Publication Date: Friday, September 13, 2002
(September 13, 2002)
By Diana Reynolds Roome
"This is where I belong now," says Helen Gonfiotti, bobbing cheerfully in the pool. "I only wish I'd known about it much earlier."
A few weeks ago, Mountain View resident Gonfiotti started warm water therapy at the Betty Wright Swim Center, hoping to regain mobility and relief from the pain of severe osteoarthritis. She had seen leaflets about it in her doctor's office, and he was all for her trying aquatherapy, a healing method that is mostly available in hospitals.
However, hospital pools are not available to the public, and public pools are too cool for many people who need a healing environment. The Betty Wright Swim Center offers local access to a gentle environment of ninety-degree temperatures under the guidance of trained and supportive rehabilitation specialists. It is also adapted for special requirements such as wheelchair access.
"Here I'm feeling the best results of all," says Gonfiotti, who had found pain relief from acupuncture and chiropractic care, but not much increased mobility. Now she is immersed up to her neck in the Water Wellness class, which is helping her regain mobility and relieve some of her chronic pain. "I am moving body parts I haven't moved for almost a year. My pain is different from what it was before -- it's still intense, but before it was intensely excruciating. My friend calls it pain with hope, instead of pain with despair."
Water has always been known as a natural healer, says Sheralee Beebee, manager and Aquatic Rehabilitation Specialist at the center, but it is only recently that aquatic therapy has been recognized as a serious treatment option for a range of painful and disabling conditions.
"After a low back injury, for example, often physical therapy is so painful that patients rehabilitate passively and their muscles atrophy. Then they have to rehabilitate not only their back but also the rest of an inactive body. Water helps them restore the balance of strength in the body."
In warm water, people can also relax -- a state that is often difficult to achieve for those in pain. Tissues soften and stretch more easily, says Beebee. Water assists and amplifies movement, yet offers gentle resistance to muscles that can be very beneficial when building strength and agility. The pressure helps to squeeze blood back to the heart without making the heart work any harder. This all-over pressure assists circulation, too, and swollen feet and legs often return to their normal size after half an hour of exercise.
Though the warm water pool is open to all comers, for most it is a unique opportunity to experience pain-free (or at least reduced-pain) exercise.
"After a stroke, you don't want to fall," says George Chadwick, who still works after a stroke that paralyzed him down his left side. "Everything, including our response, is much slower. But in water you can fall, and it doesn't hurt."
Richard Scott suffered five strokes, which affected both sides of his body. "But I can walk in the water," says the Sunnyvale resident who has been swimming at the center for a year and is able to enter the pool in his wheelchair for individual therapy.
According to Beebee, who specializes in stroke, arthritis, Parkinson's, and recovery from injury, an aquatic trainer or therapist can gain access to the patient's body from all angles, below as well as above, and move it in all directions. This gives water therapy enormous advantages.
The center, which recently underwent reorganization, now offers a range of opportunities, from back injury prevention and arthritis classes, to aquatic massage and classes with exotic names like watsu and ai chi, energy techniques which incorporate special breathing, visualization and flowing movements for relaxation and stress reduction.
There are gentle aqua aerobics, perinatal aquafitness, and deep water running, designed for people looking for a cardiovascular workout without putting strain on knees, hips, low back or feet. Therapy sessions are often paid for by insurance plans, Medicare Workman's Comp and Auto accident insurers, with a physicians referral.
In Gonfiotti's Water Wellness class, participants suffer from problems ranging from quadriplegia due to spinal cord injury to paralysis after stroke. Many have difficulty walking and may need assistance on land. In the water, they are self-sufficient, and radiate confidence and calm.
The class starts out looking deceptively passive, as participants close their eyes and try to maintain their balance standing in the pool. But Vladimir Choubabko, a swim coach with long experience in aquatic therapy, keeps everyone working to their capacity.
With the water's lift pushing feet off the bottom, it requires immense effort for people with paralysis, arthritis, pain, respiratory disorders or fragile bones. This seemingly simple exercise is essential to building core strength, though trainers like Choubabko are highly conscious of each individual's progress and will not ask anyone to do more than he or she is able. Foam flotation loops support those who wish for them.
Holding onto a rail, students are able to glide knees over toes, hips over knees, and bend their spines back in ways they could never do on dry land. "They're listening to where the tightness resides in their bodies," says Beebee, "and Vladimir helps them relax and breathe into those spots. This gives clients the power to release tension in their own bodies on their own. All our practitioners are assisting people to understand their own bodies."
Standing on one leg, they practice lateral pelvic range motion exercises, swinging one leg across them while maintaining strength and rigidity in the other. Pelvic flexibility, says Beebee, is essential to the ability to walk, sit, stand and climb stairs, and in the forgiving medium of warm water this swing becomes possible.
"The pelvis is the center of the skeletal body as the heart is the center of circulation. It should move and tilt, like the compass on the front of a boat. Yet in most people, the pelvis is stiff and immobile."
One problem, Beebee explains, is that prescribed rehabilitation after injury or illness does not last long, even for people whose disability is long-term or chronic. Often there is nothing to bridge the gap between intensive physical therapy and the slow return to optimal function. With pain and mobility problems still besetting them, they may lose whatever level of fitness they still had.
Most people, Beebee adds, want to take responsibility for their own health and like the "feel-good" of maintaining it, just like anyone working out at a regular gym. "If we lose strength, we lose agility, and if we lose both it affects our ability to carry on daily living."
"It's critical for me not to stop therapy," says Lorraine Larson, who suffered a back injury when she was in her early thirties. "If I didn't go through classes daily, the quality of my life wouldn't be as good. If you get three hours when you're in less pain, you're euphoric."
Larson has been swimming at the center for four or five years and goes to the pool on most days. When she is in bad shape, the staff there can usually offer understanding and caring as well a practical remedy, such as the natural traction offered by hanging in deep water and letting the blood flow between the vertebrae.
"Hanging helps to elongate the spine," says Larson. " When you inhale and exhale correctly, using stomach muscles, the process takes pressure off the lumbar joints. You'd be amazed at what you can get out of just breathing here."
For more information, call Betty Wright Swim Center @ C.A.R., 3864 Middlefield Road, Poalo Alto, CA 94306. Tel: 650-494-1480