Elixir of life, indicator of sustainability, perfect panacea – the definitions are endless. Over the ages, water has created civilisations, love, entertainment, political turmoil, magic, war and death. Life’s matter, matrix, mother and medium – water is undeniably the most precious resource on earth. As popular as its purifying property, water is known for its therapeutic effects, too.
Hydrotherapy or aquatic therapy, which are activities and exercises that happen in an aquatic environment, dates back to Ancient Greece, China, Roman and Egyptian civilisations. Even Hippocrates had prescribed ‘hydropathy’ to the sick. As the world marched towards progressiveness, aquatic therapy gained popularity and slowly, it evolved into various forms of fitness and rehabilitation – Ai Chi, aqua cycling, aqua jogging, aqua aerobics, aqua zumba, Bad Ragaz Ring, Burdenko, Halliwick, High-intensity interval training (HIIT), Woga, Watsu… More and more practices cropped up all over the world, with each one following different methods to ensure physical, mental and emotional well-being of a person. While aqua therapy is popular elsewhere in the world, in India, the reception is slow, but growing..
High Intensity Interval Training
“Aqua therapy is a rapidly growing branch of healthcare sector. Earlier, it was a domain of physiotherapists, but now, the benefits of water are being explored by other healthcare practitioners, too,” observes C.G. Prashanth, who has been an aquatic therapy consultant since 2005.
In his 20 years of clinical work, Prashanth has found aquatic therapy to be a very effective tool in rehabilitation of patients. “It has tremendous potential of application in acute recovery conditions to chronic conditions. The therapist needs good training and reasoning skills while applying the concept to patients,” says Prashanth, who is a physiotherapy specialist at Qatar Rehabilitation Institute of Hamad Medical Corporation, Doha.
Each water-specific therapy approach is based on clinical rationalisation and scientific basis. However, all the concepts use the properties and hydrodynamics of water as a foundation. “It uses metacentric effect by inter-playing the rotational torque created when forces of gravity and buoyancy are not in alignment. Aqua therapy establishes rotational control in transverse axis, sagittal axis and longitudinal axis. By giving a fixed point and challenging each rotation, there is muscle activation that helps in developing strength and recovery, giving a creative scope for therapists to produce muscle action using buoyancy and gravity,” Prashanth adds.
In India, aqua therapy faces several obstacles, ranging from socio-cultural to infrastructure issues to lack of awareness by health care community and patients. However, Prashanth has been doing his bit by bringing together aquatic therapy practitioners under Aquatic Therapy Network of India, a charitable trust registered in Dharwad in Karnataka to foresee and support the growing stream of fitness and healthcare. “Having witnessed many success stories of patients and listened to the patients’ feedback on aquatic therapy, I am sure it will be a strong domain of future rehabilitation care in India. It has already made its mark and is growing rapidly to gain its due recognition,” he says.
High-intensity Interval Training, an advanced, yet highly effective form of cardiovascular training, involves brief bursts of very high-intensity work followed by a recovery period. This has emerged as an alternative to traditional workouts, especially for people for whom land-based exercises are unsuitable. Comprising a warm-up period of exercise, followed by three to 10 repetitions of high-intensity exercise, separated by medium intensity exercise for recovery, and ending with a period of cool down exercise, HIIT is one of the most sought-after fitness regimes.
“It’s a very challenging activity which can be done by anyone, even with injuries. It’s a niche form which can be practised by obese, pre-natal, post-natal, hernia-affected, and arthritis-struck persons,” says Pooja Arora, a Bengaluru-based aqua coach and an HIIT expert.
Tracing her journey from a young mother in her 30s to a health coach, Pooja says, “I had an obese childhood and I was diagnosed with early symptoms of arthritis nine years ago. I was in so much pain that I couldn’t cycle or run. Doctor suggested water-based workouts. Back then, no one knew of aqua therapy and I started learning whatever I could, going places.”
Watsu training at Auroville
Her coaching classes are based on a special programme devised by her. “Water has better benefits because of gravitational differences. A 70 kg person weighs just 7 kg in water. A person with knee injury can jump in the pool because weight is taken off from the joints. Physical workout, memory exercises, muscular and neuro rehabilitation are all possible,” adds Pooja, who has devised different modules for each day – competitive exercises, military training, complete core workout, ab workouts, heated pool exercises, etc.
Apart from coaching, she runs a YouTube channel to create awareness and pass the knowledge. She says, “My motto and what I preach is the same – make the pool your gym.”
Unlike Halliwick and Bad Ragaz Ring, which are specific active modalities for the differently-abled and for physical rehabilitation post surgery or accident, watsu is a passive therapy during which the client is held, moved and treated in relaxation mode with eyes closed by a practitioner. Watsu and related modalities are primarily focused on wellness. “Wellness is a broad term; Watsu modalities like Oceanic Bodywork Aqua, Water dance, Healing Dance and Liquid Flow are more designed for reinvigorating the internal energy flow, stimulating the inner sense of well-being, and improving overall health on all levels of the being,” explains Guy Ryckaert, a Watsu practitioner in Quiet Healing Center, Auroville, Tamil Nadu, where his team runs a Watsu pool for therapy and offers a training programme in Watsu and other aquatic bodywork modalities.
Developed in the 1980s in the US, Watsu spread quite quickly in the States and in Europe, but Ryckaert terms it ‘a relatively young therapy’. It was introduced in India in the late 1990s by Watsu India, an organisation affiliated with the Worldwide Aquatic Bodywork Association (WABA), at the Quiet Healing Center. Over the past decade, there has been a growing interest for both therapy sessions and training.
Watsu training, which includes multiple practice sessions over a period of two to three years and requires a heated warm water pool, can be done by only WABA-certified teachers. “In India, professional staff and adequate infrastructure are not easily available for training. Nevertheless, efforts are being made to organise some basic Watsu training or specific spa provider programmes in other locations within India,” Ryckaert says.
The best part of aqua exercises is that one doesn’t need to know swimming,” says Mumbai-based fitness consultant Shivani Patel, who specialises in aqua zumba, aqua aerobics, aqua pilates and aqua yoga for the past seven years.
“The benefits of water workouts are plenty– it goes easy on your joints, helps build muscle mass, burn calories and release anxiety and stress,” she observes.
“Water being buoyant, it works against gravity and offers support to your body, making your joints experience lesser stress. On land, running is one of the most high-impact exercises with your legs and spine experiencing a shock wave, which is almost five times your body weight. Water can reduce this impact by almost 85 per cent. Resistance from all sides helps you develop lean muscle mass and tone muscles,” explains Shivani.
For a more intense workout, water equipment for weight lifting are incorporated. Specialised equipment like water dumbbells, kettle balls and water noodles assist people with weight training in water. Adds Shivani, “Water dumbbells are actually mostly made out of styrofoam and are extremely light when dry. But when they absorb water, they can get really heavy. For the best results, you should have a good mix of aqua fitness classes, strength training and flexibility exercises on your fitness schedule. To burn calories, include bicep curls, chest presses and floating crunches. If combined with water aerobics, you can easily burn more than 500 calories per hour.”
A study done in 2007 in Poland showed that aquatic exercises helped lessen anxiety and stress in women. Another study published in Journal of Perinatal Education also showed similar effects on pregnant women.
“Apart from these, aquatic exercises can help lower blood pressure, build endurance and have a positive impact on cardiovascular health. It is advisable for pregnant women, persons suffering from arthritis, spinal cord injury, high blood pressure, stroke or brain injury, orthopaedic injuries and also for senior citizens,” she says.