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Severe Ankle Injury Case Study from St. George’s Park

2014 October 24

2013 pool4The 2014 World Cup was disappointing for the England Senior Men’s Team for many reasons. For England fans, hopes of a medal began to fade quickly after falling to Italy and then Uruguay. The results were more upsetting for some than others, but it may have been most disappointing for physiotherapist, Gary Lewin. Lewin had his trip to the World Cup cut short after experiencing a fracture and ankle dislocation on the side of the pitch in the match against Italy. Lewin had his ankle immediately relocated on site, was taken to the hospital and then flown home to England for subsequent treatment.

Thanks to Lewin’s job, he knew exactly where to start his physiotherapy once he was cleared to do so. He went straight to St. George’s Park, which is the National Football Centre for all of England’s national teams. It was here that Lewin began working on regaining function of the injured ankle. One of the modalities he used was the centre’s HydroWorx 2000 Series pool for progressively reeducating and loading the ankle as well as maintaining fitness while he was not yet fully weight-bearing.

The pool offered him features that were essential to his treatment such as:

  1. Moveable floor to adjust water depth for progression of load
  2. Underwater treadmill for gait reeducation
  3. Resistance jets for progression of intensity

He saw significant progress during his use of the pool and was able to return to his international duties less than 12 weeks post-injury.

Download the written case study overview here>>

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Athlete with MS Made Strides with Aquatic Therapy

2014 October 23

Underwater TreadmillUnderwater Treadmill
MSBlogEbnerRick Ebner was a college football player and avid athlete. When the business owner and father of four was diagnosed with Multiple Sclerosis at the age of 32, he was devastated that the athletic lifestyle that defined him would now be gone. Thankfully, for 8 years he was able to continue to stay active, but eventually, after some undue stress, his condition began to decline and he went for many years without being able to run at all.

At the suggestion of a friend, he went to ACCUA in Savage, MN to start working in the HydroWorx 500 Series pool. At his first session, he was able to run for about 45 seconds. After a few months, he was up to running for 20 minutes at 4.0 mph.  By doing this aquatic therapy with Chris Kost, he was able to not only get back to doing something he loved, but also to stop using his cane for a majority of activities and reach goals he never thought would be possible again. At one point, Ebner had a goal of getting in 4,000 strides on the elliptical at the gym. He eventually saw that number decline to 3,200 and thought that his goal was forever out of reach. Thanks to his hard work and determination, he was finally able to get back up to 4,000 strides in the pool!

Some of the protocols that Kost used in order to improve Ebner’s mobility included:

  • Walking at 1.5 to 2.0 mph with a focus on lengthening strides
  • Side-stepping
  • Karaoke
  • Jogging
  • Backward walking
  • Treadmill “Ride and Jumps”
  • Balancing on one leg against resistance jets
  • Single leg jumps on treadmill

Ebner has gained strength, confidence, balance, and capability through exercising and rehabilitating on the treadmill in the pool.

Watch the Case History and Pool Protocol videos below:


Download a case study from St. George’s Park on improving left-side weakness in a multiple sclerosis patient>>

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Upcoming Webcast: Strategies to Perfect Upper Body Rehab Outcomes with Aquatic Therapy

2014 October 22

_DSC5570BarrywebinarOften, the use of hydrotherapy for shoulder rehab is overlooked. Many people think that there is not much that water can do better than land therapy for shoulders. But we are finding more and more clinicians that are using water for upper body rehabilitation with great results!

Join us for an exciting webcast, streaming live from the HydroWorx pool at Coastal Carolina University in Conway, SC. The webcast will take place on October 29, 2014 from 1:00pm – 2:00pm EDT.

Barry Lippman, MS, ATC, NASM-PES, Associate Athletic Trainer/Rehab Coordinator for Coastal Carolina University, will provide specific strategies for developing advanced shoulder rehab programs, emphasizing the use of aquatic therapy as a medium to implement them. The strategies are developed to safely, efficiently and effectively bridge the challenging gap between rehabilitation and performance.

