Hitting the Pool for Back Pain

BY JESSICA SUPER, DPT, CSCS

Aquatic exercise can ease the pressure that causes lower back pain.

If you live with low back pain, you know how much it can interrupt your daily life. Sleeping is difficult, chores feel like a burden and even a short walk can be daunting. Moving your body is one of the most reliable ways to reduce back pain over time, and one of the most beginner-friendly places to start moving is in the pool.

Performing guided exercise in warm water with a licensed physical therapist is referred to as aquatic therapy. Many programs take place in chest-deep water, so you don’t have to be a swimmer. Aquatic therapy is different from traditional water aerobics as it focuses more on core strength, stability and balance specific to your needs. How does it help?

Buoyancy reduces load on joints and discs. When you’re immersed in water, your body “weighs” less because buoyancy offsets gravity. In waist-deep water, you unload about half your body weight; in chest-deep water, about 75%. The lighter load makes it easier to move stiff or painful areas and practice better movement patterns without exacerbating symptoms.

Hydrostatic pressure supports circulation and provides stability. Water exerts a uniform pressure around your body that helps push fluid back toward the heart. This can reduce swelling, improve blood flow and offer a subtle stabilizing “hug” around the trunk. Many people find this makes balance exercises and core activation feel more secure than on land.

Water provides adjustable resistance. If you move slowly, the water resists a little. If you move faster, the water resists more. This makes it easy to adjust effort without weights or machines. Exercises often feel smoother and safer for irritated backs.

Warmth relaxes muscles. Physical therapy pools are usually warmer than lap pools, often in the low 90s F. Warm water helps muscles relax and can make stretching and mobility work more comfortable.

Studies report that when comparing supervised aquatic exercise with standard physical therapy treatments like heat and TENS, water-exercise groups demonstrate greater reductions in pain and disability, with many maintaining those improvements for up to 12 months. 

Aquatic exercises should feel comfortable to moderately challenging, but not painful. You should be able to talk in full sentences while working. A typical session lasts 45–60 minutes and focuses on multiple elements specific to individual needs. For example:

Warm-up/cardiac endurance: water walking in different directions.

Core and lower extremity strength: standing marches, mini-squats holding the pool rail, hip abduction/adduction and gentle “pull-downs” with a foam noodle to engage core muscles.

Mobility, range of motion, and stretching: hamstring and hip flexor stretches at the pool wall, gentle spinal rotations and ankle mobility work.

Balance: tandem or single-leg stances.

Who tends to benefit most? Those whose pain worsens with standing or walking and those recovering from a painful flare-up; people with stiffness, low fitness or balance worries; and those who have failed other conservative treatments. Many use the pool to calm pain and restore movement, then transition to land-based therapy.

Aquatic therapy isn’t a magic cure, but it is a gentle and often enjoyable way to get meaningful exercise with low back pain. Regular sessions build strength, flexibility and confidence. If low back pain has been keeping you on the sidelines, the pool might be the most comfortable place to start to improve your health.

Jessica Super is a doctor of physical therapy and owner of Dynamic Physical Therapy in Palm Desert. She is a member of Desert Doctors and can be reached at (760) 501.6655. For more information, visit www.desertdoctors.org.

References: 1) Wang X-Q., et al. “Efficacy of Therapeutic Aquatic Exercise vs, Physical Therapy Modalities for Patients With Chronic Low Back Pain: A Randomized Clinical Trial.” JAMA Network Open. 2022;5(1):e2142063; 2) Shi Z., et al. “Aquatic Exercises in the Treatment of Low Back Pain: A Systematic Review and Meta-Analysis of Eight Studies.” American Journal of Physical Medicine & Rehabilitation. 2018;97(2):116-122.

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Check out Melissa’s article on maintaining balance as we age in Desert Health News:  https://deserthealthnews.com/story/maintaining-balance-as-we-age/

Maintaining Balance as We Age

By Melissa Flores, DPT

Maintaining balance as we age is crucial for overall health, independence and quality of life. Some of the many benefits of working to maintain balance include fall prevention, aging at home and maintaining cognitive and neurological health.

