting your shoulders across your body. The goal is to bring both knees across the body to the opposite shoulder.

Doing this for time 3-5 minutes each is sufficient for a workout. It's a great but safe way to get the core burning without the damaging after-effects of other certain core exercises we do on land.

Happy swimming!

Dr. Justin C. Lin


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