Attendees will learn:

  • A systematic approach to upper body training in the pool
  • A progression and regression for late term upper body rehabilitation using water as a medium
  • How to use water to work around specific contraindications
  • Effective scapular stabilization techniques to prepare athletes for overhead throwing
  • How to gain and maintain upper body strength while minimizing residual soreness

This 1 hour webcast will be broadcast live from the HydroWorx pool at Coastal Carolina University in Conway, SC. Want to attend the webcast in person? Live attendees will have the opportunity to try the HydroWorx pool at Coastal Carolina. Make sure you bring your bathing suit and towel!

If you are interested in attending in person, please contact Michele Reber today by email at

Register for the webcast today!

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Pediatric Aquatic Therapy at SoPAC 2014

2014 October 22

HydroWorx 2000 Series poolWe are always inspired by children whose lives are impacted by water. We have seen and heard stories of so many kids that have made significant progress as a result of the use of aquatic therapy.  Even the founder of HydroWorx was inspired by his own story of healing in the pool at a young age.

That is why we proudly support the Section on Pediatrics at their Annual Conference (SoPAC). The Section on Pediatrics’ mission is to promote the highest quality of life for all children, people with developmental disabilities, and their families. SoPAC 2014 takes place in St. Louis, MO from October 23-25, 2014. If you will be there, stop by HydroWorx Booth #116 for your chance to win a t-shirt and gift card!

One example of a young girl who benefitted from the use of aquatic therapy is Amber. Amber was diagnosed with fibromyalgia at a young age and has found that she is able be more mobile in the pool. A chronic disease such as fibromyalgia does not have a cure and requires constant management to relieve symptoms. For Amber, activities she enjoys are difficult to do because she easily becomes stiff and sore.

At Children’s Hospital in St. Paul, MN, Amber began therapy in the pool, with physical therapist, Cindy Jarosch. At the beginning, Cindy focused simply on stretching and relaxation to get Amber used to the water and to gain a benchmark for future work.

Depending on Amber’s energy level and pain tolerance at each session, Cindy was able to modify the depth of the pool accordingly to adapt to her needs. With the adjustable depth, she could make the pool deeper to relieve more of her body weight and make movements easier, or she could make the water more shallow to progress activities toward dry land.

Amber was eventually able run in the water and increase speed, which is something she could not do on land.

Watch Amber’s story below:

To learn more about the ways that aquatic therapy can benefit pediatrics, click here>>

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ACL Protocol for First Hydrotherapy Session Post-Op

2014 October 17

ACLVideoThe experts at Michael Johnson Performance (MJP) rely on aquatic therapy for almost all of their clients who are undergoing rehabilitation. Director of Rehab, Lorenzo Vite, feels that practically any injury is a candidate for aquatic therapy during their rehab. At MJP, they not only use hydrotherapy for the rehabilitation it offers, but also as a bridge to moving to land-based activities. Lorenzo notes that athletes are less hesitant to do activities for the first time on land if they have already been doing them in the pool. The pool work gives them confidence to rely on their injured body part to do what it is supposed to do.

In this case study from MJP, Lorenzo introduces a 15-year old football player to the HydroWorx 500 Series pool for the first time. The football player is 5 weeks post-op on a recurrent ACL injury. This initial session gets the athlete acclimated to the features of the pool as Lorenzo focuses on his gait pattern to correct any errors. Using the underwater cameras, the athlete was able to immediately identify and make slight changes in his gait to ensure proper healing and muscle usage.

He began with some initial stretching of the knee in the warm water and then moved right into treadmill work. Lorenzo was sure to keep the pace at a walk, despite the athlete’s willingness to do more based on his lack of pain in the water. On the treadmill, with an intense focus on gait, the athlete walked forward, backward and did a side shuffle, maintaining consistent and accurate heel-toe strike. He also had the athlete work on lateral and front step-ups.

Based on the doctor’s progression timetable and the athlete’s comfortability, the physical therapist will appropriately increase resistance level using resistance jets, speed of the treadmill and types of activities in the water until the athlete is able to move to land based activities.

Watch the case history of the patient and his first session in the HydroWorx pool in the videos below:




To learn more about ACL rehabilitation using aquatic therapy, download our “ACL Recovery” tip sheet here>>


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