Falls are the leading cause of injury in older adults, often resulting in fractures, head trauma and even long-term disability. Balance is key for performing daily tasks such as walking, climbing stairs, bending and getting into and out of chairs or beds; maintaining balance reduces the risk of tripping during these everyday activities. 

Research shows that older adults with better balance are more confident in their movements, reducing the fear of falling, which can be a common barrier to staying active. This allows individuals to continue participating in social activities, preventing isolation and supporting emotional health. 

Three body systems are involved in helping to maintain balance: vision, which most people primarily rely on, vestibular (inner ear) and proprioception (body awareness). All three of these systems can decline with age and a reduction in activity. Inactivity causes muscles, especially those in the legs, hips and core, to weaken, reducing your ability to control movement and react to instability. As we become less active, the brain also becomes less efficient at sending and receiving signals to and from the balance systems. This can result in difficulty making quick or flexible adjustments to maintain balance. 

Here are some simple tips to maintain or improve balance:

• Practice balance exercises such as standing on one foot, Tai Chi or yoga.
• Stay physically active by walking, swimming or dancing.
• Strengthen core and leg muscles through simple movements and exercises.
• Ensure proper vision and hearing.
• Remove home hazards such as loose rugs or poor lighting.

Melissa Flores is a doctor of physical therapy with Dynamic Physical Therapy in Palm Desert and can be reached at (760) 501.6655. Visit www.dynamicptpalmdesert.com for more. 

Sources: 1) Laughton, Carrie A., et al. “Aging, Muscle Activity, and Balance Control: Physiologic Changes Associated with Balance Impairment.” Gait & Posture, vol. 18, no. 2, Oct. 2003, pp. 101–108; 2) Piirainen, J. M., J. Avela, N. Sippola, and V. Linnamo. “Age Dependency of Neuromuscular Function and Dynamic Balance Control.” European Journal of Sport Science, vol. 10, no. 1, 2009, pp. 69–79; 3) Boyé, N. D., E. M. Van Lieshout, E. F. Van Beeck, K. A. Hartholt, T. J. Van der Cammen, and P. Patka. “The Impact of Falls in the Elderly.” Trauma, vol. 15, no. 1, 2012, pp. 29–35.

If you’ve noticed changes in your balance or stability, the team at Dynamic PT is here to help. Our therapists are highly trained in balance training to improve your overall safety, confidence, and daily function. Request an appointment here: https://www.dynamicptpalmdesert.com/schedule.html

Physical Therapy for Positional Vertigo

Have you been feeling dizzy with head movements? 

Does the room spin when you turn over or get in/out of bed? 

Does bending over or looking up make you dizzy? 

You may be experiencing something called Benign Paroxysmal Positional Vertigo, or BPPV. BPPV is a disorder of the vestibular system where crystals in the inner ear break free from their intended location, get into the semicircular canals, and cause an increase in sensitivity to head movement/position changes. 

BPPV often occurs spontaneously, but it can also occur following a fall, car accident, or other head trauma. This type of dizziness can be very debilitating. However, BPPV is very treatable and we provide that treatment at Dynamic Physical Therapy! Symptoms can typically be diminished in 1-2 visits. 

 If you are experiencing any of these symptoms and would like a Physical Therapist to evaluate and determine appropriate treatment for you, please call Dynamic Physical Therapy at (760) 501-6655 or request an appointment here:

https://www.dynamicptpalmdesert.com/schedule.html

New Treatments for Spinal Pain Did you know your stomach or liver could be creating low back, mid back, or neck pain? The internal organs are all attached to the rib cage and spinal bones via thin pieces of connective tissue called fascia or visceral ligaments. This is what helps to keep your internal organs in the right place while you go about your day. Injuries to the body from falls, accidents, or trauma can create a tightness or strain in this fascia and over time that tightness will pull on the spine and can create persistent pain. Things like infections, abdominal surgery, and cesarean sections can also create adhesions which have the same pull on the organs and spinal structures. Visceral manipulation is a very gentle manual therapy technique that can be applied in order to restore mobility in the visceral fascia, which can create less pull on the spine and reduce neck, mid back, and lower back pain. Read more here: https://www.dynamicptpalmdesert.com/visceral-manipulation.html Dynamic Physical Therapy is pleased to announce that Melissa Mercogliano, PT, DPT will be offering Visceral Manipulation services at the clinic this year. She has been a PT for 38 years, but has spent the last 10 years focusing on visceral manipulation training and is now a teacher assistant for several of the class levels. Request an appointment here: https://www.dynamicptpalmdesert.com/schedule.html

Dr. Melissa Mercogliano PT, DPT, OCS Visceral manipulation can be an integral part of treatment for the following conditions: Lower back pain Sciatica Neck pain Rib cage pain ​Shoulder pain Hip pain Frozen shoulder​ GERD Acid reflux Stomach pain Nausea Bloating Dizziness Gastroparesis Headaches Fatty liver disease Abdominal pain Constipation Pelvic pain Endometriosis pain Menstrual cramps

Call : 760-501-6655 Visit : 44651 Village Court Suite 120               Palm Desert, CA 92260 Email : physicaltherapy@dynamicptpalmdesert.com Website : www.dynamicptpalmdesert.com

Visceral Manipulation at Dynamic Physical Therapy

Visceral Manipulation at Dynamic Physical Therapy

We are pleased to offer Visceral Manipulation to patients starting November 4th. Our Physical Therapist Melissa Mercogliano PT, DPT, OCS is a teaching assistant for Visceral Manipulation courses and will be offering this treatment at our facility.

Visceral manipulation is a gentle hands-on osteopathic therapy that focuses on improving mobility of the organs in your abdomen.

She was recently featured in the latest issue of Desert Health Magazine! Find more information in the article here: https://deserthealthnews.com/story/visceral-manipulation/ In order to schedule a visit with Melissa, request an appointment here: https://www.dynamicptpalmdesert.com/schedule.html

Pre-Op and Post-Op Treatment for Total Knee Replacements at Dynamic PT

Chronic knee pain is a leading cause of musculoskeletal disability in the United States. This condition often leads to TKA (also known as total knee replacement), which is the most commonly performed orthopedic surgery in the lower extremity. Physical Therapists play a huge role in helping patients before and after surgery.

Prior to the surgery, PT’s help patients design a preoperative exercise program including strengthening, balance, and flexibility to improve outcomes post surgery. Post surgery, PT’s help patients walk with a normal gait pattern, regain full range of motion of the operative knee, improve balance and proprioception, and improve lower extremity strength to help patients return to their normal life activities without any limitations. Dynamic PT offers both pre and post op treatment for all joint replacements. Scheduling an evaluation with a PT allows for the PT to review your medical history, current limitations, and goals and make appropriate recommendations. Call

760-501-6655

to schedule an appointment or request an appointment here:

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Rotator Cuff Tears and Physical Therapy by Melissa Flores PT, DPT

The rotator cuff consists of 4 individual muscles which all work together to keep the head of the upper arm stabilized within the center of the joint during movements. Rotator cuff injuries are common and the risk of an injury increases with aging. Rotator cuff tears are typically diagnosed with Magnetic Resonance Imaging (MRI). Several studies have shown that depending on the severity of the tear and needs of the patient, physical therapy exercises can help to improve flexibility, strength, and stability of the shoulder. For many patients physical therapy can help patients learn to manage their symptoms and return to the activities they enjoy with minimal, manageable pain. Should a rotator cuff tear require surgery, physical therapy can help to regain range of motion, strength, and allow patients to return to the activities they enjoy. Call : 760-501-6655

or request an appointment here:

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